一起霍乱疫情分离株的耐药性和分子流行病学分析  

Antibiotic resistance and molecular epidemiological analysis of the isolated strains from a cholera epidemic

作　　者：王云霞[1] 严寒秋[2] 刘海波[1] 史文凤[1] 周海健[3] 王斌[2] WANG Yun-xia;YAN Han-qiu;LIU Hai-bo;SHI Wen-feng;ZHOU Hai-jian;WANG Bin(Fangshan District Center for Disease Control and Prevention,Beijing 102488,China;不详)

机构地区：[1]北京市房山区疾病预防控制中心,102488 [2]北京市疾病预防控制中心/北京市预防医学研究中心/食物中毒诊断溯源技术北京市重点实验室 [3]中国疾病预防控制中心

出　　处：《首都公共卫生》2019年第4期172-175,共4页Capital Journal of Public Health

基　　金：国家“十三五”科技重大专项(编号:2018ZX10714002-003-002)

摘　　要：目的对2017年北京市房山区一起霍乱疫情的O1群霍乱弧菌的分子流行病学特征和耐药性进行分析。方法采集患者和有关人员及外环境(包括食物)样本109件,用实时荧光PCR检测碱性蛋白胨水增菌液中O1/O139群霍乱弧菌特异性基因;同时按常规法分离培养鉴定;对鉴定的阳性菌株用实时荧光PCR检测霍乱弧菌CTX基因,用微量肉汤稀释法进行20种药物敏感试验,用Not I和SfiⅠ限制性内切酶进行脉冲场凝胶电泳实验和聚类分析。结果109件样本增菌液O1群霍乱弧菌特异性基因阳性率19.27%(21/109,患者、密切接触者中家属和就餐地厨师肛拭子各1件阳性,就餐地后厨外环境样本18件阳性);常规培养鉴定O1群小川型霍乱弧菌阳性率5.50%(6/109,患者和就餐地厨师肛拭子各检出1株,就餐地后厨外环境涂抹检出4株);6株O1群小川型霍乱弧菌,霍乱CTX基因均阴性,对20种抗生素中12种100%敏感,对头孢唑林100%耐药,PFGE分子分型条带具有一致性。结论该起霍乱疫情的病原为O1群小川型非产毒株;PFGE分子分型溯源表明疫情与厨师有关;应关注霍乱疫情菌株的耐药监测。Objective To analyse the antibiotic resistance and molecular epidemiological characteristics of an epidemic Vibrio cholerae O1 in Fangshan district,Beijing,2017.Methods 109 samples were collected from the patients,related personnel and external environment(including food).The specific gene of serogroup O1/O139 Vibrio cholerae were detected by real-time PCR in alkaline saline peptone water enrichment broth,and the bacteria isolation and identification were conducted by the conventional method simultaneously.CTX gene was detected by real-time PCR in the confirmed Vibrio cholerae O1 isolates.Antimicrobial susceptibility was determined by micro-broth dilution method to confirm the sensitivities to 20 different antibiotics.Cluster analysis were performed by pulsed field gel electrophoresis(PFGE)of Sfi I and Not I restriction enzymes.Results The positive rate of specific gene of serogroup O1 Vibrio cholerae was 19.27%in 109 enrichment broth(21/109,1 sample from patient,1 from the close contact family member,1 from the chef at the dining place and 18 samples from the external environment of the kitchen at the dining place were positive).The positive rate of the routine bacteria culture and identification was 5.50%(6/109,1 strain from the rectal swab of a patient,1 strain from the rectal swab of a chef at the dining place,and 4 strains from the environmental smear of the the kitchen at the dining place were isolated).CTX gene was all negative in 6 O1 Vibrio cholerae ogawa strains.All the isolates were 100%susceptible to 12 antibiotics,but 100%resistant to cefazolin.PFGE showed that they had the consistent bands profile.Conclusions The endemic was caused by non-toxigenic Vibrio cholerae O1 group.PFGE indicate that the epidemic is likely to trace back to the chief.Attention should be paid to the drug resistance surveillance of the strains isolated from the cholera epidemic.

关 键 词：霍乱弧菌 实时荧光PCR 脉冲场凝胶电泳 药物敏感实验 

分 类 号：R378.3[医药卫生—病原生物学]