深圳地区四家医院感染性腹泻来源沙门菌耐药性及分子分型研究

目的分析2012-2016年深圳地区感染性腹泻沙门菌耐药状况及分子型别特征,为沙门菌感染防控提供科学依据。方法收集深圳地区四家医院的137株沙门菌,传统血清学方法鉴定沙门菌血清型,微量肉汤稀释法测定菌株药物敏感性,脉冲场凝胶电泳(PFGE)对鼠伤寒沙门菌和肠炎沙门菌作分子同源性分析。结果 137株沙门菌可分为30种菌型,鼠伤寒沙门菌和肠炎沙门菌是本地优势菌型。菌株对链霉素、氨苄西林、阿莫西林/克拉维酸钾耐药最为严重,对青霉素类、头孢类、氨基糖苷类、大环内酯类抗生素的耐药呈逐年增高的趋势。49株鼠伤寒沙门菌经脉冲场凝胶电泳可获得38种带型,相似度65.5%~100%,TY18为优势带型;27株肠炎沙门菌经脉冲场凝胶电泳可获得9种带型,相似度61.8%~100%,EN7为优势带型。结论感染性腹泻来源沙门菌耐药状况比较严重,菌株PFGE带型多样化,呈高度散发,部分带型与其耐药谱之间具有一定的聚集与关联性。

Characteristics of drug resistance and molecular typing for Salmonella in diarrhea patients from four hospitals in Shenzhen

We analyzed the antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of Salmonella strains of infectious diarrhea isolated four hospitals in Shenzhen during 2012-2016.A total of 137 Salmonella strains collected in 4 hospitals in Shenzhen were identified by serotyping,micro-dilution method was used to detect the antimicrobial susceptibility of the isolates.Pulsed field gel-electrophoresis(PFGE) was used for molecular typing and cluster analysis of S.typhimurium and S.enterica strains.Results showed that 137 strains of Salmonella were divided into 30 kinds of serotype.S.typhimurium was the predominant serotype.The drug susceptibility test indicated that the antibiotic resistance of the strains to chloromycetin,ampicillin and amoxicillin were more serious than other drugs,the resistance to penicillins,cephalosporins,aminolycosides and macrolides showed increase trends year by year.Of 49 strains of S.typhimurium were divided 38 molecular patterns by PFGE,with similarity ranged from 65.5％ 100％,TY18 was the main PFGE pattern.The 27 strains of S.enterica were divided into 7 molecular patterns by PFGE,with similarity ranged from 61.8％-100％,EN7 was the main PFGE pattern.The status of drug resistance of infectious diarrhea isolates was rather severe,PFGE patterns showed diversity,suggesting the diarrhea cases were distributed sporadically.Partial PFGE patterns and its corresponding antidrug spectrum have certain aggregation relationship.