济南市2003-2007年志贺菌菌型分析

Analysis of the Bacterial Types and the Drug Resistance of the Shigellas in Jinan During the Years from 2003 to 2007

目的了解济南市2003-2007年志贺菌菌型分布、常用抗生素耐药率及超广谱p内酰胺酶（ESBLs）情况，为临床抗生素的合理使用提供依据。方法采用微生物分析仪和血清凝集试验确定菌型，药敏试验采用K—B法，ESBLs检测采用纸片扩散初筛和确证实验。结果福氏志贺氏为优势菌，其中2005年之前均为福氏2a型，之后增加了福氏2b型、福氏4c型、痢疾志贺菌及宋内氏志贺茼，但仍以福氏2a型为主。对青霉素类、复方新诺明和氯霉素等常用抗生素耐药率较高，并检出2株产ESBLs的志贺菌。结论该地区志贺菌感染以福氏志贺菌为主，福氏2a型为优势血清型，有逐渐多样化趋势，对常用抗生素多耐药，要加强对ESBLs的检测。

Objective To know the bacterial types, the antibiotic susceptibility and the extended-spectrum β-lactamases （ESBLs） of the Shigellas in Jinan city during the years from 2003 to 2007,to direct the clinical usage of the antibiotics and the epidemiological survey. Methods The strains were identified by serum agglutination test. The antibiotic susceptibility was determined by Kirby-Bauer test. ESBLs were detected by disc screening test and disc confirmatory test. Results The identification of strains showed that it was Fu type before 2005 to,there were F2b,F4a,S. sonnei and S. dysenteriae types besides F2a after 2005. The drug resistance rates of CB,AP,SMZ and C were higher,and there were 2 strains that produced ESBLs. Conclusion The F2a of diarrheagenic Shigella is popular in Jinan according to the study. Such antibiotics as Cephalosporin,Carbopenems,Aminoglucosides and Nitrofurantoin could be first used in the clinical medication. The investigation of the ESBLs should be reinforced in the routine work.