细菌性痢疾病原菌血清分型及耐药性分析

目的了解本地细菌性痢疾（简称菌痢）流行的病原菌主要血清型及耐药性，为有效预防和控制菌痢提供依据。方法对近2年来肠道门诊和住院部腹泻患者的粪便标本共1617例进行细菌分离培养、生化鉴定、血清学分型及药敏试验。结果从1617例腹泻患者的粪便标本中共分离出志贺菌165株，分布4个菌群，其中B群（福氏志贺菌）88株，D群（宋内志贺菌）40株，C群（鲍氏志贺菌）21株，A群（痢疾志贺菌）16株，分型诊断检出13个血清型及亚型，以B群2a为主；志贺菌总体耐药率对萘啶酸耐药率最高，达90．0％以上，其次对氨苄西林、利福平、四环索、复方新诺明耐药率在70．0％～87．5％之间，对诺氟沙星耐药率在20．5％～31．3％之间；对头孢噻肟、庆大霉素、环丙沙星耐药率较低，在2．5％～6．8％之间。结论本地区菌痢流行的病原菌主要血清分型为B群2a，其次是D群;对多种抗生素耐药性有增高的趋势，应加强耐药性监测与防治。

Analysis of serotype and drug resistance of pathogenic bacterium in bacillary dysentery

Objective To investigate the serotype and drug resistance of pathogenic bacterium in bacillary dysentery in our region, in order to provide evidence for prevention and control of bacillary dysentery. Methods 1 617 cases of stoli samples were collected from outpatients and inpatients with diarrhea. Bacterium isolation, cultivation and biochemical identification, serotyping and drug sensitive test were carried out. Results 165 strains of shigella were isolated, among which 88 strains were S. flexneri, 40 strains were S. sonnei, 21 strains were S. boydii and 16 strains were S. dysenteriae. 13 se-rotypes and subtypes were detected, serotype 2a of S. flexneri mostly. The total susceptibility rate of snigella was highest to nalidixic acid (more than 90%), followed by that to ampicillin, rifamoin, tet-racycline, trimoxazole (70. 0%-87.5%). The susceptibility rate to norfloxacin was 20. 5%-31.3%, and lower susceptibility rate (2.5%-6. 8%) was found to eefotaxime, gentamicin and eiprofloxacin. Conclusion The main serotype of bacillary dysentery was serotype 2a of S. flexneri in our region, then S. sonnei. The susceptibility of snigella to antibiotics is increasing, so drug susceptibility test should be performed periodically.