一起耐多药福氏1a志贺菌感染暴发疫情的调查和分子特征  

Investigation and molecular characteristics of an outbreak caused by multidrug resistant Shigella flexneri subtype 1a infection

作　　者：彭杰夫 姜仁杰[2] 董晨[1] 徐士林[2] 艾静[1] 周璐[1] 钱慧敏[1] PENG Jie-fu;JIANG Ren-jie;DONG Chen;XU Shi-lin;AI Jing;ZHOU Lu;QIAN Hui-min(Jiangsu Provincial Center for Disease Control and Prevention,Jiangsu Nanjing 210009,China;不详)

机构地区：[1]江苏省疾病预防控制中心,江苏南京210009 [2]盐城市疾病预防控制中心

出　　处：《江苏预防医学》2024年第4期464-468,共5页Jiangsu Journal of Preventive Medicine

摘　　要：目的对发生在江苏省某精神病院的一起细菌性痢疾暴发疫情进行调查分析。方法开展流行病学调查,采集样本进行分离培养和鉴定,对分离到的菌株进行抗生素药物敏感实验和二代测序,对二代测序数据进行耐药基因、毒力基因、系统发育分析,结合流行病学数据进行溯源和传播路径分析。结果从5例病人和1名密切接触者中分离到了6株耐多药福氏1a志贺菌,携带包括超广谱β-内酰胺酶耐药基因、磺胺类耐药基因和喹诺酮类高水平耐药突变位点等多种耐药基因。系统发育分析发现6株菌高度同源,菌株可能来自于本地或者周边设区市,分离自无症状感染者的菌株的耐药差异来自于质粒的丢失。结论本次疫情由耐多药福氏1a志贺菌引起,应关注该型别的耐药菌株,加强特殊场所、特殊人群的菌痢防控,并在未来疫情调查中推广二代测序和相应生物信息学分析。Objective To investigate a bacillary dysentery outbreak in a mental hospital in Jiangsu Province.Methods An epidemiological survey was performed.Specimens were collected,isolated,cultured and identified.The isolates were subjected to antimicrobial susceptibility test and second-generation sequencing,and the second-generation sequencing data were used for drug-resistant gene,virulence gene and phylogenetic analyses.In addition,tracing and transmission route analyses were performed based on epidemiological data.Results Six Shigella flexneri subtype 1a isolates were obtained from 5 cases and one close contact,carrying multiple drug-resistant genes,including extended spectrumβ-lactase resistance gene,sulfonamide resistance gene,and high-level quinolone resistance gene.Phylogenetic analysis showed that 6 S.flexneri subtype 1a isolates shared high sequence homology,and might be derived from local or neighboring cities.In addition,the difference in levels of drug resistance in S.flexneriisolatesfrom asymptomatic cases was attributed to plasmid loss.Conclusions The outbreak was caused by S.flexneri subtype 1a infections.High attention should be paid to drug-resistant S.flexneriisolates,and intensified dysentery control is required in specific places and among specific populations.In addition,second-generation sequencing and bioinformatics analysis are recommended in future epidemics surveys.

关 键 词：志贺菌 精神病院 耐多药 分子特征分析 

分 类 号：R378.2[医药卫生—病原生物学]