2009—2013年浙江省平湖市沙门菌临床感染血清型及耐药性分析

目的了解浙江省平湖市沙门菌临床感染血清型别、药物敏感性及临床表现。方法对分离到的91株沙门菌属进行生化鉴定和血清分型,采用法国梅里埃公司VITEK-2 Compact进行鉴定和药敏试验。结果血清分型共鉴定出11种沙门菌血清型,血液感染血清型以甲型副伤寒、伤寒沙门菌以主;肠道感染血清型以鼠伤寒沙门菌、肠炎沙门菌为主,感染临床症状以发热、阵痛、黄色水样便为主。沙门菌对氨苄西林、哌拉西林、四环素敏感率分别为34.07%、36.26%、45.05%,对三代、四代头孢、喹诺酮类、碳青酶烯类敏感率保持在70%~100%之间。5种常见沙门菌血清型对氨苄西林/舒巴坦耐药程度明显不同,其中鼠伤寒沙门菌、肠炎沙门菌为75.00%和47.62%,甲型副伤寒、伤寒、丙型副伤寒20%。结论沙门菌是引起7岁患儿腹泻的病原菌之一,不同来源的标本分离菌株血清型不同,不同血清型沙门菌存在不同程度的耐药,应加大对重点人群的监测和管理。沙门菌对大多数抗菌药物敏感,头孢类、喹诺酮类可作为临床首选药物。

Serotypes and drug resistance of Salmonella isolated from clinical infection cases in Pinghu,Zhejiang

Objective To understand the serotypes and drug susceptibility of Salmonella as well as the clinical manifestation of Salmonella infection in Pinghu from 2009 to 2013. Methods The biochemical identification and serotyping of 91 Salmonella strains isolated were conducted and the drug susceptibility test was performed by using Merieux Alliance VITEK-2 Compact from French. Results Eleven serotypes were detected in the 91 Salmonella isolates, Paratyphi A and Salmonella typhi were the major serotypes of blood stream infection; Salmonella typhimurium and Salmonella enteritidis were the major serotypes of intestinal infection. Fever, pains, yellow watery stools were the main clinical symptoms of Salmonella infection. The drug sensitive rate of the Salmonella strains was 34. 07% to Ampicillin, 36. 26% to Piperacillin and 45. 05% to Tetracycline. The Salmonella strains were sensitive to the third and forth-generation cephalosporins, quinolones and carbapenems （70% - 100% ）. The drug resistant rates of 5 common serotypes of Salmonella to Ampicillin/sulbactam were obvious different. The resistant rates of Salmonella t）phimurium and Salmonella enteritidis were 75.00% and 47.62%. The resistant rates of Paratyphi A, Salmonella typhi and Paratyphoid C were less than 20%. Conclusion Salmonella is one of the pathogens causing diarrhea in children under 7 years old, The serotypes of Salmonella varies by sources from which they are detected, and the drug resistances of Salmonella varies by their serotypes. It is necessary to strengthen the surveillance among the risk population. Salmonella is sensitive to most antibiotics, and cephalosporins or quinolones may be the first choice in clinical treatment.