青岛市2011—2022年感染性腹泻病原菌监测及沙门菌耐药性分析  

Surveillance of pathogenic bacteria in infectious diarrhea and analysis of Salmonella drug resistance in Qingdao from 2011 to 2022

作　　者：张雪娇 陈征远 邓国金 孙海燕 冀贞浩[4] ZHANG Xuejiao;CHEN Zhengyuan;DENG Guojin;SUN Haiyan;JI Zhenhao(Department of Pharmacy,Jiaozhou Central Hospital of Qingdao,Qingdao,Shandong 266300,China;不详)

机构地区：[1]青岛市胶州中心医院药剂科,山东胶州266300 [2]青岛市即墨区人民医院 [3]青岛市即墨区中医医院 [4]西安市疾病预防控制中心

出　　处：《医学动物防制》2025年第3期254-260,共7页Journal of Medical Pest Control

基　　金：陕西省自然科学基础研究项目(2020JQ-969);中央转移支付重大传染病防控项目(财社[2022]183号)。

摘　　要：目的了解2011—2022年青岛市感染性腹泻病原菌谱及沙门菌耐药情况,为其防治提供参考。方法根据国家标准方法对病例样本进行增菌培养、分离纯化、生化鉴定和血清分型,采用微量肉汤稀释法对沙门菌进行药敏试验,组间比较采用χ^(2)检验,趋势分析采用趋势χ^(2)检验。结果共检测样本3063份,检出病原菌5种414株,检出率为13.52%;志贺菌221株(53.38%),沙门菌103株(24.88%),致泻性大肠埃希菌63株(15.22%),副溶血性弧菌20株(4.83%),非O1和O139血清型霍乱弧菌7株(1.69%),无混合感染样本。男性病原菌检出率(13.16%)低于女性(13.86%),差异无统计学意义(χ^(2)=0.32,P=0.573)。病原菌检出率最高的是10~<20岁年龄组(69.70%),职业为学生(20.22%),高峰时间为9月(30.77%)。志贺菌检出率逐渐下降(χ_(趋势)^(2)=32.76,P<0.001),沙门菌检出率逐渐上升(χ_(趋势)^(2)=22.60,P<0.001)。检出的优势株为福氏志贺菌(64.25%)、肠炎沙门菌(81.55%)和肠道致病性大肠埃希菌(66.67%)。沙门菌常见耐药谱为氨苄西林-氨苄西林/舒巴坦-链霉素-四环素-萘啶酸,呈多重耐药。结论青岛市感染性腹泻的病原菌主要为志贺菌和沙门菌,感染具有典型的季节性和人群分布特征。今后应拓宽病原菌监测种类并对优势菌进行耐药性监测,进而制定相应防治策略。Objective To understand the pathogenic bacteria spectrum in cases of infectious diarrhea and drug resistance properties of Salmonella in Qingdao from 2011 to 2022,and to provide references for its prevention and treatment.Methods Case samples were subjected to enrichment culture,isolation and purification,biochemical identification,and serotyping according to national standard methods.Drug susceptibility testing for Salmonella was performed using the micro-broth dilution method.Theχ^(2)test was used for inter-group comparisons,trends were analyzed using the trendχ^(2)test.Results A total of 3063 samples were tested and 414 strains of 5 kinds of pathogenic bacteria were detected,with a detection rate of 13.52%.The breakdown included 221 strains of Shigella(53.38%),103 strains of Salmonella(24.88%),63 strains of diarrheagenic Escherichia coli(15.22%),20 strains of Vibrio parahaemolyticus(4.83%)and 7 strains of non-O1 and non-O139 serotypes Vibrio cholerae(1.69%),with no mixed infection samples were detected.The detection rate of pathogenic bacteria in males(13.16%)was lower than that in females(13.86%),the difference was not statistically significant(χ^(2)=0.32,P=0.573).The highest detection rate of pathogenic bacteria was in the age group of 10-<20 years old(69.70%),in the group whose occupation was student(20.22%),and the peak time was September(30.77%).The detection rate of Shigella gradually decreased(χ_(trend)^(2)=32.76,P<0.001),while the detection rate of Salmonella gradually increased(χ_(trend)^(2)=22.60,P<0.001).The dominant strains detected were Shigella flexneri(64.25%),Salmonella enteritidis(81.55%),and enteropathogenic Escherichia coli(66.67%).The common drug resistance spectrum of Salmonella was ampicillin-ampicillin/sulbactam-streptomycin-tetracycline-nalidixic acid,showing multidrug resistance.Conclusion The pathogenic bacteria of infectious diarrhea in Qingdao are mainly Shigella and Salmonella.Infections are characterized by typical seasonal and demographic distribution.In the future,surveilla

关 键 词：感染性腹泻 病原菌 血清型 耐药性 监测 流行特征 防治 分析 

分 类 号：R181.3[医药卫生—流行病学] R574[医药卫生—公共卫生与预防医学]