2015年-2017年嘉兴市属医院粪便检出沙门菌的临床分析
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摘要
目的分析嘉兴市属医院2015年-2017年粪便标本检出沙门菌感染的流行病学特征、血清学分型及耐药性。方法收集嘉兴市属医院门诊及住院患者的粪便标本,进行沙门菌分离鉴定、血清分型及药敏试验。结果 240株沙门菌检出的患者中,以婴幼儿(0岁～3岁)为主,占42.92%。全年都有检出,以6月-10月最多见;沙门菌血清型分为26种。位居前三的是鼠伤寒沙门菌、肠炎沙门菌、斯坦利沙门菌,分别占45.83%、19.58%、15.83%;对氨苄西林、氨苄西林/舒巴坦、复方新诺明、头孢呋辛有很高的耐药性;对头孢曲松、头孢吡肟、环丙沙星及左氧氟沙星的耐药率分别为12.9%、4.1%、7.6%和4.2%。未发现耐亚胺培南、美罗培南、替加环素和阿米卡星的菌株。结论嘉兴市属医院粪便检出沙门菌逐年增多,特别是2017年,鼠伤寒沙门菌和肠炎沙门菌为主要血清型,临床上要结合药物敏感试验合理规范用药。
Objective To analyze the epidemiological characteristics, serological typing and drug resistance of Salmonella infections in fecal specimens collected from 2015-2017 in Jiaxing Municipal Hospital. Methods The fecal specimens from outpatients and hospitalized patients in Jiaxing Municipal Hospital were collected, and the isolation, identification, serotyping and drug sensitivity test of Salmonella were carried out. Results A total of 240 positive specimens were collected from 2015-2017. The majority of the cases were mainly infants and young children, accounting for 42.92%. They were detected throughout the year, most in June-October. A total of 26 Salmonella serotypes were isolated, among which Salmonella typhimurium was the first, accounting for 45.83%, followed by Salmonella enteritis(19.58%) and Salmonella Stanley(15.83%). Salmonella had high resistance to ampicillin, ampicillin/sulbactam, compound novamoxin and cefuroxime, and the resistance rates to ceftriaxone, cefpime, ciprofloxacin and levofloxacin were 12.9%, 4.1%, 7.6% and 4.2%. No strains resistant to imipenem, meropenem, tegocycline and Amikacin were found. Conclusion The number of Salmonella detected in Jiaxing's feces is increasing year by year, especially in 2017. Salmonella typhimurium and Salmonella enteritis are the main serotypes. The drug sensitive test should be clinically practiced and combined to the therapy for rational use.
Objective To analyze the epidemiological characteristics, serological typing and drug resistance of Salmonella infections in fecal specimens collected from 2015-2017 in Jiaxing Municipal Hospital. Methods The fecal specimens from outpatients and hospitalized patients in Jiaxing Municipal Hospital were collected, and the isolation, identification, serotyping and drug sensitivity test of Salmonella were carried out. Results A total of 240 positive specimens were collected from 2015-2017. The majority of the cases were mainly infants and young children, accounting for 42.92%. They were detected throughout the year, most in June-October. A total of 26 Salmonella serotypes were isolated, among which Salmonella typhimurium was the first, accounting for 45.83%, followed by Salmonella enteritis(19.58%) and Salmonella Stanley(15.83%). Salmonella had high resistance to ampicillin, ampicillin/sulbactam, compound novamoxin and cefuroxime, and the resistance rates to ceftriaxone, cefpime, ciprofloxacin and levofloxacin were 12.9%, 4.1%, 7.6% and 4.2%. No strains resistant to imipenem, meropenem, tegocycline and Amikacin were found. Conclusion The number of Salmonella detected in Jiaxing's feces is increasing year by year, especially in 2017. Salmonella typhimurium and Salmonella enteritis are the main serotypes. The drug sensitive test should be clinically practiced and combined to the therapy for rational use.
引文
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[11] 赵嘉咏,张玉凯,谢志强,等.2011-2013年河南省肠炎沙门菌耐药与分子分型研究[J].中华预防医学杂志,2016,50(3):261-265.
[12] 顾宝柯,袁政安,金汇明,等.上海市沙门菌病流行特征分析[J].环境与职业医学,2008,25(3):245-247.
[13] 王素英.儿童感染性腹泻病原菌分布及耐药分析[J].医学理论与实践,2018,31(11):1678-1679.
[14] 周勇,张欣强,侯水平,等.广州市76 株沙门菌的血清型分布及耐药性分析[J].现代预防医学,2014,41(2):349-350,352.
[15] 张晶,张欣强,侯水平,等.广州市566 株腹泻病例沙门菌的血清型分布及耐药性分析[J].实用预防医学,2016,23(5):616 -617,623.
[16] 许云敏,杜艳,单斌,等.2005-2014年CHINET沙门菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(3):294-301.
[2] 龙冬玲,卓菲,黎建华,等.2012年深圳市罗湖区沙门菌菌型分布及耐药情况分析[J].中国卫生检验杂志,2014,24(2):285-287.
[3] Asgharpour F,Rajabnia R,Ferdosi SE,et al.Investigation of class I integron in Salmonella infants and its association with drug resistance[J].Jundishapur J Microbiol,2014,7(5):e10019.
[4] Clinical and Laboratory Standards Institute.M100-S24 Standards for antimicrobial usceptibility testing[S].CLSI,2014.
[5] 朱超,许学斌.沙门菌属血清型诊断[M].上海:同济大学出版社,2009:12-85.
[6] Walker CL,Aryee MJ,Boschi-Pinto C,et al.Estimating diarrhea mortality among young children in low and middle income countries[J].PLoS ONE,2012,7(1):e29151.
[7] Liu L,Oza S,Hogan D,et al.Global,regional,and national causes of child mortality in 2000-13,with projections to inform post-2015 priorities:An updated systematic analysis[J].Lancet,2015,385(9966):430-440.
[8] Ran L,Wu S,Gao Y,et al.Laboratory-based surveillance on typhodial Samonella infections in China[J].Foodborne Pathog Dis,2012,9(4):305-312.
[9] Bangtrakulnonth A,Pornreongwong S,Pulsrikan C,et al.Sitserovars from humans and other sources in Thailand,1993-2002[J].Emerg Infect Dis,2004,10(1):131-136.
[10] Galanis E,Lo Fo Wong DM,Patrik ME,et al.Web-based surveillance and global Salmonella distribution,2000-2002[J].Emerg Infect Dis,2006,12(3):381-388.
[11] 赵嘉咏,张玉凯,谢志强,等.2011-2013年河南省肠炎沙门菌耐药与分子分型研究[J].中华预防医学杂志,2016,50(3):261-265.
[12] 顾宝柯,袁政安,金汇明,等.上海市沙门菌病流行特征分析[J].环境与职业医学,2008,25(3):245-247.
[13] 王素英.儿童感染性腹泻病原菌分布及耐药分析[J].医学理论与实践,2018,31(11):1678-1679.
[14] 周勇,张欣强,侯水平,等.广州市76 株沙门菌的血清型分布及耐药性分析[J].现代预防医学,2014,41(2):349-350,352.
[15] 张晶,张欣强,侯水平,等.广州市566 株腹泻病例沙门菌的血清型分布及耐药性分析[J].实用预防医学,2016,23(5):616 -617,623.
[16] 许云敏,杜艳,单斌,等.2005-2014年CHINET沙门菌属细菌耐药性监测[J].中国感染与化疗杂志,2016,16(3):294-301.