2021-2023年柳州市腹泻病例沙门菌耐药及分子分型研究  

Study on resistance and molecular typing of Salmonella in diarrhea patients in Liuzhou city from 2021 to 2023

作　　者：刘一[1] 陈威[1] 许敏[1] 陈柳军[1] 余钧池[1] 陈煌炜 龙洁 LIU Yi;CHEN Wei;XU Min;CHEN Liujun;YU Junchi;CHEN Huangwei;LONG Jie(Liuzhou Centre for Disease Prevention and Control,Liuzhou,Guangxi 545007,China)

机构地区：[1]柳州市疾病预防控制中心,广西柳州545007

出　　处：《应用预防医学》2024年第4期236-240,251,共6页Applied Preventive Medicine

摘　　要：目的对柳州市哨点医院采集的腹泻病例样本的沙门菌进行分离鉴定,对其耐药性以及细菌同源性聚类等方面进行分析,为指导临床治疗用药以及食源性疾病防控提供科学依据,同时也为沙门菌引起的突发公共卫生事件溯源提供数据支持。方法收集2021-2023年柳州市哨点医院采集的腹泻病例急性期样本,对其中分离到的沙门菌进行血清分型、药物敏感性(药敏)试验以及脉冲场凝胶电泳(PFGE)分子分型。结果2021-2023年共收集932份腹泻病例样本,检出82株沙门菌,共分为8种血清型。其中鼠伤寒沙门菌55株(67.07%),肠炎沙门菌8株(9.76%)。选取的63株沙门菌药敏试验结果显示,耐药率较高的抗生素分别为氨苄西林(AMP)(76.19%)、四环素(TET)(66.67%)和链霉素(STR)(63.49%);所有菌株对头孢他啶/阿维巴坦均表现为敏感。2021-2023年沙门菌对9种抗生素的耐药率均呈逐年上升趋势。多重耐药菌达45株,多重耐药率为71.43%,多重耐药谱以(TET-STR-AMP)的耐药比例最高(46.67%)。PFGE分型获得28种带型图谱,相似度在3.42%~100.00%之间,其中有2组带型图谱相似度为100.00%,相似度>85.00%的菌株仅有2组。结论2021-2023年柳州市沙门菌引发的腹泻病例以鼠伤寒沙门菌为主,分子分型无绝对优势带型,对部分抗菌药物的耐药率呈逐年上升趋势,今后应进一步加强对沙门菌分子分型及其耐药情况的持续监测。Objective To isolate and identify Salmonella from diarrhea case samples collected from Liuzhou sentinel hospitals and analyze their drug resistance and bacterial homology clustering,providing scientific basis for guiding clinical treatment medication and foodborne disease prevention and control,as well as promoting data support for tracing the source of sudden public health incidents caused by Salmonella.Methods The acute phase samples of diarrhea cases were collected from Liuzhou sentinel hospitals between 2021 and 2023.The isolated Salmonella were subjected to serotyping,drug sensitivity(drug sensitivity)tests,and pulsed field gel electrophoresis(PFGE)molecular typing.Results From 2021 to 2023,a total of 932 samples of diarrhea cases were collected,and 82 strains of Salmonella were detected,which were divided into 8 serotypes.Among them,55 strains of Salmonella typhimurium(67.07%)and 8 strains of Salmonella enteritis(9.76%)were found.The results of the selected 63 strains of Salmonella showed that the antibiotics with high resistance rates were ampicillin(76.19%),tetracycline(66.67%),and streptomycin(63.49%).All strains were sensitive to ceftazidime/avibactam.The resistance rate of Salmonella to 9 antibiotics had been increasing year by year from2021 to 2023.There were 45 strains of multidrug-resistant bacteria,with a multidrug-resistant rate of 71.43%.The highest proportion of multidrug-resistant strains was found in the tetracycline-streptomycin-ampicillin(AMP-TET-STR)spectrum(46.67%).28 band patterns were resulted from PFGE typing,with a similarity between3.42%and 100.00%.Among them,there were 2 groups of band patterns with a similarity of 100.00%,and only2 groups of strains with a similarity greater than 85.00%.Conclusions The diarrhea cases caused by Salmonella in Liuzhou from 2021 to 2023 are mainly caused by Salmonella typhimurium,with no absolute dominant band in molecular typing.The resistance rate to some antibiotics has been increasing year by year.In the future,continuous monitoring of Salmonella mo

关 键 词：沙门菌 血清型 耐药 分子分型 

分 类 号：R378.22[医药卫生—病原生物学]