194株志贺菌的流行病学分析及药物敏感调查

目的　了解闵行区引发痢疾的志贺菌优势菌型及其药物敏感状况 ,为痢疾临床治疗和预防控制提供依据。方法　采用血清凝集试验、菌种ATB鉴定仪系统生化鉴定和K -B法对从腹泻病人分离的志贺菌进行流行病学分析和药物敏感试验。结果　 194株志贺菌中福氏志贺菌 16 1株 ,宋内志贺菌 33株。共分为 8个血清型 ,其中福氏 1a 4 6株 ,福氏 2b 4 2株 ,福氏 2a 19株 ,福氏x变种 19株 ,福氏 4c 30株 ,还有福氏 4a、福氏 5a、福氏 5b共 5株。复方新诺明耐药率 89 .6 9%、氨苄西林耐药率 88 .14 %、氯霉素耐药率 6 0 . 31% ,头孢噻肟、丁胺卡那、头孢噻吩、头孢唑啉、庆大霉素、氟哌酸均敏感 ,耐药率均在 10 %以下。结论　本地区志贺菌感染的优势菌型为福氏 1a型和福氏2b型 ,而新型的志贺菌福氏 4c型和宋内志贺菌今后应引起足够重视。药物头孢噻肟、丁胺卡那霉素、头孢噻吩、头孢唑啉可作为目前临床治疗痢疾的常用药物。

Epidemiological Analysis on 194 Strains of Shigellae and Drug Sensitivity Investigation

Objective The purpose of this investigation was to have a better understanding of the predominating strains of shigellae that induced dysentery in this region and the related drug sensitivity status in order to provide scientific basis for the prophylaxis and control of dysentery. Methods Serum agglutination test and ATB identification media was used for systematic biological identification of bacteria, and K-B Methods was adopted for epidemiological assay and drug sensitivity test on shigellae isolated from patients with diarrhea. Results In 194 strains of shigella, there were 161 strains of Sh. flexneri and 33 strains of Sh. Sonnet, the former of which involved 8 serological types, including 46 strains of 1a, 42 strains of 2b, 19 strains of 2a, 19 strains of X variant, 30 strains of 4c and a total of 5 strains including 4a, 5a and 5b. The drug resistance rate of TMP-SMZ, Ampicillin and Chloramphenicol was 89 69%, 88 14% and 60 31%, resepectively; all shigellae were sensitive to Cefotaxime, Amikacin, Cefalotin, Cefazolin, Gentamicin and Norfloxacin, with a drug resistance rate below 10%. Conclusion In this region, the predominating strains of shigellae are Sh. Flexneri 1a and 2b, while the new Sh Flexneri 4c and Sh. Sonnet should be paid sufficient attention in the future. Drugs such as Cefotaxime, Amikacin, Cefalotin and Cefazolin can be used as conventional approaches to cure dysentery in the clinic.