深圳市龙华区其他感染性腹泻人群病原构成及耐药情况分析

Analysis of pathogenic composition and drug resistance of other infectious diarrhea populations in Longhua district of Shenzhen city

目的分析深圳市龙华区2017-2018年其他感染性腹泻的病原构成情况,并对病原的耐药情况进行摸查,为更好地预防和控制感染性腹泻在该地区的流行和规范用药提供依据。方法收集辖区哨点医院监测门诊腹泻病例(排除病毒性感染)的粪便标本,开展包括沙门菌、副溶血弧菌、致泻大肠、空肠弯曲菌等致病菌的检测,并对分离到的阳性菌株利用微量肉汤稀释法检测其对30种抗生素的耐药情况。结果检测样本1219份,阳性菌株169份,分离率为13.9%。其中,沙门菌128份,副溶血弧菌38份,其他细菌4份,包括1株EIEC,2株ETEC和1株嗜水气单胞菌。沙门菌的血清型以鼠伤寒沙门菌(45.3%)和肠炎沙门菌(11.7%)为主,副溶血弧菌的血清型以O3K6(76.3%)为主。绝大部分的沙门菌均发生多重耐药,且肠炎沙门菌出现对多粘菌素E耐药的情况,但斯坦利沙门菌只对链霉素耐药,副溶血弧菌仅对头孢唑林耐药。结论鼠伤寒沙门菌仍是龙华区细菌性腹泻的主要致病因子,且绝大多数已经出现多重耐药。副溶血弧菌引起的腹泻病例占比不高,且暂时未发生多重耐药的情况。

Objective In order to better prevent and control the prevalence of infectious diarrhea in this area and provide a basis for the standardized medication of diarrheal diseases,this programme is to analyze the pathogen composition of other infectious diarrhea and investigate the drug resistance of pathogens of Longhua district of Shenzhen city in the year of 2017 to 2018.Methods Fecal specimens of diarrhea cases(excluding viral infections)were collected from sentinel hospitals in the district,and detected for bacteria including Salmonella,Vibrio parahaemolyticus,diarrheogenic Escherichia coli and Campylobacter jejuni.MIC(minimal inhibitory concentration)was used to for susceptibility testing of all isolates.Results1219 samples had been tested and 169 positive strain had been isolated,with the separation rate of about 13.9%;among which,there were 128 Salmonella,38 Vibrio parahaemolyticus,1 EIEC,2 ETEC,and 1 isolated Aeromonashydrophila.The main serotype of Salmonella was typhimurium(45.3%)and enteritidis(11.7%),and the main serotype of Vibrio parahaemolyticus was O3K6(76.3%).Most of the Salmonella had multidrug resistance,and S.enteritidis resistance to polymyxin E,but Stanley only showed resistant to streptomycin.Vibrio parahaemolyticus only showed resistant to cefazolin and ampicillin.Conclusion Salmonella typhimurium was still the main cause of bacterial diarrhea in this region,and most of them had multidrug resistance.The proportion of diarrhea caused by Vibrio parahaemolyticus was not high,and there was no case of multidrug resistance.