上海市汤卜逊沙门菌流行特征分析

Epidemiological characteristics of Salmonella in Shanghai

目的研究上海市汤卜逊沙门菌暴发菌株的流行特征。方法调查和收集本地区在全球沙门菌监测(GSS)腹泻病例中分离的汤卜逊沙门菌散发和暴发病例的菌株,并经过系统表型鉴定和耐药性分析;脉冲凝胶电泳(PFGE)选用:XbaⅠ限制性内切酶,聚类软件选用BioNumerics4.0软件。结果2007年GSS分离汤卜逊沙门菌22株,在上海市非伤寒沙门菌型的确诊腹泻病例中排第3位,2007年黄浦区中心医院报告的8株集聚性腹泻病例分离的汤卜逊沙门菌对四环素、奥格门丁、氨苄西林、氯霉素、萘啶酸、磺胺异恶唑6种抗生素的耐药率均为100%,耐药谱明显高于其他散发病例菌株。20株腹泻株和2株食品被PFGE图谱分为15个带型,其中8株暴发菌株显示单一PFGE图谱,其余14个PFGE带型的菌株均仅有1株,分别来自汤卜逊沙门菌散发菌株(12株)和食品株(2株),菌株间的遗传相似度不高。结论2007年10月上海市黄浦区某工地发生的1起暴发病例是由在遗传上完全相同的汤卜逊沙门菌的多重耐药克隆株引起的,PFGE技术可以通过菌株之间的分子同源性关系来证实监测病例中存在的局部暴发病例。

To study the epidemiological characteristics of Salmonella thompson （S. thompson） outbreak isolates in Shanghai Huangpu district, the isolates from sporadic and outbreak diarrhea cases in WHO Global Salm-Surv （GSS） were collected and the phenotype confirmation and antibiotic resistance were identified. XbaⅠrestriction enzyme was used for PFGE and BioNumerics 4.0 software was used to conduct cluster analysis for results analyzing. Ranking third in clinical isolates of non-typhoidal Salmonella in Shanghai, 22 strains of S. thompson were separated from diarrhea patients in GSS 2007. The 8 S. thompson strains isolated from clustered cases of diarrhea in Huangpu district central hospital in 2007 were 100% resisted to Tetracycline, Augmentin, Ampicillin, Chloramphenicol, Nalidixic acid and Sulfafurazole, which indicated that the drug resistance of S. thompson strains was much higher than that of the sporadic strains. All the 20 strains from patients and 2 food-borne strains were divided into 15 subtypes by PFGE, and then 8 outbreak isolates strains from patients showed homologous graphics in PFGE. The other 12 sporadic strains and the 2 food-borne strains showed different subtypes in PFGE, and there was no genetic homology among them. Results demonstrated that the outbreak case in a construction site in Shanghai Huangpu district in 2007 was occurred by multiple-resistance clone strains of S. thompson, and indicated that PFGE could confirmed the local outbreak cases by molecular homology of strains.