文章摘要
赵嘉咏,张胜勇,穆玉姣,张白帆,夏胜利,黄学勇,许汴利.河南省登封市2009-2015年甲型副伤寒沙门菌耐药性及PFGE分型研究[J].中华流行病学杂志,2016,37(5):714-717
河南省登封市2009-2015年甲型副伤寒沙门菌耐药性及PFGE分型研究
Drug tolerance and PFGE molecular typing of Salmonella paratyphi A isolated in Dengfeng, Henan province, 2009-2015
收稿日期:2015-10-28  出版日期:2016-05-13
DOI:10.3760/cma.j.issn.0254-6450.2016.05.026
中文关键词: 甲型副伤寒沙门菌;分子分型;脉冲场凝胶电泳;药敏测试
英文关键词: Salmonella paratyphi A;Molecular typing;Pulsed Field Gel Electrophoresis;Drug susceptibility test
基金项目:国家科技重大专项(2012ZX10004201,2012ZX10004215);河南省科技攻关项目(152102310133)
作者单位E-mail
赵嘉咏 450016 郑州, 河南省疾病预防控制中心传染病所病原微生物实验室  
张胜勇 452470 登封市疾病预防控制中心检验科  
穆玉姣 450016 郑州, 河南省疾病预防控制中心传染病所病原微生物实验室  
张白帆 450016 郑州, 河南省疾病预防控制中心传染病所病原微生物实验室  
夏胜利 450016 郑州, 河南省疾病预防控制中心传染病所病原微生物实验室  
黄学勇 450016 郑州, 河南省疾病预防控制中心传染病所病原微生物实验室  
许汴利 450016 郑州, 河南省疾病预防控制中心传染病所病原微生物实验室 xubl@hncdc.com.cn 
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中文摘要:
      目的 分析2009-2015年河南省登封市甲型副伤寒沙门菌临床分离株耐药性与PFGE分子型别特征。方法 采集登封市2家医院临床诊断为副伤寒病例患者静脉血,利用沙门菌科玛嘉选择性培养基分离培养,API20E肠杆菌科系统生化板条鉴定后使用丹麦SSI分型血清进行沙门菌O抗原及H1/2相鞭毛诱导血清凝集试验。根据PulseNet China病原体分子分型网络实验室公布的沙门菌PFGE操作指南与美国临床实验室标准化协会沙门菌K-B法药敏测试方案,对其进行PFGE分子分型与聚类分析及8类13种抗生素药敏测试。结果 从248例患者血培养物中共分离到126株甲型副伤寒沙门菌,血清抗原式为1,2,12:a:-。126株甲型副伤寒沙门菌对广谱合成类青霉素氨苄西林(AMP)的耐药率为83.3%,对三代头孢类抗生素头孢他啶(CAZ)、头孢噻肟(CTX)的耐药率分别为29.4%和31.2%;对四代头孢类抗生素头孢吡肟(FEP)的耐药率为17.5%;对一代喹诺酮类抗生素萘啶酸(NAL)的耐药率为62.6%,对三代氟喹诺酮类抗生素环丙沙星(CIP)、诺氟沙星(NOR)的耐药率为19.3%和26.4%;对氨基糖苷类抗生素庆大霉素(GEN)、链霉素(STR)的耐药率为22.8%和47.9%;对氯霉素类抗生素(CHL)的耐药率为19.2%;对增效磺胺类抗生素甲氧苄氨嘧啶(TMP)与复方新诺明(SXT)的耐药率为24.2%和58.6%;对四环素(TET)的耐药率为46.7%。126株甲型副伤寒沙门菌中耐2种以上抗生素的多重耐药菌株为109株(86.5%),其中耐2~3种的为9株(7.1%),耐5~8种的为76株(60.3%),耐9~10种的为17株(13.5%),耐11~12种的为7株(5.6%);三代头孢类抗生素CAZ、CTX,一代与三代喹诺酮类抗生素NAL、CIP、NOR,氨基糖苷类抗生素STR耐药率总体呈年份上升趋势;经Xba Ⅰ酶切与PFGE后,126株甲副菌株获得14种带型,每种带型包含菌株数1~98株不等,相似度为64.10%~100.00%,PTYA1、6、9、10为其主要优势带型。结论 河南省登封市临床分离的甲型副伤寒沙门菌耐药状况比较严重,PFGE带型呈现多样性的同时又具有较显著的优势带型特点,部分带型与其对应的耐药谱具有一定的关联性与聚集性。
英文摘要:
      Objective To investigate the drug tolerance and PFGE patterns of Salmonella (S.) paratyphi A strains isolated from sentinel hospitals in Dengfeng, Henan province, during 2009-2015. Methods Venous blood samples were collected from paratyphoid patients and cultured in double phase blood culture bottle. Suspicious strains were identified and used for Salomonella. O antigen and H1/2 phase flagellum-induced serum agglutination test with API20E biochemical systems and SSI Salmonella typing sera. According to Salmonella molecular typing and K-B drug susceptibility testing method published by PulseNet China bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute, we analyzed the drug susceptibility and PFGE molecule characteristics of S. paratyphi A strains isolated from the patients. Results A total of 126 strains of S. paratyphi A were isolated from 248 blood samples, the antigen modes of them were 1, 2, 12:a:-. The resistance rate of 126 strains of S. paratyphi A was 83.3% to ampicillin; 29.4% to ceftazidime, 31.2% to cefotaxime, 17.5% to cefepime; 62.6% to nalidixic acid; 19.3% to ciprofloxacin, 26.4% to norfloxacin; 22.8% to gentamicin, 47.9% to streptomycin; 19.2% to chloramphenicol, 24.2% to methicillin benzyl ammonium, 58.6% to compound sulfamethoxazole and 46.7% to tetracycline. The 126 strains of S. paratyphi A had different levels of resistance to 8 kinds of antibiotics, 109 strains were multidrug resistant (86.5%), 9 strains were resistant to 2-3 kinds of antibiotics (7.1%), 76 strains were resistant to 5-8 kinds of antibiotics (60.3%), 17 strains were resistant to 9-10 kinds of antibiotics (13.5%), 7 strains were resistant to 11-12 kinds of antibiotics (5.6%). The 126 strains of S. paratyphi A were divided into 14 molecular patterns by digestion with Xba Ⅰ and pulsed field gel electrophoresis. The antibiotics resistance to third generation cephalosporin (CAZ, CTX), one generation and three generation of quinolones (NAL, CIP, NOR) and aminoglycosides antibiotics (STR) showed an upward trend. Each pattern contained 1-98 strains with similarity ranged from 64.10% to 100.00%. PTYA 1, 6, 9 and 10 were the main PFGE belt types. Conclusion The drug resistance of clinical isolates of S. paratyphi A was serious in Dengfeng, Henan province, PFGE patterns showed a diversity, but predominant patterns could also be found. The PFGE patterns of some strains had clustering and were related with their antidrug spectrums.
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