2020-2022年广东省儿童弯曲菌的耐药性和分子流行特征分析  

Antimicrobial resistance and molecular epidemiological characteristics of Campylobacter in children in Guangdong Province from 2020 to 2022

作　　者：刘佳俊 何冬梅[1] 徐静[1] 程琦 史亚辉 欧阳方竹 柯碧霞[1] LIU Jia-jun;HE Dong-mei;XU Jing;CHENG Qi;SHI Ya-hui;OUYANG Fang-zhu;KE Bi-xia(Guangdong Provincial Center for Disease Control and Prevention,Guangdong Provincial Key Laboratory of Pathogen Detection for Emerging Infectious Disease Response,Guangzhou 510080,China;School of Public Health,Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东省疾病预防控制中心,广东省新发传染病应急检测技术研究与应用重点实验室,广州510080 [2]广东药科大学公共卫生学院,广州510080

出　　处：《中国人兽共患病学报》2024年第10期950-958,共9页Chinese Journal of Zoonoses

基　　金：国家科技重大专项(No.2018ZX10714002-003-006)。

摘　　要：目的了解2020-2022年广东省儿童感染空肠弯曲菌和结肠弯曲菌的检出率、耐药特征、毒力特征及多位点序列分型等分子流行特征和病原学特征。方法在广东省广州市2家医院采集2020-2022年疑似感染儿童病例的肛拭子或粪便样本,过滤法分离培养弯曲菌,用微生物质谱系统进行鉴定;采用琼脂稀释法进行抗生素耐药水平分析;提取细菌基因组核酸,开展全基因组测序,基于全基因组测序结果分析弯曲菌耐药基因、毒力基因、多位点序列分型和基于全基因组单核苷酸多态性的系统发育分析。结果本研究的持续性常规监测检出弯曲菌53株,弯曲菌的阳性检出率为2.94%,其中,空肠弯曲菌占81.13%(43/53),结肠弯曲菌占18.87%(10/53)。集中采样处理的多病原监测筛查出弯曲菌16株,其中,空肠弯曲菌11株,结肠弯曲菌5株。对其中46株弯曲菌完成了耐药实验和全基因组测序,包括33株空肠弯曲菌和13株结肠弯曲菌。弯曲菌对临床治疗广泛使用的红霉素的耐药率为21.73%(10/46),对四环素的耐药率为80.43%(37/46),对喹诺酮类抗生素萘啶酸和环丙沙星的耐药率为76.08%(35/46)和71.73%(33/46),对氯霉素的耐药率最低,为2.17%(1/46)。结肠弯曲菌的耐药率普遍高于空肠弯曲菌,在红霉素、庆大霉素、链霉素、泰利霉素和克林霉素指标上的差异具有统计学意义。共检出30株多重耐药菌,有9种多重耐药表型。基于全基因组序列分析,46株弯曲菌携带喹诺酮类、四环素类、β-内酰胺类、氨基糖苷类等抗生素耐药基因;携带5类共128种毒力因子基因;所有46株弯曲菌比对出35种ST型,系统发育分析显示无明显优势ST型,结肠弯曲菌较空肠弯曲菌的SNPs更多。结论2020-2022年广东省弯曲菌的阳性检出趋于稳定,空肠弯曲菌的检出率高于结肠弯曲菌。弯曲菌分离株对四环素和喹诺酮类抗生素耐药严重,多重耐药谱广泛,其中结肠弯曲菌�This study was aimed at understanding the detection rate,drug resistance characteristics,virulence characteristics,multi-locus sequence typing,and other molecular epidemic and pathogenic characteristics of Campylobacter jejuni and Campylobacter coli in children in Guangdong Province from 2020 to 2022.Anal swabs or stool samples of suspected infection cases in children from 2020 to 2022 were collected from two hospitals in Guangzhou,Guangdong Province.Campylobacter was isolated and cultured through the filtration method,and identified with a microbial mass spectrometry system;antibiotic resistance was analyzed with the agar dilution method;bacterial genome nucleic acids were extracted,and whole-genome sequencing was conducted;and drug resistance genes,virulence genes,multi-locus sequence typing,and phylogenetic analysis based on whole-genome single nucleotide polymorphisms were analyzed from whole-genome sequencing results.First,53 strains of Campylobacter were detected through continuous routine monitoring in this study,with a positive detection rate of 2.94%.Among them,Campylobacter jejuni accounted for 81.13%(43/53)and Campylobacter coli accounted for 18.87%(10/53).In addition,16 strains of Campylobacter were screened through multi-pathogen surveillance,including 11 strains of Campylobacter jejuni and 5 strains of Campylobacter coli.Drug resistance experiments and whole genome sequencing were conducted on 46 Campylobacter isolates,including 33 isolates of Campylobacter jejuni and 13 isolates of Campylobacter coli.The resistance rate of Campylobacter to erythromycin,a widely used clinical treatment,was 21.73%(10/46);that to tetracycline was 80.43%(37/46);those to the quinolone antibiotics nalidixic acid and ciprofloxacin were 76.08%(35/46)and 71.73%(33/46)respectively;and that to chloramphenicol was lowest,at 2.17%(1/46).The drug resistance rate was generally higher for Campylobacter coli than Campylobacter jejuni,and the differences in the indicators of erythromycin,gentamicin,streptomycin,telithromycin,and cli

关 键 词：空肠弯曲菌 结肠弯曲菌 耐药性 全基因组测序 毒力因子特征 

分 类 号：R378[医药卫生—病原生物学]