2020年海南省人源沙门菌耐药性及携带耐药基因分析  

Antimicrobial profiles and resistance genes in Salmonella isolates in diarrheal patients in Hainan province in 2020

作　　者：华德[1] 王鲁彦 邝仕壮 吴清波 甘晓婷[1] 张亚淋 遇晓杰 吴庆梓 Hua De;Wang Luyan;Kuang Shizhuang;Wu Qingbo;Gan Xiaoting;Zhang Yalin;Yu Xiaojie;Wu Qingzi(Hainan Provincial Center for Disease Control and Prevention,Haikou 570203,Hainan,China;Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]海南省疾病预防控制中心,海南海口570203 [2]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《疾病监测》2023年第6期722-728,共7页Disease Surveillance

基　　金：国家传染病重大专项(No.2018ZX10101002)。

摘　　要：目的了解海南省人源沙门菌耐药性及携带耐药基因情况,并对耐药基因与耐药表型一致性关系进行初步评价。方法对2020年收集自海南省腹泻患者粪便中分离的63株沙门菌,开展血清学鉴定、药物敏感性检测以及全基因组测序,使用ResFinder数据库对耐药基因进行注释和分析,并对耐药表型及耐药基因进行关联分析。结果63株沙门菌对氨苄西林、复方新诺明的耐药率较高,达50.00%以上,对三代头孢的耐药率达15.00%以上,多重耐药现象明显,多重耐药率达44.44%。菌株携带多种类型的耐药基因,特别是氨基糖苷类耐药基因,携带率达100.00%。耐药基因与耐药表型关联分析发现:β-内酰胺类药物耐药基因与氨苄西林和头孢噻肟耐药表型一致好,耐药基因预测耐药表型的准确率分别为88.89%和98.41%。在去除单独parC基因突变的情况下,喹诺酮类耐药基因预测结果与表型一致性较好,Kappa值达0.50以上。结论海南省人源沙门菌对多种抗菌药物耐药水平高,存在多重耐药现象。菌株携带多种类型的耐药基因,其中,β-内酰胺类药物耐药基因的存在能准确地预测耐药表型,而喹诺酮类耐药基因的预测准确性相对较弱。本研究为这两类药物耐药基因检测替代药敏实验提供了初步依据,但尚需扩大菌株数量进行更准确细致的关联研究。Objective To characterize the drug resistance of Salmonella in Hainan province,and to evaluate the accuracy of predicting drug resistant phenotype by drug resistance genes.Methods Total 63 Salmonella strains were collected from human in Hainan Province and were subjected to serological identification,antimicrobial susceptibility testins and whole genome sequencing.The association between the drug resistant phenotype and the corresponding resistance genes were analyzed.Results By measuring the sensitivity of all tested strains to 11 kinds of antibiotics,we found that the resistance rates of 63 strains to ampicillin and cotrimoxazole were high,more than 50.00%,and the resistance rate to the third generation cephalosporin was more than 15.00%.There was high level multiple drug resistance with the rate reaching 44.44%.We also found the strains carried a variety of drug resistance genes,especially aminoglycoside resistance genes which were harbored in all strains(100.00%).The association analysis showed that the prediction results of ampicillin and cefotaxime using their encoding resistance genes were in good agreement with the phenotype,and the prediction accuracy rates reached 88.89%and 98.41%,respectively.When the single parC gene with mutation in the strain was excluded,the prediction results of quinolone resistance genes were well consistent with the phenotype,and the Kappa value is beyond 0.50.Conclusion Salmonella in Hainan province is highly resistant to traditional antibiotics and has high level of multiple drug resistance.The drug resistance gene information obtained by second-generation sequencing has high accuracy in predictingβ-lactams resistance phenotype,while the prediction accuracy of quinolone resistance genes is relatively lower.This provides a sight of replacing antimicrobial susceptibility test by detecting resistance genes for these two types of antibiotics.However,it is still needed to expand the number of strains for more accurate and detailed correlation studies.

关 键 词：沙门菌 耐药 全基因组测序 耐药基因 

分 类 号：R211[医药卫生—中医学] R378