2010-2018年安徽省马鞍山市腹泻患者中非伤寒沙门菌的分子分型与耐药性研究  

Molecular typing and drug resistance of Non-typhoid Salmonella in diarrhea patients from 2010 to 2018 in Ma’anshan,Anhui Province,China

作　　者：洪颖 王利[2] 陈谨[2] 王蓉[2] 罗颖 杨晨 陈道利 柳燕[1] HONG Ying;WANG Li;CHEN Jin;WANG Rong;LUO Ying;YANG Chen;CHEN Dao-li;LIU Yan(Anhui Medical University,Hefei 230032,China;Ma’anshan Center for Disease Control and Prevention,Ma’anshan 243000,China)

机构地区：[1]安徽医科大学,合肥230032 [2]马鞍山市疾病预防控制中心,马鞍山243000

出　　处：《中国人兽共患病学报》2020年第8期646-653,共8页Chinese Journal of Zoonoses

基　　金：“十三五”国家科技重大专项(No.2018ZX10711001-005-002);国家自然科学基金(No.81571963,No.81772273);艾滋病和病毒性肝炎等重大传染病防治科技重大专项(No.2018ZX10713003-002-005)联合资助。

摘　　要：目的了解马鞍山地区腹泻监测人群非伤寒沙门菌的感染状况、血清学分布、分子分型与耐药性等特征。方法对2010-2018年腹泻患者中分离的非伤寒沙门菌进行血清学分型、脉冲场凝胶电泳(PFGE)和药物敏感性试验。结果从2998例腹泻患者中检出非伤寒沙门菌腹泻263例(8.8%),其中2例为2种非伤寒沙门菌混合感染;6-7月份非伤寒沙门菌感染率较高,05岁年龄组感染率最高(15.9%)(χ^2=72.98,P<0.001);265株非伤寒沙门菌分为36个血清型,优势血清型为阿贡纳沙门菌、肠炎沙门菌和鼠伤寒沙门菌;阿贡纳沙门菌的PFGE带型分布较集中,有菌株成簇存在的现象;测试菌株总耐药率为95.6%(66/69),多重耐药率为82.6%(57/69);测试菌株对AMP(79.7%)、STR(75.3%)和Sul(66.6%)耐药率较高,对AMI和AZI完全敏感;发现2株ESBLs的菌株,均为多重耐药菌株;鼠伤寒沙门菌和肠炎沙门菌对不同药物的敏感性有所不同,前者对喹诺酮类药物较敏感,而后者对四环素类药物较敏感。结论马鞍山地区优势血清型为阿贡纳沙门菌,与其他地区不同。阿贡纳沙门菌有成簇存在的情况,提示有既往暴发的可能。总耐药及多重耐药现象严重,应谨慎用药并加强对病例的耐药监测。In order to investigate the infection status,serological distribution,molecular typing and drug resistance of Non-typhoid Salmonella in Ma’anshan.Serum typing,pulse field gel electrophoresis(PFGE)and drug sensitivity tests were performed on Non-typhoid Salmonella strains isolated from diarrhea patients from 2010 to 2018.The results showed that 263 cases(8.8%)of Non-typhoid Salmonella diarrhea were detected from 2998 cases,two of which were mixed infection.The higher infection rate of Non-typhoid Salmonella was found in June and July than other months,with the highest infection rate of 15.9%among 05 years old(15.9%)(χ^2=72.98,P<0.001).The 265 strains of Non-typhoid Salmonella were divided into 36 serotypes.The dominant serotypes were Salmonella Agona,Salmonella Enteritis and Salmonella Typhus.The PFGE distribution of Salmonella Agona was concentrated were polymorphic and there were clusters of strains.The total drug resistance rate was 95.6%(66/69)and the multiple drug resistance rate was 82.6%(57/69).High drug resistance to AMP(79.7%),STR(75.3%)and Sul(66.6%),however fully sensitivie to AMI and AZI were observed.Two ESBLs strains were found,both were multidrug-resistant.The sensitivity of salmonella typhus and salmonella enteritis to drugs is different,the former is more sensitive to quinolones,while the latter is more sensitive to tetracycline.In Conclusions,the dominant serotype Non-typhoid Salmonella in Ma’anshan is Salmonella Agona,which is different from other areas.The presence of clusters in Salmonella Agona suggests the possibility of previous outbreaks.Total and multiple drug resistance are serious,drug use should be carefully and drug resistance monitoring should be strengthened.

关 键 词：沙门菌 血清型 分子分型 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]