河南省食源和人源革兰氏阴性菌耐药特征和分子分型研究  

Study on drug-resistant characteristics and molecular typing of Gramnegative bacteria isolated from food and human sources in Henan province

作　　者：李艳芬[1] 戚浩彧 张濛[1] 邱正勇[1] 吴玲玲[1] 崔莹[1] 张广伟[1] 李辉[1] LI Yanfen;QI Haoyu;ZHANG Meng;QIU Zhengyong;WU Lingling;CUI Ying;ZHANG Guangwei;LI Hui(Henan Centerfor Disease Control and Prevention/Henan Provincial Key Laboralory of Foodborne Disease Pahogen Traceability Medicine,Zhenghou,Henan 450016,China)

机构地区：[1]河南省疾病预防控制中心/河南省食源性疾病病原学溯源医学重点实验室,河南郑州450016

出　　处：《河南预防医学杂志》2022年第9期641-646,共6页Henan Journal of Preventive Medicine

基　　金：河南省医学科技攻关省部共建项目(SBGJ202103030);河南省医学科技攻关联合共建项目(LHGJ20190678)。

摘　　要：目的掌握河南省食源和人源主要革兰氏阴性菌(GNB)分离株耐药和分子分型特征,为指导抗生素的合理使用和聚集性病例识别提供依据。方法对2021年河南省食品安全风险监测收集到的364株沙门氏菌和致泻性大肠埃希氏菌(DEC)分离株使用微量肉汤稀释法进行药物敏感性试验,使用脉冲场凝胶电泳技术(PFGE)进行分子分型和同源性分析。结果282株沙门氏菌对15种抗生素的耐药率范围为5.32%~83.69%,氨苄西林最高,亚胺培南最低;食源和人源沙门氏菌对氨苄西林、氨苄西林/舒巴坦、甲氧苄啶/磺胺甲噁唑、庆大霉素、氯霉素、多粘菌素E、阿奇霉素、萘啶酸8种抗生素的耐药率存在统计学差异(P<0.05)。82株DEC耐药率范围为1.22%~64.63%,四环素最高,亚胺培南和多粘菌素E最低;食源和人源DEC对庆大霉素、阿奇霉素、头孢噻肟、头孢唑林、环丙沙星、萘啶酸6种抗生素的耐药率存在统计学差异(P<0.05)。共检出284株多重耐药菌、182种耐药谱;1株全耐药沙门氏菌来源于患者;不同来源沙门氏菌和DEC的多重耐药率存在统计学差异(P<0.05)。沙门氏菌分属23个PFGE型,肠炎沙门氏菌PFGE型为优势带型;DEC存在聚集性,来源于同一地区食品和患者肠致病性大肠埃希氏菌(EPEC)。结论河南省食源和人源主要GNB呈现高度耐药,多重耐药现象普遍;PFGE基因型呈多样性,EPEC存在地区同源性。Objective To master the drug-resistant and molecular typing characteristics of Gram-negative bacteria(GNB)isolated from food and human sources in Henan province,and provide the evidence for guiding the rational use of antibiotics and identifying clustering cases.Methods In total,364 isolates of salmonella and diarrheagenic escherichia coli(DEC)collected in the food safety risk monitoring in Henan province in 2021 were tested for drug sensitivity using the micro-broth dilution method.Pulsed-field gel electrophoresis(PFGE)was used for molecular typing and homology analysis.Results The resistance rate of 282 Salmonella to 15 antibiotics ranged from 5.32% to 83.69%,ampicillin was the highest,and imipenem was the lowest.The drug resistance rates of food-borne and human-borne Salmonella to ampicillin,ampicillin/sulbactam,trimethoprim/sulfamethox-azole,gentamicin,chloramphenicol,colistin E,azithromycin,and nalidixic acid were significantly different(P<0.05).The resistance rate of 82 DEC ranged from 1.22% to 64.63%.Tetracycline was the highest,and imipenem and colistin E were the lowest.The drug resistance rates of food-borne and human-borne DEC to gentamicin,azithromycin,cefotaxime,cefazolin,ciprofloxacin and nalidixic acid were significantly different(P<0.05).A total of 284 multidrug-resistant strains and 182 drug resistance spectra were detected;one strain of PDR Salmonella was from patients;the multiple drug resistance rates of Salmonella and DEC from different sources were significantly different(P<0.05).Salmonella was classified into 23 PFGE types,and Salmonella enteritidis PFGE type was the dominant band type.DEC was clustered from food and patients in the same area.Conclusion The main GNB isolated from food and human sources in Henan province are highly resistant,and MDR are common;PFGE genotypes have diversity;EPEC exists regional homology.

关 键 词：革兰氏阴性菌 耐药 多重耐药 PFGE 同源 

分 类 号：R446.5[医药卫生—诊断学]