武汉市2006～2007年细菌性痢疾监测病原菌分析

Analysis of monitoring pathogenic bacterium of bacillary dysentery between 2006 and 2007 in Wuhan

目的：了解武汉市细菌性痢疾的病原菌志贺菌生化血清学分型和相关毒力基因分布及其药物敏感状况,为细菌性痢疾临床治疗和预防控制提供依据。方法：按《全国细菌性痢疾监测方案》提供的方法进行病原菌分离鉴定和药敏试验;利用PCR方法采用8对引物set1A、set1B、shet2A、shet2B、ial、ipaH、stx1与virA分别对志贺菌分离株毒力相关基因进行检测。结果：临床初步诊断为细菌性痢疾标本539份,经生化与血清学复核鉴定为志贺菌17株,检出率为3.2%。其中宋内氏菌15株,福氏志贺菌2株。经PCR方法检测ipaH阳性27份,检出率为5.0%,且17株分离培养阳性的志贺菌均100%ipaH-PCR阳性,宋内氏与福氏志贺菌分离株毒素基因分布有所不同。药敏试验显示17株志贺菌敏感药物为阿莫西林Amoxicillin（100%）、环丙沙星Ciprofloxacin（100%）,全部耐药的有利福平Rifampicin（100%）,且有5株菌出现了3种或3种以上的多重耐药现象。结论：2006-2007年武汉市细菌性痢疾病原菌以宋内氏志贺菌为主,其次为福氏志贺菌;ipaH-PCR比传统分离培养的阳性率高;并对目前常用的抗生素表现一定的耐药性,应引起重视。

Objective：Understanding the biochemistry serology typing,distribution of related virulence genes and drug sensitive state of Shigella,which is the pathogenic bacterium of bacillary dysentery to provide evidence for clinical treat and Control and Prevention in bacillary dysentery.Methods：According to monitoring of pathogenic bacterium of bacillary dysentery in China,we do the separation and identification of pathogenic and bacterium drug sensitive test.And polymerase chain reaction（PCR） were also used to detect related virulence genes of Shigella,in which eight primers such as set1A,set1B,shet2A,shet2B,ial,ipaH,stx1 and virA were used.Results：In 539 specimens of bacillary dysentery by clinical initial diagnosis,17were identified by biochemistry and serology.The rate was 3.2%.15 were of S.sonnei,2 of S.flexneri.ipaH of positive in 27 by PCR,and the rate is 5.0%.the 17 positive straits by separation ＆ identification were all ipaH positive.There was some difference in the distribution of related virulence genes between S.flexneri and S.sonnei.All the 17straits were sensitive to amoxicillin and ciprofloxacin.while allwere drug resistance to rifampicin.Five of which were drug resistant to three or more than three kinds of antibiotics.Conclution：Most of the pathogenic bacterium in bacillary dysentery is S.sonnei,secondary is S.flexneri in wuhan between 2006 to 2007.The positive rate is is higher by ipaH-PCR than traditional separation and identification.More importantly,many are drug resistant to the commonly used antibiotics at present.