浙江省台州市儿童腹泻132例沙门菌耐药性检测及肠毒素基因的相关分析  

Correlation analysis of drug resistance of Salmonella and enterotoxin genes in 132 children with diarrhea in Taizhou area

作　　者：黄邀[1] 陈玲玲[1] 陆卫民[1] 

机构地区：[1]浙江省台州医院儿内科,浙江省台州317000

出　　处：《中国基层医药》2018年第3期356-359,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 分析浙江省台州市儿童腹泻沙门菌的耐药性及相关肠毒素基因型.方法 将因发热、腹泻等症状就诊且经粪便培养证实为沙门菌感染的儿童132例,检测沙门菌血清分型并对菌株进行10种抗生素耐药性分析,同时检测菌株肠毒素基因（spvA、spvB、rck）.结果 分离出的132例沙门菌经血清学鉴定,共有10种血清型,其中以鼠伤寒沙门菌以及肠炎沙门菌最为多见;分离出的132株沙门菌对氨苄西林（51.82％）以及氨苄西林/舒巴坦（51.52％）的耐药性最高,而对亚胺培南、厄他培南无耐药,在132株沙门菌中,其中单耐药菌株27株（20.45％）,其余均对两种及以上药物耐药;在分离出的132株沙门菌中,132株均呈spvA阳性（阳性率100.00％）,38例呈spvB阳性（阳性率28.79％）,45例呈rck阳性（阳性率34.09％）;spvB检出阳性儿童其发热率、便血率以及脱水发生率均显著高于spvB检出阴性儿童（χ^2分别为6.022、6.661、6.978,均P〈0.05）,rck检出阳性儿童其发热率、便血率显著高于rck检出阴性儿童（χ^2分别为9.134、12.673,均P〈0.05）.结论 浙江省台州市沙门菌感染腹泻儿童主要以鼠伤寒沙门菌以及肠炎沙门菌感染为主,菌株耐药率较高,菌株肠毒素spvB基因与沙门菌感染儿童发热、便血以及脱水发生率明显相关,而rck基因与沙门菌感染儿童发热、便血明显相关.Objective To investigate the drug resistance of Salmonella and enterotoxin gene in diarrhea children of Taizhou.Methods 132 children with Salmonella infection who had fever ,diarrhea and other symptoms and were confirmed by fecal culture were selected .The Salmonella serotype , drug resistance analysis of 10 kinds of antibiotics,and enterotoxin gene （spvA,spvB,rck） were detected.Results 132 cases of Salmonella isolated from blood serological were identified a total of 10 serotypes,Salmonella typhimurium and Salmonella Enteritidis were the most common.In 132 strains of Salmonella ,the highest drug resistance rate was to ampicillin （51.82%） and ampicil-lin/sulbactam（51.52%）,and had no resistance to imipenem ,ertapenem.In 132 strains of Salmonella,including sin-gle drug resistance of 27 strains（20.45%）,the rest had two or more drugs resistance .In 132 strains of Salmonella, 132 strains were spvA positive（positive rate 100%）,38 cases were spvB positive（positive rate 28.79%）,45 cases were rck positive（positive rate 34.09%）.The incidence rates of fever,dehydration and hematochezia in spvB positive children were significantly higher than those in spvB negative children （χ^2 =6.022,6.661,6.978,all P〈0.05）.The incidence rates of fever and hematochezia in rck positive children were significantly higher than those in rck negative children （χ^2 =9.134,12.673,all P〈0.05）.Conclusion Salmonella infection diarrhea children in the Taizhou area are mainly Salmonella typhimurium and Salmonella enteritidis infection ,the strains are highly resistant strains , enterotoxin spvB gene is correlated with the incidence rates of fever ,dehydration and hematochezia ,and rck gene is correlated with the incidence rates of fever and hematochezia .

关 键 词：腹泻 沙门菌感染 抗药性 细菌 肠毒素基因 

分 类 号：R446.5[医药卫生—诊断学] R725.7[医药卫生—临床医学]