南京市哨点医院96株沙门菌血清分型及药敏试验结果分析  

Analysis on serotyping and drug sensitive test results of 96 Salmonella strains in sentinel hospital in Nanjing

作　　者：张韶华[1] 葛藤 金萍[1] 王燕[1] 叶艳华[1] 江晓[1] 程婷婷[1] 刘品 ZHANG Shao-hua;GE Teng;JIN Ping;WANG Yan;YE Yan-hua;JIANG Xiao;CHENG Ting-ting;LIU Pin(Nanjing Center for Disease Control and Prevention,Jiangsu210003,China)

机构地区：[1]南京市疾病预防控制中心,江苏210003

出　　处：《医学动物防制》2022年第3期221-225,共5页Journal of Medical Pest Control

基　　金：江苏省卫生厅预防医学基金科研课题(Y2018003)。

摘　　要：目的了解2019年南京市哨点医院沙门菌血清型分布和耐药现况,为沙门菌病的临床用药和疫情防控提供科学依据。方法依据GB 4789.4—2016对哨点医院采集的患者粪便样本中的沙门菌进行血清分型鉴定,根据美国临床和实验室标准协会(Clinical&Laboratory Standards Institute,CLSI)推荐微量肉汤稀释法对分离鉴定的菌株进行抗生素敏感试验。结果96株沙门菌共鉴定出32个血清型:其中肠炎沙门菌28株,占29.17%;鼠伤寒沙门菌16株,占16.67%;伤寒沙门菌9株,占9.37%;其余血清型43株,占44.79%。有92株(95.83%)菌株对1种及以上抗生素耐药,其中对3种及以上抗生素耐药的菌株有56株(58.33%)。链霉素(61.46%)的耐药率最高,对磺胺异噁唑(55.21%)、氨苄西林(52.08%)、奈啶酸(45.83%)、四环素和多西环素(43.75%)的耐药也较高。所有菌株均对美罗培南、亚胺培南、阿米卡星敏感,对庆大霉素、阿奇霉素、卡那霉素及头孢类药物也较为敏感。结论南京市肠道门诊引起腹泻的沙门菌血清型分布呈多态性,均有不同程度的耐药及多重耐药情况。通过逐步建立本地沙门菌血清型及耐药谱数据库,可为积极防控沙门菌病提供科学依据。Objective To understand the serotype distribution and drug resistance status of Salmonella in sentinel hospital in Nanjing in 2019,and to provide scientific basis for clinical medication and prevention and control of salmonellosis.Methods The serotyping identification of Salmonella in feces from sentinel hospital was implemented according to GB 4789.4—2016,the antibiotic sensitivity test of the isolated and identified strains was implemented based on micro broth dilution method recommended by Clinical&Laboratory Standards Institute(CLSI).Results A total of 32 serotypes were identified from 96 Salmonella strains:there were 28 strains of Salmonella enteritis,accounting for 29.17%;16 strains of Salmonella typhimurium,accounting for 16.67%;9 strains of Salmonella typhi,accounting for 9.37%.The remaining 43 serotypes accounted for 44.79%.The 92(95.83%)strains were found to be resistant to 1 antibiotic or above,and 56(58.33%)strains were resistant to 3 antibiotics or above.Wherein,the drug resistance rate of streptomycin(61.46%)was maximum,and the drug resistance to sulfamethoxazole(55.21%),ampicillin(52.08%),nediazic acid(45.83%),tetracycline and doxycycline(43.75%)also remain being higher.All strains were sensitive to gentamicin,azithromycin,kanamycin and cephalosporins in addition to meropenem,imipenem and amikacin.Conclusion The Salmonella serotypes in diarrhea caused by intestinal outpatients in Nanjing is polymorphically distributed,and all Salmonella serotypes have different degree of drug resistance and multiple drug resistance.The scientific basis for the active prevention and control of salmonellosis is supported to be provided by gradually establishing the database of local Salmonella serotypes and drug resistance spectrum.

关 键 词：沙门菌 血清型 抗生素敏感试验 耐药性 多重耐药 肉汤稀释法 分析 

分 类 号：R378.22[医药卫生—病原生物学]