广东省茂名市儿童食源性沙门菌感染的血清型分型和耐药特征  

Serotyping and drug resistance of food-borne Salmonella in children in Maoming, Guangdong

作　　者：彭淑萍[1] 李波[1] 廖国东[1] 许铭清[1] 黄水飞[1] PENG Shuping;LI Bo;LIAO Guodong;XU Mingqing;HUANG Shuifei(Maoming Center for Disease Control and Prevention,Maoming,Guangdong 525000,China)

机构地区：[1]茂名市疾病预防控制中心,广东茂名525000

出　　处：《中国热带医学》2020年第7期661-665,共5页China Tropical Medicine

摘　　要：目的分析茂名市儿童食源性腹泻中沙门菌感染的血清型分型情况和耐药性特征,了解茂名市儿童沙门菌感染的流行趋势,为防控儿童食源性疾病和临床治疗提供参考数据。方法收集茂名市2018-2019年从儿童食源性腹泻病例监测医院中分离的沙门菌366株进行血清型分型,采用微量肉汤稀释法进行耐药性检测。结果 5 279例儿童食源性腹泻病例中沙门菌检出率为366例,检出阳性率为6.93%,3岁以下儿童病例检出率占94.54%,男女病例比例为1.63∶1,发病时间集中在6-11月份,存在双高峰的特点。血清型分为33个型别,优势血清型分别为1,4,[5],12:i:-(33.33%)、鼠伤寒沙门菌(26.23%)和斯坦利沙门菌(12.84%)。366株沙门菌有80.32%菌株存在不同程度的耐药,分成为62种耐药谱且多重耐药菌株达70.49%。其中对四环素类、磺胺类、青霉素类和氯霉素类抗生素耐药严重,耐药率达50.0%~70.0%;碳青霉烯类、多粘菌素类和三代以上的头孢菌素类抗生素敏感率均>90.0%。结论茂名市儿童食源性沙门菌感染以3岁以下幼儿感染为主且男童多见,呈现夏秋季流行特点。茂名市沙门菌的主要血清型构成发生变化,以1,4,[5],12:i:-为优势型,同时耐药谱多样且耐药情况严重。需持续加强对儿童食源性沙门菌,特别是1,4,[5],12:i:-型别感染的监测并合理使用抗生素。ObjectiveTo analyze the serotype and drug resistance of Salmonella infection in children with food-bornediarrheal disease, and to understand the epidemic trend of salmonella infection in children, we provide reference data forclinical treatment.MethodsTotally 366 strains of Salmonella isolated from children’s food-borne diarrheal disease from2018 to 2019 were collected and serotyped. The drug resistance of the isolates were detected by microbroth dilution.ResultsThe positive rate of Salmonella was 6.93% in 366 out of 5 279 cases of children with food-borne diarrhea, 94.54%of cases were detected in children under 3 years old, and the male-female ratio was 1.63∶1. The onset time was concentratedfrom June to November and appeared a double peak characteristic. The dominant serotypes were 1, 4, [5], 12: i:-(33.33%),Salmonella typhimurium(26.23%) and Salmonella stanley(12.84%). 80.32% of the 366 Salmonella strains had differentdegree of drug resistance, which was divided into 62 kinds of drug resistance spectrum and 70.49% of multi-drug resistancestrains.Among them,the resistance rate to tetracycline, sulfonamides, penicillins and chloramphenicol antibiotics was serious,the resistance rate was 50.0%-70.0%, the sensitivity rates of carbapenems, polymyxin and cephalosporins above the thirdgeneration were all higher than 90.0%.Conclusion Salmonellainfections of children in Maoming are most common inchildren under 3 years old,the onset of the disease is prevalent in summer and autumn,the composition of main serotypes havechanged and the dominant type is 1,4,[5],12:i:-.The drug resistance spectrum is various and the drug resistance situation isserious.It is necessary to continuously strengthen the surveillance of children’s food-borne Salmonella infection,particularly for1,4,[5],12: i:-serotypes and use antibiotics rationally.

关 键 词：沙门菌 儿童 血清型 耐药特征 食源性疾病 

分 类 号：R378[医药卫生—病原生物学]