河南省细菌性痢疾病原学特征研究

目的探讨河南省2008年志贺菌的病原学特征,了解掌握其血清型别、耐药谱及携带毒力基因情况,为临床用药及流行病学研究提供合理依据。方法从形态特征、生化反应、血清分型、药物敏感试验及毒力基因检测等方面分别对河南省各细菌性腹泻监测点分离到的272株志贺菌株进行了系统鉴定和病原学研究。结果 272株志贺菌包括福氏志贺菌250株(91.91%)、宋内志贺菌22株(8.09%);选择其中100株志贺菌进行了针对14种抗生素的药物敏感试验(AST),对氨苄西林、萘啶酸、四环素、氯霉素耐药率分别为99.1%、99.1%、100%、85.7%;对头孢噻吩/头孢噻肟、环丙沙星、复方新诺明及妥布霉素的耐药率为20%~70%之间(KF/CTX 21.6%/20.6%、C IP40.2%、SXT 66.7%、TOB 15.7%);选取120株志贺菌进行毒力基因set2、ipaH、ial、set1B的检测,82.50%的志贺菌含有这4种毒力基因。结论河南省2008年分离的志贺菌包括福氏和宋内2种血清型,以福氏志贺菌为主;菌株普遍携带有4种毒力因子,绝大多数菌株对3种以上抗生素不敏感,表明临床分离志贺菌的耐药问题日益严重,给腹泻疾病的治疗带来较大影响。

Etiology of shigellosis in Henan province, 2008

Objective To understand the etiological characteristics of Shigella,its serotype,drug resistance and toxic gene carriage in Henan province,and provide evidence for rational antibiotic use and epidemiological research.MethodsThe morphological-biochemical identification,serotyping and toxic gene detection were conducted for the Shigella strains isolated from patients in diarrhea surveillance sites in Henan province in 2008.Results A total of 272 Shigella strains were detected,including 250 S.flexneri strains and 22 S.sonnei strains.The drug susceptibility test for 100 Shigella strains by K-B method showed severe resistance to 14 antibiotics;the resistant rate was 99.1% to ampicillin,99.1% to nalidixic acid,100% to tetracycline and 85.7% to chlormycetin,and the resistant rate was 21.6%/20.6% to cefalotin/cefotaxime,40.2% to ciprofloxacin,66.7% to trimethoprim＋sulfamethoxazole and 15.7% to tobramycin.In 120 Shigella strains,82.50% carried 4 toxic genes-set2,ipaH,ial,set1B,which would lead to diarrhea and related symptoms.Conclusion S.flexneri and S.sonnei stains were detected in Henan in 2008.Drug susceptibility test and PCR indicated that most strains were resistant to commonly used antibiotics and carried toxic genes.Close attention should be paid to the drug resistance of Shigella.