文章摘要
柯碧霞,何冬梅,谭海玲,曾洪辉,杨彤,李柏生,梁宇恒,卢玲玲,梁骏华,黄琼,柯昌文.广东省2013-2014年食源性疾病主动监测的病原学特征分析[J].中华流行病学杂志,2016,37(10):1373-1378
广东省2013-2014年食源性疾病主动监测的病原学特征分析
Active etiological surveillance for foodborne diseases in Guangdong province, 2013-2014
收稿日期:2016-03-19  出版日期:2016-10-13
DOI:10.3760/cma.j.issn.0254-6450.2016.10.012
中文关键词: 食源性疾病主动监测;致病菌;病原学特征
英文关键词: Foodborne diseases active surveillance;Pathogenic bacteria;Etiological characteristics
基金项目:广东省省级科技计划(2013B060400012,2014A020219004);中美新发和再发传染病合作项目(1U2GGH000018-01)
作者单位E-mail
柯碧霞 511430 广州, 广东省疾病预防控制中心  
何冬梅 511430 广州, 广东省疾病预防控制中心  
谭海玲 511430 广州, 广东省疾病预防控制中心  
曾洪辉 510440 广州, 广东省生物制品与药物研究所耐药监测室  
杨彤 510440 广州, 广东省生物制品与药物研究所耐药监测室  
李柏生 511430 广州, 广东省疾病预防控制中心  
梁宇恒 511430 广州, 广东省疾病预防控制中心  
卢玲玲 511430 广州, 广东省疾病预防控制中心  
梁骏华 511430 广州, 广东省疾病预防控制中心  
黄琼 511430 广州, 广东省疾病预防控制中心  
柯昌文 511430 广州, 广东省疾病预防控制中心 kecw1965@aliyun.com 
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中文摘要:
      目的 了解广东省腹泻病例中沙门菌、志贺菌、副溶血弧菌和4种致泻性大肠埃希菌[肠产毒性大肠埃希菌(ETEC)、肠致病性大肠埃希菌(EPEC)、产志贺毒素大肠埃希菌(STEC)、肠侵袭性大肠埃希菌(EIEC)]的感染情况及其血清型别、耐药变化和分子特征。方法 对2013-2014年广东省食源性疾病主动监测检出的沙门菌、志贺菌、副溶血弧菌和4种致泻性大肠埃希菌菌株进行血清分型、药物敏感试验和PFGE分型。结果 2013-2014年检测粪便标本57 834份,分离到3 372株致病菌,检出率为5.83%;沙门菌的检出阳性率最高,其次是副溶血弧菌、致泻性大肠埃希菌、志贺菌。3 213株沙门菌分为143种血清型,最常见的血清型为鼠伤寒、4,5,12:i:-、肠炎、斯坦利和德尔卑沙门菌。沙门菌对头孢类和氟喹诺酮类药物均较敏感;不同血清型沙门菌对抗生素的耐药率有明显差异,10种最常见血清型中,肠炎沙门菌对头孢类药物的耐药率最高,德尔卑沙门菌对环丙沙星的耐药率最高。2 289株各血清型沙门菌的PFGE型别分布多样,表现出较大的指纹图谱多态性。85株副溶血弧菌分为10种血清型,最主要的血清型为O3:K6(61.18%),其次是O4:K8(10.59%);tdh携带率高(81.18%),trh携带率较低(7.06%),有10株菌(11.76%)不携带该两种毒力基因;副溶血弧菌对亚胺培南、萘啶酸、复方新诺明、氯霉素、四环素的敏感率均>95%。13株志贺菌分别为宋内志贺菌9株、福氏志贺菌3株、鲍氏志贺菌1株;对头孢他啶、环丙沙星、氯霉素较敏感(76.92%)。检出的86株致泻性大肠埃希菌中ETEC 29株(33.72%),EPEC 27株(31.39%),STEC 27株(31.39%),EIEC 3株(3.48%)。结论 2013-2014年广东省食源性疾病主动监测中沙门菌检出率最高(5.57%),其次是副溶血弧菌、致泻性大肠埃希菌、志贺菌;沙门菌、副溶血弧菌和志贺菌对头孢类和氟喹诺酮类药物敏感;沙门菌感染中仅发现聚集性病例,但未监测到暴发。
英文摘要:
      Objective To study the infection status, serotypes, drug resistance and molecular characteristics of Salmonella, Shigella, Vibrio parahemolyticus, enterotoxigenic Escherichia (E.) coli (ETEC), pathogenic E. coli (EPEC), Shiga Toxin producing E. coli (STEC) and Enteroinvasive E. coli (EIEC) collected from diarrhea patients in Guangdong. Methods The strains of Salmonella, Shigella, V. parahemolyticus and 4 kinds of E. coli isolated from foodborne diseases surveillance during 2013-2014 were collected to conduct serotyping, drug resistance test and pulsed-field gel electrophoresis (PFGE). Results A total of 3 372 stains of pathogens were isolated from 57 834 stool samples during 2013-2014, the overall positive rate was 5.83% and the positive rate of Salmonella was highest, followed by that of V. parahemolyticus, 4 kinds of E. coli and Shigella. And 3 213 strains of Salmonella were divided into 143 serotypes. The most prevalent serotypes were Salmonella typhimurium, 4, 5, 12:i:-, Enteritidis, Stanley and Derby. Salmonella was sensitive to cephalosporin and fluoroquinolones, and showed significant differences in drug resistance rate among different serotypes. In top 10 common serotypes, S. enteritidis and S. derby were most resistant to cephalosporin and ciprofloxacin respectively. PFGE was performed for 2 289 strains of Salmonella, showing distribution diversity and significant fingerprint polymorphisms. The 85 strains of V. parahemolyticus were divided into 10 serotypes, O3:K6 (61.18%) was the most common serotype, followed by O4:K8. The results showed that the carrying rate of virulence genes tdh (81.18%) was high, while the carrying rate of trh was low (7.06%), and there were 10 strains carrying no the two kinds of virulence genes. The sensitive rate of V. parahemolyticus to imipenem, nalidixic acid, SMZ-TMP, chloramphenicol and tetracycline were more than 95%. Thirteen strains of Shigella were detected, including 9 strains of Shigella sonnei, 3 strains of Shigella flexneri and 1 strains of Shigella bogdii. The strains all showed sensitivity to ceftazidime, ciprofloxacin and chloramphenicol (76.92%). There were 86 strains of E. coli detected, including 29 strains of ETEC (33.72%), 27 strains of EPEC (31.39%), 27 strains of STEC (31.39%) and 3 strains of EIEC (3.48%). Conclusions In the active etiological surveillance for foodborne diseases in Guangdong during 2013-2014, the detection rate of Salmonella was highest (5.57%), followed by that of V. parahemolyticus, 4 kinds of E. coli and Shigella. Salmonella, V. parahemolyticus and Shigella were sensitive to cephalosporin and fluoroquinolones. Clustered cases of Salmonella infection were found in the surveillance, but no outbreaks occurred.
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