珠海市斯坦利沙门菌耐药特征和分子分型分析  

Characteristics of antimicrobial resistance and molecular typing of Salmonella stanley in Zhuhai

作　　者：方艳梅[1] 杨春晓[1] 张丽荣[1] 魏泉德[1] FANG Yanmei YANG Chunxiao ZHANG Lirong WEI Quande(Zhuhai City Center for Disease Control and Prevention, Zhuhai, Guangdong 519064, China)

机构地区：[1]珠海市疾病预防控制中心,广东珠海519064

出　　处：《中国热带医学》2017年第9期862-866,共5页China Tropical Medicine

基　　金：广东省医学科学技术研究基金(No.2016115104259991)

摘　　要：目的分析2012—2016年珠海市斯坦利沙门菌的耐药情况与脉冲场凝胶电泳(PFGE)分子分型。方法将腹泻病人的粪便进行沙门菌分离培养,生化鉴定和血清学分型,采用药敏纸片法(K-B法)进行12种抗生素的耐药试验。根据美国PulseNet实验室推荐的沙门菌PFGE分型试验方案进行分子分型。结果分离培养共获得斯坦利沙门菌108株,检出高峰期在7—10月,主要感染人群是小于1岁的幼儿(55.6%),感染病例男女比为1.84∶1。药敏试验显示本地斯坦利沙门菌对庆大霉素、三代和四代头孢类抗生素及环丙沙星较为敏感,对复方磺胺类抗生素耐药率为64.8%(70/108),对氨苄青霉素、萘啶酮酸、四环素、氯霉素和链霉素呈现低水平的耐药(10.2%~16.7%),但对链霉素的中度敏感率为68.5%,有18株(16.7%)菌呈多重耐药。108株菌经PFGE分型分为6个聚类簇,共获得66种带型,每种带型包含菌株数1~21株不等,相似值在62.4%~100%,优势带型为ST15(21株)和ST18(10株)。结论珠海市斯坦利沙门菌的耐药情况较为乐观,但对磺胺类抗生素耐药率比较高,也出现多重耐药株,需继续加强监测。斯坦利沙门菌遗传基因多样性,多重耐药株的型别多样,菌株来源广泛。Objective To investigate the antimicrobial resistance status and pulsed field gel electrophoresis（PFGE）patterns of Salmonella stanley isolates in Zhuhai City, 2012-2016. Methods The stool samples from infectious diarrhea patients were isolated and cultured by the sentinel surveillance hospitals, and the strains were identified by the biochemical methods and serotyping. The disk diffusion method（K-B） was used to determine the susceptibility of all strains to 12 kinds of antimicrobial agents, and the molecular typing was performed according to the Salmonella PFGE genotypic test recommended by Pulsenet Laboratory. Results A total of 108 strains of S. stanley were isolated, and the peak-season of the pathogen isolation was mainly from July to October of the year. The children under 1 year old were mainly affected, accounting for 55.6%,and the gender ratio（male to female） was 1.84∶1. Over 90% of Salmonella isolates were sensitive to gentamicin（GEN）,cephalosporin and ciprofloxacin（CIP）. The resistance rate to sulfamethoxazole（S3） was 64.8%（70/108）. There were low levels of resistance to ampicillin（AMP）, nalidixicacid（NA）, tetracycline（TE）, chloramphenicol（C） and streptomycin（S）（10.2%-16.7%）. The medium sensitive rate of S was 68.5%. However, there were 18（16.7%）strains showed multidrug resistance（MDR）.The 108 Salmonella strains were divided into 6 clusters and 66 PFGE types, each type included 1-21 strains, the similarity range was from 62.4% to 100%, and the common types was ST15 and ST18, which included 21 strains and 10 strains,respectively. Conclusions The drug resistance of S. stanley in Zhuhai City is relatively optimistic, but the resistance rate to sulfonamides is relatively high, and some multidrug resistant strains also appear, which reminds us to strengthen the resistance monitoring. S. stanley shows genetic diversity, and the PFGE patterns of MDR strains are also various. The range of the strainsource is wide.

关 键 词：沙门菌 抗生素敏感性 PFGE 分子分型 

分 类 号：R378.2[医药卫生—病原生物学]