国家监测点2005年志贺菌菌型分布和药敏结果分析

Analysis on the status of Shigella spp antimicrobial resistance through data from the National Shigellosis Surveillance System in China, in 2005

目的分析2005年国家监测点志贺菌菌型分布和药敏结果。方法用WHONET 5．4软件对国家监测点的志贺菌药敏试验结果（K-B纸片扩散法）进行统计分析。结果①福氏志贺菌最为常见,占75．5%;其次为宋内志贺菌,占24．4%。②志贺菌分离株对四环素和氨苄西林的耐药率均超过90．0%;对头孢噻肟的耐药率最低,为6．1%。③志贺菌分离株的多重耐药情况较为严重,五重及其以上的多重耐药率占54．9%。④不同省份志贺菌优势菌型和耐药谱有差异。结论志贺菌的耐药现状不容乐观,三代头孢菌素仍是治疗志贺菌感染的较好选择。志贺菌优势菌型和药敏特征需要连续监测,才能及时了解病原特点。

Objective The Ministry of Public Health released the National Surveillance project on Shigellosis in August, 2005. This study was to reveal the antimicrobial resistance status of Shigella isolates through the National Shigellosis Surveillance System in 2005 in China, so as to provide evidence for the development of surveillance, prevention and cure of Shigellosis. Methods All the lab assistants received training from Chinese Center for Disease Control and Prevention. The project prescribed the uniform experimentation, quality control method, reagent, etc. Disc diffusion test（K-B） was carried out, following the CLSI methods. Data were analyzed by WHONET 5.4 software. Results （1） 3 serotypes were identified and S. flexneri was common that accounted for 75.5 % of all Shigella isolates followed by 24.4% of S. sonnei, but only 1 strain of S. dysenteriae was separated. （2） The resistant rates to tetracycline and ampicillin in Shigella spp were quite high, as over 90.0 %. However, the resistant rate to Cefotaxime was the lowest, only 6.1%. The resistant rates were different between serotypes with the resistant rates of S. flexneri to ampicillin, ampicillin/clavulanate and ciprofloxacin were higher than those of S. sonnei （ P 〈 0. 001 ）. （3） The multiple-antibiotic-resistance status in Shigella spp was quite serious and the resistant rate to five and more antimicrobials was 54.9 %. The most common resistant patterns were seen on ampicillin, nalidixin, tetracycline and Sulfamethoxazole. （4） There were some differences in subtypes and antimicrobial resistance among different provinces. Conclusion Cefotaxime seemed the best in curing Shigellosis at the clinic level. Programs regarding monitoring subtypes and antimicrobial resistance of Shigella should be in a continuous manner so as to understand the pathogens timely and to control the disease pertinently.