自职业体检者检出和清除高水平耐药肯塔基沙门菌ST198.2-1  

Identification and clearance of high-level drug-resistant Salmonella Kentucky ST198.2-1 from an occupational health examinee

作　　者：钟艳 阮静芳 覃夏婵 韦蓓 刘玥[4] 周敏[5] 许学斌[4] Zhong Yan;Ruan Jingfang;Qin Xiachan;Wei Bei;Liu Yue;Zhou Min;Xu Xuebin(Department of Laboratory Medicine,Qintang District People′s Hospital,Guigang 537121,China;Health Management Centre,Qintang District People′s Hospital,Guigang 537121,China;Department of Pharmacy,Qintang District People′s Hospital,Guigang 537121,China;Division of Pathogen Testing and Analysis,Shanghai Center for Disease Control and Prevention,Shanghai 200336,China;Laboratory Department of Ruijin Hospital Affiliated to Shanghai Jiao Tong University of Medicine,Shanghai 201801,China)

机构地区：[1]贵港市覃塘区人民医院检验科,贵港537121 [2]贵港市覃塘区人民医院健康管理科,贵港537121 [3]贵港市覃塘区人民医院药剂科,贵港537121 [4]上海市疾病预防控制中心病原生物检定所,上海200336 [5]上海交通大学附属瑞金医院检验科,上海201801

出　　处：《中华检验医学杂志》2024年第9期1094-1097,共4页Chinese Journal of Laboratory Medicine

基　　金：国家重点研发计划(2017YFC1600100)。

摘　　要：体检者女,49岁,就职于广西贵港某纸业公司(从事餐纸生产),2023年6月11日至贵港市覃塘区人民医院申领健康证,体检筛查肠道病原菌(沙门菌、志贺菌)时分离到沙门菌,多次经验使用抗菌药物清除未果。参比实验室对前后2次分离菌株进行血清分型、耐药表型、全基因组测序均鉴定为肯塔基沙门菌ST198,基于中国沙门菌区域血清型数据库构建ST198耐药基因型系统进化树,定义2株菌均属高水平耐药ST198.2-1亚分支克隆。临床启动多学科会诊根据抗菌药物敏感性试验结果调整医嘱为阿莫西林/克拉维酸和阿奇霉素,8月19日复检3次阴性确认清除肯塔基沙门菌。A 49-year-old female examinee,employed at a paper company in Guigang,Guangxi(engaged in the production of napkins),visited the Qintang District People′s Hospital in Guigang on June 11,2023,to apply for a health certificate.Salmonella was isolated during a physical examination screening for enteric pathogens(Salmonella,Shigella),and repeated use of empirical antibacterial drugs failed to eradicate the pathogen.A reference laboratory identified the two isolates as S.Kentucky ST198 by performing serotyping,drug resistance phenotyping,and whole genome sequencing.Based on the regional serotype database of Salmonella in China,a phylogenetic tree of S.Kentucky ST198 resistance genotypes was constructed,defining both isolated strains as high-level drug-resistant ST198.2-1 subclade clones.Following a multidisciplinary consultation and based on antimicrobial susceptibility test results,the treatment was adjusted to amoxicillin/clavulanate and azithromycin.On August 19,three consecutive negative test results confirmed the eradication of Salmonella Kentucky.

关 键 词：沙门菌属 血清分型 基因组 数据库 克隆 

分 类 号：R446.5[医药卫生—诊断学]