663株志贺氏菌流行分布及耐药性变迁的实验研究

目的研究繁昌县1994~2003年志贺氏菌的流行分布及其对抗生素的耐药性变化,为相关疾病的防治提供依据。方法应用WHONET 5.3及EXCEL软件对分离的663株志贺氏菌及改良K irby-Bauwer法进行13种抗生素敏感试验的测试结果进行分析。结果B群志贺氏菌是主要的流行菌,占80.4%,最常见的血清型为2 a、1 a、1b和3 a;夏季感染率较高,秋季达到高峰;志贺氏菌对四环素、氨苄青霉素、SMZ耐药率较高,在50.0%~98.5%之间;对庆大霉素、卡那霉素、头孢唑啉、头孢呱酮、呋喃唑酮等仍较敏感,但也开始出现耐药现象;对4种喹诺酮药物随年代不同耐药率有不同程度的升高。结论志贺氏菌各群分布每年因季节不同而有所变化;志贺氏菌对多各种抗生素耐药,尤其是对庆大霉素、卡那霉素和头孢类抗生素开始出现耐药现象应引起重视。

Study on the Distribution and Drug Resistance in 663 strains of Shigella spp

Objective To study the distribution and drug resistance change of Shigella in Fanchang county of Anhui from 1994 to 2003.Methods The total of 663 clinical isolates were collected for susceptibility testing(Kirby-Bauer) of 12 antimicrobial-agents,the test was performed by disk diffusion method and analyzed by WHONET 5.3 and EXCEL software.There were four quinolones Pipemidicadcid,Ofloxacin,Norfloxacin and Cipfofloxacin used in the test.The other eight antimicrobial agents such as Teracycline,Ampicillin,Gentamycin,Sulfadimidine(SMZ),Kanamycin,Cefamezin,Cefoperazone and Cefoperazone were used as well.Results The results showed that the strains could be divided into 4 groups.There were 533 strains of Shigella Flexneri,most influent clinical isolates in Fanchang area,accounted for 80.4% of all strains.The Dyseneriae had 60 strains,Sonnei had 53 strains.Boydil had 17 strains.The percentage of the strains above 3 clinical isolates were 9.0%,8.0% and 2.6% respectively.Shigella infection rate was relatively high in the summer and was the highest in the autumn based on the test results.The resistance rates of Shigella spp.to Teracycline,Ampicillin and Sulfadimidine(SMZ) varied from 50.0% to 98.5%,while the Shigella resistance rates to Gentamycin,Kanamycin,Cefamezin,Cefoperazine and Furazolidonum were 8.7%,4.1%,3.3%,2.1% and 1.7% respectively,as for the rates to Pipemidicadcid,Ofloxacin,Norfloxacin and Cipfofloxacin were 92.4%,86.4%,93.9% and 98.5% respectively.Conclusions Shigella varied in light of the geographic and seasonal changes.Shigella had resistance to many antibiotics.It was emphasized here that it`s very important to pay close attention for the resistance phenomenon starting on Gentamycin,Kanamycin and Cefamezin etc..In addition,the regular trend analysis should be reported.