2016-2018年北京市顺义区成年人腹泻患者弯曲菌感染监测及病原学特征分析

Surveillance and analysis of etiology characteristics of Campylobacter infection in adult diarrhea patients in Shunyi district of Beijing,2016-2018

目的综合分析北京市顺义区3年期间基于过滤法从成年人腹泻患者分离的弯曲菌菌株的分型特征、耐药特点及分布特征,为我国弯曲菌感染的防控及风险评估提供基础数据。方法连续3年(2016—2018年)收集腹泻监测项目中的腹泻患者粪便标本,应用增强过滤法分离弯曲菌并进行菌种鉴定。应用多位点序列分型(MLST)和脉冲场凝胶电泳(PFGE)2种方法进行细菌分子分型。采用琼脂稀释法进行分离菌株的抗生素敏感性分析。结果2016—2018年,腹泻病例中弯曲菌的检出率分别为5.65%(17/301)、10.51%(39/371)和7.75%(29/374)。共分离弯曲菌87株,空肠弯曲菌占87.36%(76/87),结肠弯曲菌占12.64%(11/87)。76株空肠弯曲菌被分为55种序列分型(ST),11株结肠弯曲菌被分为9种ST型别。病例发病时间聚集且分离的弯曲菌为相同ST型别的情况出现了6次,通过PFGE分析,5次聚集病例分离的菌株均呈现单一PFGE带型。76株空肠弯曲菌的多重耐药率为55.26%(42/76),11株结肠弯曲菌的多重耐药率为90.91%(10/11)。结论弯曲菌是北京市顺义区成年人腹泻患者的重要病原菌,过滤法可作为弯曲菌分离培养的有效技术方法。从顺义区腹泻患者分离的结肠弯曲菌多重耐药严重,应引起公共卫生、临床等多部门的关注。

Objective To understand the molecular type,antibiotic susceptibility and distribution characteristics of Campylobacter isolated from adult diarrhea patients in Shunyi district of Beijing,and provide evidence for the prevention and control of Campylobacter infection as well as related risk evaluation.Methods Stool samples were collected from the adult diarrhea patients in a surveillance project in Shunyi from 2016 to 2018.Campylobacter strains was isolated using filtration method and the species identification was carried out using Biochemical test and Real-time PCR.Multi-locus sequence typing(MLST)and pulsed-field gel electrophoresis(PFGE)were used for molecular sub-typing.The antibiotic susceptibility test was performed with agar dilution method.Results The isolation rate of Campylobacter was 5.65%(17/301)in 2016,10.51%(39/371)in 2017 and7.75%(29/374)in 2018,respectively.A total of 87 strains of Campylobacter were isolated.Among them,87.36%(76/87)were C.jejuni strains and 12.64%(11/87)were C.coli strains.All the C.jejuni isolates belonged to 55 STs and 11 C.coli isolates belonged to 9 STs.PFGE was performed for the isolates with same ST and the close isolation time in 6 clusters,and 5 PFGE patterns were observed.The antibiotic susceptibility tests indicated that 55.26%(42/76)of the C.jejuni isolates and 90.91%(10/11)of the C.coli isolates exhibited resistance to three or more types of antibiotics.Conclusion Campylobacter is an important pathogen causing diarrhea in adults in Shunyi of Beijing.The filtration method is an effective method for isolation of Campylobacter from stool samples.Multi-drug resistance in C.coli is serious in Campylobacter from patient stool sample in Shunyi,to which more attention should be paid in public health and clinical practices.