2014-2016年武汉与宁波常见沙门菌血清型分离株的PFGE分型与耐药谱分析  

Analysis of PFGE typing and drug resistance spectrum of isolated strains of common Salmonella serotype in Wuhan and Ningbo, China from 2014 to 2016

作　　者：唐锋 宋启发[2] 熊燕[3] 陈智[3] 陈中举 王芳[3] 方爱英[5] 罗万军[6] TANG Feng;SONG Qi-fa;XIONG Yan;CHEN Zhi;CHEN Zhong-ju;WANG Fang;FANG Ai-ying;LUO Wan-jun

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)检验部,湖北武汉430016 [2]宁波市疾病预防控制中心微检科,浙江宁波315010 [3]武汉市疾病预防控制中心微检科,湖北武汉430015 [4]华中科技大学同济医学院附属同济医院检验科,湖北武汉430030 [5]江汉大学附属医院检验科,湖北武汉430016 [6]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)医院感染管理办公室,湖北武汉430016

出　　处：《中华医院感染学杂志》2019年第20期3041-3049,共9页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金面上基金资助项目(2017CFB709);浙江省医药卫生科技计划基金资助项目(2016KYB274);湖北省卫生计生委面上基金资助项目(WJ2017M194);武汉市科技局应用基础前沿基金资助项目(2018060401011314);武汉市卫生计生委临床医学科研基金资助项目(WX12B05)

摘　　要：目的分析武汉和宁波医疗机构分离的我国常见血清型沙门菌的脉冲场凝胶电泳指纹图谱及耐药谱,了解两市间沙门菌株流行病学特征及溯源关联。方法收集2014-2016年武汉和宁波医疗机构检出的114株我国最常见血清型(鼠伤寒、肠炎和德尔俾)沙门菌株,开展PFGE分型和微量稀释法检测耐药谱及聚类分析。结果在两市地方株聚类分析中,鼠伤寒分13型(相似度51.70%~100.00%),肠炎分7型(相似度76.50%~100.00%),德尔俾分21型(相似度52.40%~100.00%)。各血清型均存在源自同一个克隆株(相似度≥85.00%)而耐药谱不同的两地同源菌株,尤其检出4株宁波肠炎沙门菌与1株武汉肠炎沙门菌为无差异同一克隆株(相似度100.00%)。在两市同种类耐药谱检测中,耐药株达35.96%,氨苄青霉素耐药率最高(17.54%),多药耐药株达6.14%。在58株武汉地方株中,鼠伤寒沙门菌对四环素耐药率最高(37.50%),肠炎沙门菌对哌拉西林、头孢唑林和氨苄青霉素耐药率最高(58.33%),德尔俾沙门菌对米诺环素耐药率最高(16.67%)。在56株宁波地方株中,鼠伤寒与肠炎沙门菌对甲氧苄氨嘧啶耐药率均最高(43.75%、54.55%),德尔俾沙门菌对奈啶酸和氨苄青霉素耐药率最高(34.48%)。结论在两地PFGE分型方面,肠炎沙门菌同源性相对较高;鼠伤寒和德尔俾沙门菌同源性低、差异性大,相互传播引起遗传重组变异的概率大。在临床经验性用药方面,哌拉西林、头孢唑林和氨苄青霉素在武汉应谨慎使用,甲氧苄氨嘧啶在宁波应谨慎使用。OBJECTIVE To analyze the pulsed-field gel electrophoresis(PFGE)fingerprint typing and antibiotic resistance spectrum of isolated strains of common Salmonella serotype in Wuhan and Ningbo,so as tounderstand the epidemiological feature and traceability of Salmonella isolates between these two cities.MEHTODS A total of 114 strains of the most common Salmonellaserotype(including S.typhimurium,S.enteritidis and S.derby)were isolated and identified from the medical institutions in Wuhan and Ningbo from 2014to 2016.The PFGE fingerprint based classification and the drug resistance spectrum based on microdilution method were carried out,and the clustering analysis of strains between cities was performed through BioNumerics 7.6software.RESULTS According to the clustering analysis of the local strains,the S.typhimurium were divided into 13genotypes(51.70%-100.00%similarity),the S.enteritidis were divided into 7genotypes(76.50%-100.00%similarity)and the S.derby were divided into 21genotypes(52.40%-100.00%similarity).Eech serotype was found to be derived from homologous strains withsame genetic clone(≥85.00%similarity),but different drug resistance spectrum.In particular,four strains of S.enteritidis from Ningbo and one strain of S.enteritidis from Wuhan were identified to be the same clone(100%similarity).Among the same kind of resistant spectrum in the two cities,drug-resistant strains reached to 35.96%,with the highest resistance incidence to ampicillin(17.54%),and multi-drug resistant strains reached to 6.14%.Among 58local strains of Wuhan,the highest resistance incidence was detected in S.typhimurium against tetracycline(37.50%),S.enteritidis against piperacillin,cefazolin and ampicillin(58.33%),and S.derbyagainst minocycline(16.67%)respectively.Among 56local strains of Ningbo,the highest resistance incidence was observed in both S.typhimuriumand S.enteritidis against trimethoprim(43.75%and 54.55%respectively)and S.derbyagainst nalidixic acid and ampicillin(34.48%).CONCLUSION In terms of PFGE typing analysis,S.enteriti

关 键 词：沙门菌 血清型 脉冲场凝胶电泳 分子流行病 同源性 耐药性 

分 类 号：R378.22[医药卫生—病原生物学]