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2011—2013年河南省肠炎沙门菌耐药与分子分型研究
作者:赵嘉咏 张玉凯 谢志强 潘静静 苏佳 穆玉姣 黄学勇 张白帆 夏胜利

摘要:

目的  分析2011—2013年河南省肠炎沙门菌临床分离株的耐药状况与分子分型。方法  收集2011年3月至2013年12月分离于河南省7个腹泻病多病原监测哨点医院的120株肠炎沙门菌,根据国际细菌性传染病分子分型监测网络公布的非伤寒沙门菌PFGE分型方法与美国临床与实验室标准协会沙门菌纸片法(Kirby-Bauer, K-B)药敏测试方案,对120株肠炎沙门菌进行8类抗生素的药敏测试与PFGE分子分型分析。结果  120株肠炎沙门菌中,77株分离自男性,43株分离自女性;从0~5岁低龄儿童中共分离78株(65.0%),其中6月龄至2岁婴幼儿57株(47.5%);分离时间集中于每年的5—10月份,其中3—4月份11株(9.2%),5—7月份48株(40.0%),8—10月份54株(45.0%),其余月份7株(5.8%),具有较典型的夏秋季节特征。120株肠炎沙门菌对氨苄西林的耐药率为50.0%(60株);对头孢他啶的耐药率为14.2%(17株),对头孢噻肟的耐药率为18.3%(22株);对头孢吡肟的耐药率为5.8%(7株);对萘啶酸的耐药率为61.7%(74株);对环丙沙星的耐药率为8.3%(10株),对诺氟沙星的耐药率为5.8%(7株);对庆大霉素的耐药率为42.5%(51株),对链霉素的耐药率为21.7%(26株);对氯霉素类抗生素的耐药率为30.0%(36株);对甲氧苄氨嘧啶的耐药率为11.7%(14株),对复方磺胺甲唑的耐药率为71.7%(86株);对四环素的耐药率为47.5%(57株)。120株肠炎沙门菌均对2种以上抗生素耐药,其中耐3~4种的为28株(23.3%),耐5~6种的为38株(31.7%),耐7~8种的为39株(32.5%)。经XbaⅠ酶切和PFGE电泳后,120株肠炎沙门菌共分为44种带型(EN1~EN44),各带型包含菌株数为1~35株不等,带型相似度在54.3%~100.0%之间,EN14、EN19分别包含35和29株菌,为该血清型主要优势带型。结论  河南省临床分离的肠炎沙门菌耐药状况比较严重,PFGE带型具有优势带型特点的同时又与其对应的耐药谱具有一定的关联性与聚集性。

关键词:沙门菌,肠炎;分子分型;电泳,凝胶,脉冲场

Abstract:

Objective  To investigate the antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of Salmonella Enteritidis (S.Enteritidis) strains in Henan province.Methods  S. Enteritidis strains were isolated from seven sentinel hospitals from March 2011 to December 2013. According to molecular typing and Salmonella (Kirby-Bauer, K-B) drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI), we analyzed drug sensitivity of 8 kinds antibiotics and PFGE molecule characteristics of 120 S. Enteritidis isolates from seven sentinel hospitals.Results  Among 120 strains of S. Enteritidis, 77 were isolated from male patients, 43 from female patients. A total of 78 strains S. Enteritidis were isolated from young children ranged from 0 to 5 years old (65.0%), including 57 strains isolated from 6 months to 2 years old (47.5%). The isolated time mainly centralized on May to October of the year, 11 strains isolated in March-April (9.2%), 48 were in May-July (40.0%),54 in August-October (45.0%), 7 in other months, with a typical summer seasonal characteristics. The resistance rate of 120 strains S. Enteritidis to ampicillin was 50.0% (n=60); to ceftazidime was 14.2% (n=17), to cefotaxime was 18.3% (n=22); to cefepime was 5.8% (n=7); to nalidixic acid was 61.7% (n=74); to ciprofloxacin was 8.3% (n=10), to norfloxacin was 5.8% (n=7); to gentamicin was 42.5% (n=51); to streptomycin was 21.7% (n=26); to chloramphenicol was 30.0% (n=36); resistance to methicillin benzyl ammonium was 11.7% (n=14), compound sulfamethoxazole resistance rate was 71.7% (n=86); the tetracycline resistant rate was 47.5% (n=57). All 120 strains of S. Enteritidis had different levels of resistance to 8 kinds of antibiotics, all strains were multidrug resistant strains, 28 isolates were resistant to 3-4 kinds of antibiotics (23.3%), 38 isolates were resistant to 5-6 kinds of antibiotics (31.7%), 39 isolates were resistant to 7-8 kinds of antibiotics (32.5%). All 120 strains of S. Enteritidis were divided into 44 molecular patterns by digestion with XbaI and pulsed field gel electrophoresis. each pattern contained 1-35 strains with similarity ranged from 54.3%-100%. EN14 and EN19 were the main PFGE types, including 35 and 29 strains respectively.Conclusion  The status of drug resistance of clinical isolates of Salmonella in Henan province was rather serious, PFGE patterns showed advantages and partial strain's corresponding resistant spectrum have certain relevance and the same aggregation relationship.

Key words: Salmonella Enteritidis;Molecular typing;Electrophoresis, gel, pulsed-field

发表日期:2016/3

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2016.03.014.T001:表1 120株肠炎沙门菌对13种抗生素耐药情况

    10.3760/cma.j.issn.0253-9624.2016.03.014.T001:表1 120株肠炎沙门菌对13种抗生素耐药情况

  • 10.3760/cma.j.issn.0253-9624.2016.03.014.F001:图1 河南省肠炎沙门菌脉冲场凝胶电泳聚类分析图谱

    10.3760/cma.j.issn.0253-9624.2016.03.014.F001:图1 河南省肠炎沙门菌脉冲场凝胶电泳聚类分析图谱

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