浙江省海盐县2007年志贺菌、沙门菌菌型分布及耐药性分析

Analysis of distribution and drug resistance of Shigella and Salmonella in 2007 in Haiyan County

目的:了解海盐县志贺菌、沙门菌的菌型分布及耐药情况,为制定有效防治措施及指导临床合理用药提供科学依据。方法:按照GB16002-1995、GB17012-1997进行志贺菌、沙门菌检验,药敏试验采用K-B法,依据NCCLS(美国临床实验室标准委员会)规定判断结果。结果:2007年度检出的志贺菌中,B群占60.0%,D群占40.0%,A群和C群未检出,B群中以福氏2 a占优势,构成比为58.3%;检出的沙门菌中,A群占4.8%、B群占47.6%、C群占19.0%、D群占19.0%、E群占9.5%,各菌型中以B群的阿贡纳沙门菌和D群的肠炎沙门菌所占比例稍高,构成比均为19.0%。药敏试验显示志贺菌对四环素、复方新诺明、氨苄青霉素、萘啶酸的耐药率分别为95.0%、90.0%、95.0%、95.0%;沙门菌对四环素、复方新诺明、氨苄青霉素、萘啶酸的耐药率分别为28.6%、33.3%、19.0%、42.9%。结论:2007年海盐县志贺菌感染的优势菌型为福氏志贺菌2 a和宋内志贺菌,沙门菌没有明显的优势菌型。志贺菌和沙门菌的耐药情况相当严重,均对1种或多种抗生素耐药,志贺菌和沙门菌的耐药率无显著性差异,临床治疗宜选诺氟沙星、头孢噻肟、环丙沙星作为首选药物。

Objective：To find out the distribution and resistance of Shigella and Salmonella,and to provide the scientific basis formulation of effective prevention measure and clinical reasonable medication′s Instruction.Methods：Examing Shigella and Salmonella according to GB16002-1995、GB17012-1997,The medicine sensitive experiment uses the K-B law,and judgmentting result based on NCCLS.Results：Shigella detected in 2007,B crowd occupies the 60.0%,D crowd occupies the 40.0%,non in A and C,flexneri 2a get the advantage of B crowd,constituests a ratio of 58.3%;Salmonella detected,A crowd occupies the 4.8%,B crowd occupies the 47.6%,C crowd occupies the 19.0%,D crowd occupies the 19.0%,E crowd occupies the 9.5%,Salmonella serotype Agona and Enteritis serotype Agona accounts for the proportion to be slightly high,constituests a ratio of 19.0%.Drug sensitivity test showed Shigella to tetracycline,trimethoprim-sulfamethoxazole,ampicillin,and nalidixic acid resistance rates were 95.0%,90.0%,95.0%,95.0%;Shigella to Tetracyclin,trimethoprim-sulfamethoxazole,ampicillin,and nalidixic acid resistance rates were 28.6%、33.3%、19.0%、42.9%.Conclusion：Flexneri 2a and Shigella advantages other fungus,and no obvious advantage of Salmonella serotype Agona in HaiYan of 2007.Shigella and Salmonella serotype are very serious in drug resistance,bearing the medicine to 1 kind or many kinds of antibiotics,there was no significant difference between Shigella and Salmonella serotype in Shigella and Salmonella strains resistant.Clinical treatment should be selected norfloxacin,cefotaxime,ciprofloxacin as the preferred drug.