2015年广东省沙门菌监测及其耐药性分析  

Surveillance and drug resistance analysis of Salmonella in Guangdong province in 2015

作　　者：何冬梅[1] 柯碧霞[1] 曾洪辉 杨彤 梁宇恒[1] 谭海玲[1] 李柏生[1] 刘美真[1] 柯昌文[1] 

机构地区：[1]广东省疾病预防控制中心,广州511430 [2]广东省生物制品与药物研究所耐药监测室,广州510440

出　　处：《中华微生物学和免疫学杂志》2017年第8期611-617,共7页Chinese Journal of Microbiology and Immunology

基　　金：广东省科技计划项目（2013/7060400012,2014A020219004）;中美新发和再发传染病合作项目（1U2GGH000018-01）

摘　　要：目的 了解广东省腹泻患者感染沙门菌的情况,分析沙门菌的血清型分布和耐药特征.方法 采集粪便标本进行传统分离培养,对沙门菌进行血清分型和药物敏感试验.结果 2015年广东省沙门菌监测阳性率为7.64％,男女之比为1.52∶1,各年龄段患者均可感染沙门菌,以0～6岁的儿童感染为主,所占比例为81.74％.夏秋季沙门菌的分离率为10.73％,高于冬春季的分离率4.24％,差异有统计学意义（X2 =463.77,P〈0.01）.不同地区沙门菌分离率分别为：珠海16.82％, 河源15.85％, 阳江11.81％, 江门10.68％, 中山8.49％,茂名8.07％,揭阳8.05％,韶关7.35％,佛山6.97％,东莞6.03％,广州5.48％,湛江0.00％, 地区之间比较,差异有统计学意义（X2 =367.67,P〈0.01）.除1株沙门菌不能分型外,其余2 376株菌分为108种血清型.前4位优势血清型分别为4,5,12：i：-沙门菌、肠炎沙门菌、斯坦利沙门菌和鼠伤寒沙门菌.沙门菌对亚胺培南、阿奇霉素、头孢他啶、头孢噻肟和甲氧苄啶/磺胺甲噁唑的敏感率较高,但多重耐药现象严重.结论 广东省人源沙门菌以4,5,12：i：-沙门菌和肠炎沙门菌为主.头孢他啶和头孢噻肟可作为治疗沙门菌感染的首选用药.沙门菌多重耐药现象严重,需要进一步加强耐药监测.Objective To analyze the serotype distribution and antibiotic resistance characteristics of Salmonella strains isolated in Guangdong province for better understanding the condition of Salmonella infection in patients with diarrhea.Methods Fecal samples collected from patients with diarrhea in Guangdong province were used to isolate Salmonella strains.Biochemical analysis was performed to identify these isolated strains.Serotyping and antimicrobial susceptibility testing were carried out for further analysis of the isolated Salmonella strains.Results The rate of Salmonella infection was 7.64％in 2015, and the male to female patient ratio was 1.52∶1.A total of 2 377 patients of all age groups were positive for Salmonella infection and the patients aged 0-6 years accounted for 81.74％.The isolation rate of Salmonella strains in the summer and autumn was higher than that in the winter and spring （10.73％ vs 4.24％;X2=463.77, P〈0.01）.The Salmonella isolation rates in different areas were as follows： 16.82％ in Zhuhai, 15.85％ in Heyuan, 11.81％ in Yangjiang, 10.68％ in Jiangmen, 8.49％ in Zhongshan, 8.07％ in Maoming, 8.05％ in Jieyang, 7.35％ in Shaoguan, 6.97％ in Foshan, 6.03％ in Dongguan, 5.48％ in Guangzhou and 0.00％ in Zhanjiang.And the differences between different regions were statistically significant （X2=367.67, P〈0.01）.The 2 377 isolated Salmonella strains were classified into 108 serotypes except for oneSalmonella strain that could not be classified.The top four predominant serotypes were 4,5,12：i：-, Salmonella enteritidis,Salmonella stanley and Salmonella typhimurium.Most Salmonella strains were sensitive to imipenem, azithromycin, ceftazidime, cefotaxime and trimethoprim/sulfamethoxazole, but multidrug resistance was common among those strains.Conclusion Salmonella serotypes of 4,5,12：i：-and Salmonella enteritidis are the predominant pathogens causing human Salmonella infections in Guangdong province.Ceftazidime and cefotaximeare are preferred in the treatment of

关 键 词：沙门菌属 多重耐药 细菌耐药性监测 

分 类 号：R446.5[医药卫生—诊断学]