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。

Analysis on Serotype Distribution and Antibiotic Resistance of 566 strains of Salmonella isolated from diarrhea cases in Guangzhou

Objective To analyze the serotype distribution and antibiotic resistance of Salmonella from patients with infectious diarrhea in Guangzhou. Methods The serotype of 566 strains of Salmonella isolated in 2012、2013 from 8 monitoring hospitals was determined by serology agglutinating method,Antimicrobial susceptibility was determined by disk diffusion method(KB) in accordance with Clinical and Laboratory Standards Institute procedures. Results 566 strains of Salmonella consisted of 62 serotypes, of which 235 strains were Salmonella typhimurium (41.52 %) , 89 strains were Salmonella enteritidis (15.72%), 45 strains were Salmonella Stanley (7.95%). Antimicrobial susceptibility tests showed that the resistance was most frequently detected to Cephalosporin (85%), followed by ciprofloxacin (75.44%), and the resistance was also observed with Ampicillin, Peptidylsulfanilamide, tetracycline, nalidixic acid (60%). Among the 566 isolates, strains resistant to three or more antibiotics are the most(71.02%),followed by ACSSuT + drug-resistant spectrum (multi-resistant to ampicillin, chloramphenicol, streptomycin, Peptidylsulfanilamide, tetracycline or more drugs ) (27.39%).The rate of resistant to ACSSuT + of Salmonella typhimurium is 44.68%. Conclusions Salmonella typhimurium and Salmonella enteriditics are the main serotypes. It is notable that the resistance rate of Salmonella to cephalosporins and multiple drug increasing recently, especially Salmonella typhimurium .