深圳市龙岗地区沙门菌的菌群分布及耐药性

目的了解深圳龙岗地区沙门菌的流行特点和耐药情况。方法以纸片扩散法（K-B法）对从该地区2003年1月-2007年1月食物中毒和伤寒、副伤寒疫情中分离的67株沙门菌进行药敏试验。结果该地区沙门菌主要流行菌群为D群，引起食物中毒最常见，占总暴发疫情的40．30％。51．85％的食物中毒由肠炎沙门菌引起。沙门菌对氟哌酸、氯霉素、氨基糖苷类及第3代头孢类抗生素完全敏感，对青霉素、苯唑西林完全耐药，对头孢氨苄的耐药率高达41．79％，对氨苄西林、羧苄市西林、哌拉西林、四环素和复方新诺明的耐药率分别为37．31％、37．31％、25．37％、25．37％和2．99％；非伤寒沙门菌对羧苄西林、氨苄西林、强力霉素、四环素、哌拉西林、美满霉素的耐药率显著高于伤寒和副伤寒沙门菌；沙门菌多重耐药率为13．00％。结论由沙门菌引起的暴发疫情在逐年增加，除四环素、氨苄西林、羧苄西林、哌拉西林和复方新诺明外，沙门菌对其他常用抗生素都敏感。非伤寒沙门菌的耐药性显著增加，加强监测非常必要。     

食品中沙门菌污染状况及耐药性研究

目的：了解浙江省食品中沙门菌的污染状况和耐药水平。方法：根据GB4789．4—94进行沙门菌的分离鉴定；用VITEK微生物分析系统GNS121药敏卡片测定沙门菌的耐药性。结果：从1047份生肉、生奶、生水产品和生食蔬菜中分离到74株沙门菌，总阳性率为7．07％。主要血清型为德尔卑沙门菌、鼠伤寒沙门菌和圣保罗沙门菌。对其中66株沙门菌的耐药性测定结果表明，对1种以上的抗生素敏感的沙门菌占51．52％，对5种以上抗生素耐药的多重耐药株占7．58％。在15种药敏试剂中，对呋喃妥因、安苄西林、哌拉西彬他唑巴坦、阿莫西彬克拉维酸和妥布霉素的耐药性达33．33％、16．67％、12．12％、9．09％和9．09％；对环丙沙星、庆大霉素和复方新诺明存在一定的耐药菌株（约达5％-8％）；所有菌株对丁氨卡那霉素、头孢曲松、头孢替坦、头孢他啶和亚胺培南均敏感。结论：与2001年所测菌株的耐药性相比，被测菌株的耐药性有所增强，耐药谱有所变宽。     

2006-2011年福建省沙门菌监测菌株血清型分布及耐药性分析

目的分析福建省沙门菌监测病人菌株血清型分布和耐药性情况。方法依据我省制定的沙门菌监测方案,在全省5个地市设立沙门菌监测点开展工作。结果2006～2011年共分离出449株沙门菌,均为肠道沙门菌内的亚种I和亚种HIb,分属于10个群（11个亚群）,39个血清型,其中A～F群占98．89％,鼠伤寒和肠炎沙门菌是我省检出率最高的2种血清型。同时我省新增了1个P群及10个血清型（变种）。鼠伤寒沙门菌仍是我省严重耐药的血清型,沙门菌多数菌株对萘啶酸、链霉素、磺胺、甲氧苄啶、复方新诺明、四环素、氨苄西林有不同程度的耐药,对三代头孢、环丙沙星、阿莫西林＋棒酸多数菌株敏感。结论鼠伤寒和肠炎沙门菌为我省2个主要的血清型,多数菌株对萘啶酸、链霉素、磺胺类、四环素、氨苄西林有不同程度的耐药。     

2008-2010年北京市沙门菌血清型和药物敏感分析

目的分析2008-2010年北京市沙门菌血清型及药物敏感性。方法对2008-2010年通过WHO全球沙门菌监测系统及北京市肠道门诊监测系统分离到的沙门菌进行生化试验和血清分型,药敏试验采用Kirby-Bauer法。结果北京市2008-2010年共分离沙门菌菌株220株,分布于39个血清型,其中肠炎沙门菌和鼠伤寒沙门菌为优势菌型,分别占35.00%(77/220)和15.45%(34/220)。191株沙门菌药敏结果显示三代头孢类、二代喹诺酮类抗生素高度敏感,但有耐药菌株出现。氯霉素、四环素、氨苄西林、磺胺异噁唑、链霉素、萘啶酸出现不同程度的耐药,其中萘啶酸耐药性最高,耐药率达51.83%。结论北京市沙门菌血清型以肠炎沙门菌和鼠伤寒沙门菌为主。耐药分析提示应加强沙门菌耐药性监测,对合理选择及使用抗生素提供指导。     

福建省2018年临床沙门菌分离株血清型及耐药性分析

目的了解福建省2018年哨点医院分离的204株沙门菌的血清型分布及耐药特征。方法对204株沙门菌进行血清学分型,并据CLSI指导原则对14种抗生素进行药敏试验。结果204株沙门菌血清型以鼠伤寒沙门菌为主(63.2%,129/204),其次是肠炎沙门菌(10.8%,22/204),还包括德尔卑沙门菌、斯坦利沙门菌和圣保罗沙门菌等。204株沙门菌对氨苄西林、四环素、氨苄西林/舒巴坦耐药率较高,分别为73.0%、70.1%、52.9%,对亚胺培南耐药率最低(4.0%)。耐3类或3类以上抗生素的多重耐药菌占52.9%。对14种抗生素全部耐药的菌株占4.4%。结论福建省临床来源的沙门菌血清型以鼠伤寒沙门菌为主。沙门菌对氨苄西林及四环素等耐药较为严重,多重耐药现象普遍存在。需做好食源性沙门氏菌的监测工作,从源头预防沙门氏菌感染。     

2020年昆明市儿童医院非伤寒沙门菌分子分型和β内酰胺类耐药基因特征分析

目的分析2020年昆明市腹泻患儿中分离的非伤寒沙门菌株的分子分型及耐药基因特征,为儿童非伤寒沙门菌感染防治提供参考依据。方法收集2020年1至12月昆明市儿童医院实验室确诊的41例沙门菌感染病例的相关信息,并对分离到的菌株进行血清型分型及脉冲场凝胶电泳分型分析;在此基础上对菌株进行药敏试验及B内酰胺类耐药基因高通量荧光定量PCR检测。结果 2020年昆明市儿童医院确诊的41例沙门菌感染患者主要集中在夏秋季,1岁以下儿童占到了确诊数的44%,男性患儿明显高于女性;在分离的41株沙门菌中,30株为鼠伤寒沙门菌,部分菌株分子分型相似性系数较高;分离的鼠伤寒沙门菌对部分青霉素类及氨基糖苷类抗生素耐药率达到了100%,β内酰胺类耐药基因blaTEM及blaCTX-M3/6、blaOXA1在分析的菌株中携带表达较高。结论鼠伤寒沙门菌是昆明市地区儿童非伤寒沙门菌感染的主要病原体,菌株间较高的同源性提示患者有相同暴露源的可能,携带耐药基因blaTEM及blaCTX-M3/6、blaOXA1是造成菌株多重耐药的主要原因之一。     

广州市566株腹泻病例沙门菌的血清型分布及耐药性分析

目的 了解广州市近两年腹泻病例沙门菌分离株的血清型分布及耐药情况。方法 对广州市8家腹泻病监测医院2012年、2013年间上送的566株沙门菌进行血清分型,同时采用纸片扩散法(K- B法)对12种抗菌药物进行敏感性分析。结果 566株沙门菌分为62个血清型,前三位分别为鼠伤寒沙门菌41.52%（235/566）、肠炎沙门菌15.72%（89/566）和斯坦利沙门菌7.95%（45/566）。药敏分析显示菌株对头孢类抗菌药物敏感率达85%以上,对环丙沙星的敏感性也较高,为75.44%,而对氨苄西林、磺胺复合物、四环素、萘啶酸的耐药率达60%。耐3种及以上抗生素的菌株占71.02%（402/566）,出现ACSSuT+耐药谱（对氨苄西林、氯霉素、链霉素、磺胺复合物、四环素等5种或更多药物多重耐药）的总耐药率为27.39%（155/566）。鼠伤寒沙门菌ACSSuT+耐药率达44.68%（105/235）。结论 本地区沙门菌临床分离株以鼠伤寒沙门菌和肠炎沙门菌为主,菌株对头孢类抗菌药物的敏感性较高,但某些血清型菌株存在严重的多重耐药现象,其中鼠伤寒沙门菌是耐药最严重的血清型,应引起重视。     

两例多重耐药沙门菌慢性肠炎

目的 研究两例反复腹泻患儿的致病菌及耐药性。方法 粪便分离细菌后鉴定菌种并进行14种抗生素敏感试验。结果 一株为德比沙门菌，另一株为鼠伤寒沙门菌，两菌株对青霉素类，氨基糖苷类，头孢类，碘胺类及喹诺酮类全部耐药，对头孢哌酮/舒巴坦（舒普深），奥格门丁和亚胺培南敏感。结论 应注意规范合理使用抗生素，以防多重耐药菌产生。     

10年间北京地区腹泻患者沙门菌亚型分布和耐药分析

目的:了解近十年北京地区沙门菌分布和耐药状况,为流行病学和腹泻病治疗提供依据。方法:收集2000年1月-2009年12月的门诊腹泻病人大便,经培养、分离、鉴定筛选出沙门菌,以血清凝集鉴定到血清型,K-B法进行药敏试验。结果:沙门菌引起的感染以青少年为主,优势血清群为D1群,优势血清型为肠炎沙门菌,占54.8%。沙门菌表现出对氨苄西林、哌拉西林和复方新诺明有较高耐药性,而对头孢吡肟和磷霉素则保持着较好的敏感性。鼠伤寒沙门菌对青霉素类、头孢美唑、氯霉素、复方新诺明的耐药性高于肠炎沙门菌(P<0.05)。头孢曲松和氧氟沙星的耐药率有上升趋势。结论:临床医生应警惕沙门菌对喹诺酮类和三代头孢菌素耐药的升高趋势,根据药敏试验合理用药,减少耐药菌株的出现。     

深圳市龙岗区近年伤寒沙门菌耐药性及脉冲场电泳分子分型研究

目的了解深圳市龙岗区近年伤寒沙门菌的耐药性和同源性。方法收集深圳市龙岗区2004—2007年肠道传染病和食物中毒样品中的伤寒沙门菌并用生化和血清学方法进行鉴定,采用改良K-B法进行药敏试验,伤寒沙门菌基因组经限制性内切酶XbaI酶切后,采用脉冲场电泳（PFGE）获得电泳图谱,再利用BioNumerics软件对电泳图谱进行同源性分析。结果共分离到17株伤寒沙门菌,所有菌株均对青霉素和苯唑西林耐药,对第3代头孢菌素、氨基糖苷类、氟喹诺酮类、氯霉素和复方新诺明敏感。64.7%的菌株对3种或以上抗生素中度耐药或耐药。BioNumerics分析结果显示,共有14个不同的PFGE带型出现,除2株以外其余15株分布于3个相似性在85%以上的簇内。结论深圳市龙岗区伤寒沙门菌的耐药已经成为一种非常普遍的现象,需加强监测。氟喹诺酮类和第3代头孢菌素类抗生素在临床上治疗伤寒沙门菌感染仍然可以取得满意效果。深圳市龙岗区可能存在3个伤寒沙门菌的流行克隆,其传播可能是该区伤寒沙门菌发生的主要原因。     

Development of antimicrobial drug resistance among Shigellas isolated at an Israeli hospital from 1977 through 1990

BACKGROUND: Treatment of diarrhea due to Shigella sp. has become complicated in recent years by drug resistance. The emergence of resistance to antibiotics important in the treatment of shigellosis was studied among Shigella sp. isolated at the Sheba Medical Center between 1977 and 1990. METHOD: A retrospective study of resistance patterns of Shigella sp. using the Kirby-Bauer disc diffusion test. RESULTS: In the early 1980s S. sonnei replaced S. flexneri as the most frequent isolate. Ampicillin resistance rose steadily, peaking at 70% for S. sonnei in 1990 and 50% for S. flexneri in 1987 and 1990. Resistance to tetracycline roughly paralleled this. By 1990, 68% of S. sonnei and 75% of S. flexneri were insensitive. Cotrimoxazole resistance developed rapidly from 1981. By 1990, 88% of strains of S. sonnei had become resistant, compared to 63% of S. flexneri. S. boydii and S. dysenteriae were encountered less frequently, but showed important rates of resistance. Chloramphenicol remained active against almost all strains of S. sonnei, while resistance in S. flexneri reached about 30% in the late 1980s. Relatively few isolates were resistant to all four drugs. Only 20/841 (2.4%) of strains tested from 1984 to 1990 were resistant to nalidixic acid. CONCLUSION: The data presented document the emergence of antibiotic resistance as a serious public health problem among strains of Shigella isolated at a large medical center in Israel.     

Human salmonellosis in Ille-et-Vilaine in 1983

224 salmonella strains from human beings, collected by the public and private laboratories of Ille-et-Vilaine during 1983, were serotyped and tested for their susceptibility to antibiotics. Salmonella typhimurium infections were the most frequent, while the other serotypes constituted a small number of strains, generally susceptible to antibiotics. No outbreak due to a multi-resistant serotype was observed. S. typhi and S. paratyphi B represent 6,25% of the strains isolated in this area during the year. Only 22% of the 224 strains collected were resistant to one or more antibiotics.     

An outbreak of typhoid due to multidrug resistant Salmonella typhi in Pondicherry.

An outbreak of typhoid due to multi-drug resistant Salmonella typhi is reported from Pondicherry, India. While the average prevalence of drug resistant strains in 1980-1988 had been 11.7%, it increased to 52% in 1989-1990. The majority of strains (80.8%) were resistant to chloramphenicol, streptomycin, tetracycline and ampicillin; 40% were resistant to co-trimoxazole. Minimum inhibitory concentrations to 8 antibiotics for 17 representative strains were more than 10-fold greater than those of 13 sensitive strains. The multi-resistance was shown to be plasmid mediated in direct conjugation experiments and the strains belonged to Viphage type O, biotype II.     

145株沙门氏菌耐药性分析

目的了解沙门氏菌引起腹泻病人的耐药情况,合理指导临床使用抗菌药物。方法对2006-2009年腹泻病监测点感染性腹泻病例中分离出的沙门氏菌进行药敏试验,并用WHONET5.4软件对药敏试验结果进行数据分析。结果 145株沙门氏菌对12种抗生素都有不同程度的耐药,其中所有菌株耐药集中在萘啶酸、氨苄西林、四环素这3种抗菌药物,耐药率分别为59.30%、50.40%和42.10%;对头孢西丁、头孢他定和头孢噻肟轻度耐药,耐药率分别为0.70%、2.10%和5.50%。145株沙门氏菌有48.20%为多重耐药,其中鼠伤寒沙门氏菌多重耐药率高。结论沙门氏菌对抗菌药物已产生多重耐药性,合理使用抗菌药物是控制该菌耐药的关键。     

Plasmid pattern analysis of natural bacterial isolates and its epidemiological implication.

Natural isolates of Escherichia coli, Salmonella typhimurium, Klebsiella pneumoniae, and Providencia stuartii were analysed to determine their plasmid content. This data allowed the identification of nosocomial strains of K. pneumoniae and P. stuartii and helped in the differentiation of epidemic strains of E. coli 0111 and S. typhimurium. Phenotypically similar isolates of S. typhimurium could be shown to be of independent origin using plasmid pattern analysis. The dissemination of a particular plasmid through different strains of S. typhimurium resulted in a simulation of a very widely distributed epidemic strain, because the plasmid interfered with the phage type of its host strain in addition to determining resistance properties. Plasmid pattern analysis disclosed two independently existing but interacting epidemic processes: a bacterial ''epidemic'' strain may become disseminated over a large territory and may predominate there for a long time; a single plasmid, however, may also become distributed through many different bacterial strains and may spread over a large territory. Plasmid pattern analysis provides a valuable and universal epidemiological laboratory method.     

永州地区沙门菌的分布及耐药性分析

目的调查永州市第三人民医院及道县人民医院沙门菌的流行趋势并进行耐药性分析,为临床合理应用抗生素提供依据。方法对2007-2008年两院收集的108株沙门菌采用K-B纸片琼脂扩散法进行耐药性分析。结果鼠伤寒沙门菌临床感染有上升趋势,沙门菌对亚胺培南的敏感率为100.0%,但对复方新诺明的敏感性明显下降（P〈0.005）。对三代头孢菌素、复方新诺明、氟喹诺酮类及氯霉素等药物产生了不同程度的耐药。结论应加强沙门菌耐药性监测,以指导临床合理选择及使用抗生素。     

深圳市儿童医院儿童粪便分离的459株沙门菌分布特征及耐药性

目的了解儿童粪便分离沙门菌的分布特征及耐药情况。 方法分析2012年1月—2015年10月某院患儿粪便标本分离的沙门菌检出情况,以及沙门菌血清型和对常用抗菌药物的敏感性。 结果7 047例患儿送检粪便标本,459例患儿检出沙门菌,总检出率为6.51%。沙门菌肠炎患儿男女比为2.4︰1,其中3岁以下儿童352例（占76.69%）;459株沙门菌中5—10月份检出374株（占81.48%）,7、8、9月检出数量最多,分别为72、84、78株。沙门菌血清型主要为B群(69.06%)和D群（19.39%）,分别以鼠伤寒沙门菌和肠炎沙门菌血清型为主。未检出耐亚胺培南和厄他培南的菌株,沙门菌属对哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、氨曲南和头孢曲松的敏感率均＞70%,肠炎沙门菌对头孢类抗生素的敏感率低于鼠伤寒沙门菌,但对复方磺胺甲口恶唑的敏感率高于鼠伤寒沙门菌。结论该院儿童粪便检出的沙门菌主要分离自3岁以下婴幼儿,夏秋季节高发,血清型以鼠伤寒和肠炎沙门菌为主,抗菌药物治疗要结合血清型及药敏结果慎重选择。     

医院感染病原菌的耐药性监测分析

目的 分析医院感染病原菌耐药情况,为临床合理使用抗菌药物、减少耐药性提供参考.方法 对2010年医院感染病例中分离出的病原菌的耐药性进行统计分析.结果 革兰阴性菌占75.28％,革兰阳性菌占18.80％,真菌占5.92％;病原菌检出首位的是铜绿假单胞菌756株,占38.61％,对碳青霉烯类药物亚胺培南耐药率为65.34％,检出第2位的是鲍氏不动杆菌317株,占16.19％,对氨基糖苷类抗菌药物阿米卡星较为敏感,其耐药率为70.98％,检出第3位的是大肠埃希菌114株,占5.82％,产ESBLs对青霉素类药物、头孢菌素类药物、喹诺酮类药物耐药率偏高;金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌除对万古霉素敏感外,对其他抗菌药物均显示高耐药性.结论 医院感染病原菌耐药性明显,加强耐药性监测,合理使用抗菌药物,提高医务人员手卫生的依从性,是减缓耐药菌传播,控制医院感染的有力措施.     

Salmonella serotypes and incidence of multiply-resistant Salmonellae isolated from diarrhoeal patients in Hong Kong from 1973-82

Salmonella was the most frequent bacterial pathogen isolated from patients with acute diarrhoea in Hong Kong. In Queen Mary Hospital, the major hospital on Hong Kong Island, 94.7% of salmonellae isolated from faecal specimens from patients during the period 1973-82 belonged to the gastroenteric group, while 5.3% belonged to the enteric fever group. Amongst the gastroenteric group, 68 salmonella serotypes were identified, with Salmonella derby, S. typhimurium and S. anatum being the predominant ones. Three outbreaks caused by S. johannesburg, S. worthington and S. wandsworth were detected. Of S. typhimurium, 61.6% were resistant to multiple antibiotics and belonged to four major phage types: 193, 22, 138 and U288. The majority (96.8%) of S. johannesburg strains which caused a widespread epidemic were multiply-resistant. Multiple antibiotic resistance was rarely observed in most other gastroenteric salmonellae. S. typhi was the commonest of the enteric fever group isolated from the blood of patients. Nineteen phage types were identified; E1 being the commonest (18.5%) while 21% were nontypable. Many of these isolated were resistant to streptomycin or sulphadiazine, but none were resistant to ampicillin, chloramphenicol or trimethoprim.