广西富川县2000—2018年三起甲型副伤寒疫情菌株药敏试验

目的 通过体外药物敏感性试验,了解广西富川县不同年度甲型副伤寒沙门菌对15种抗生素的敏感性及耐药变迁,为甲型副伤寒的疾病监测及防治策略提供实验数据。方法 采用微量肉汤稀释法对广西富川县2000—2018年三起甲型副伤寒疫情分离的122株甲型副伤寒沙门菌进行药敏试验,分析不同最低抑菌浓度（MIC）检测结果。结果 122株甲型副伤寒沙门菌对氨苄西林（AMP）、氨苄西林/舒巴坦（AMS）、复方新诺明（SXT）、头孢噻肟（CTX）、头孢他啶（CAZ）、庆大霉素（GEN）、阿奇霉素（AZI）、亚胺培南（IMI）和磺胺异恶唑（SUL）等9种药物敏感率达100.00%,四环素（TET）、氯霉素（CHL）和头孢西丁（CFX）敏感率也达90.00%以上,头孢唑啉（CFZ）敏感率仅为71.31%;对喹诺酮类药物主要表现为耐药和中介：环丙沙星（CIP）中介率为97.54%, 萘啶酸（NAL）100.00%耐药 。CTX、CAZ和GEN三种药物抑菌效果最佳,多重耐药现象不严重 ,未出现耐三代头孢药物菌株 。结论 第三代头孢药物可作为治疗甲型副伤寒的首选药物,慎用喹诺酮类药物 ;同时应加强常用抗生素耐药监测,结合本地实际情况,合理选用治疗甲型副伤寒的首选和常规药物。

Antimicrobial resistance profiles of Salmonella paratyphi A isolates collected from 3 outbreaks in Fuchuan County of Guangxi, 2000-2018

Objective To describe and compare the profiles and evolution of antimicrobial resistance in Salmonella paratyphi A isolates collected from different years in Fuchuan County of Guangxi, through in vitro drug sensitivity tests, and we provide scientific evidence for formulating surveillance programs and control policies. Methods A panel of 122 isolates of Salmonella paratyphi A were obtained from 3 outbreaks in Fuchuan County of Guangxi, 2000-2018, and tested for minimum inhibitory concentrations (MIC) of antibiotics by the broth dilution method. Results The 122 strains were all susceptible(100.00%) to ampicillin,ampicilli/sulbactam,cotrimoxazole,cefotaxime,ceftazidime, gentamicin,azithromycin,imipenem and sulfamethoxazole. Over 90.00% of them were susceptible to tetracycline, chloramphenicol and cefoxitin. Only 71.31% of them were susceptible to cefazolin. They manifests as drug-resistance and intermediate to quinolones: The intermediate rate of ciprofloxacin is 97.54%; nalidixic acid is entirely 100.00% resistance. Cefotaxim, ceftazidime and gentamicin show the best antibacterial effects, and the phenomenon of multidrug resistance is not severity. No strains resistant to third-generation cephalosporin were detected. Conclusion Third-generation cephalosporins should be accepted as a drug of first choice for Salmonella paratyphi A. And quinolones should be used with caution. Enhanced surveillance of antimicrobial resistance in Salmonella paratyphi A is essential to provide an evidence base for empirical treatment protocols.