深圳市南山区腹泻患者弯曲菌感染及病原学特征分析

目的获得本地区秋季腹泻患者弯曲菌的感染现状及病原学特征。方法收集深圳市南山区2018年9 — 11月腹泻患者的粪便标本，采用双孔滤膜法分离培养弯曲菌并应用荧光聚合酶链式反应（PCR）方法进行菌种鉴定。 应用脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）对分离菌株进行分子分型，应用琼脂稀释法获得菌株对11种抗生素的最小抑菌浓度（MIC）。 根据菌株的序列分型（ST）结果，结合既往菌株分型数据进行本地区菌株的遗传聚类分析。结果共采集腹泻患者粪便标本150份，其中男性患者74例，女性患者76例，年龄在1～86岁之间。 150份粪便标本中共分离到弯曲菌18株，检出率为12.00%（18/150）。 菌种鉴定发现，空肠弯曲菌占77.78%（14/18），结肠弯曲菌占22.22%（4/18）。 14株空肠弯曲菌可分为11种PFGE带型，8个ST型别，以ST9763最多（35.71%，5/14），是本研究新发现ST型别。 14株空肠弯曲菌对四环素全部耐药，对红霉素、阿奇霉素、泰利霉素、庆大霉素、链霉素及克林霉素100.00%敏感。 ST型别最小生成树聚类分析结果表明，不同宿主来源菌株没有显著聚集性，腹泻患者分离菌株分布在不同来源的组群中。结论采用双孔滤膜法提高了腹泻患者中弯曲菌的检出率。本地区弯曲菌的感染仍以空肠弯曲菌为主， 分离菌株对四环素类、喹诺酮类抗生素呈现较高的耐药特征，分离的空肠弯曲菌ST呈弥散分布特点。

Infection status of Campylobacter and its etiologic characteristics in diarrhea patients in Nanshan district,Shenzhen

ObjectiveTo understand the infection status of Campylobacter and its etiologic characteristics in diarrheal patients in autumn in Nanshan district of Shenzhen.MethodsThe stool samples were collected from local diarrheal patients during September-November in 2018. Campylobacter was isolated with new filtration method and the species identification was performed by real time PCR. Molecular sub-typing was carried out by using multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The minimum inhibitory concentrations (MICs) of 11 antibiotics to the isolates were obtained with agar dilution method. The genetic cluster analysis was performed by using minimum spanning tree analysis based on the sequence typing (ST) of the isolates.ResultsA total of 150 stool samples were collected from 150 diarrheal patients, including 74 men and 76 women. The age of the patients ranged from 1 year to 86 years. Eighteen Campylobacter strains were isolated from 150 stool samples. Among the 18 isolates, 14 (77.78%) were C. jejuni positive and 4 (22.22%) were C. coli positive. Fourteen C. jejuni isolates could be classified into 11 PFGE patterns and 8 STs, and ST-9763, a novel ST identified in this study, was the predominant ST (35.71%, 5/14). All of the tested isolates were resistant to tetracycline and completely sensitive to erythromycin, azithromycin, telithromycin, gentamicin, streptomycin and clindamycin. The minimum spanning tree analysis for 14 C. jejuni strains isolated in Nanshan showed no significant clustering characteristics, the strains were distributed in groups from different sources.ConclusionThe new filtration isolation method increased the isolation rate of Campylobacter in diarrheal patients. C. jejuni was the major species causing Campylobacter infection. The isolates in this study showed high drug resistances to tetracycline and quinolones. No significant genetic cluster was found in C. jejuni strains isolated in Nanshan district.