天津地区20年度志贺菌耐药性分析及ERIC分型研究

Antimicrobial resistance in Shigella spp and based on ERIC typing character crossing two decades in Tianjin

目的比较天津市20余年跨年度(1983年与2009年)两批分离的细菌性痢疾致病菌志贺菌优势菌型分布变化及耐药状况,并通过分子分型研究其流行病学溯源。方法分离鉴定93株志贺菌血清型,并针对15种抗生素研究其耐药特点。使用肠杆菌科基因间的的重复序列PCR(enterobacterial repetitive intergenic consensus ERIC-PCR)对志贺菌进行同源性分析。结果 2009年志贺菌D群分离率较1983年明显增加。药敏结果示1983年所有福氏志贺菌对除庆大霉素以外的传统抗生素四环素、链霉素、氯霉素、的耐药率较高,在76.5%～100.0%,对阿米卡星、庆大霉素、三、四代头孢、喹诺酮类及亚胺培南100.0%敏感。2009年药敏示志贺菌对四环素、链霉素、氯霉素的耐药率降低。而对除外的青霉素类,阿米卡星、庆大霉素,三、四代头孢及喹诺酮类药物耐药性均有不同程度增加。结论天津市志贺菌优势血清型已发生变迁。临床上大量使用抗生素导致福氏志贺菌较宋内志贺菌对多种抗生素耐药性增加明显。宋内志贺菌对四代头孢及喹诺酮类药物100.0%敏感。ERIC-PCR是一种快捷有效的基因分型法,可为同源性分析和爆发流行时追根溯源建立简便可行的方法。

Objective To compare the change about superiority serotype of Shigella causing dysentery and antimicrobial resistance more than twenty years（between 1983 and 2009） in Tianjin.Molecular typing method was adopted to study the epidemiology character.Methods Serotypes of 93 Shigella spp were identified.And 15 antimicrobial agents were tested for drug resistance.Enterobacterial repetitive intergenic consensus sequences-based PCR（ERIC-PCR） was used to study the homology of the genomic DNA.Results D group isolated rate of Shigella in 2009 increased obviously.In 1983,the resistance rates of all the Shigella flexneri to tetracycline,streptomycin,and chloramphenicol varied from 76.5% to 100.0%,but they were all sensitive to gentamicin,amikacin,third,four generation cephalosporins,quinolones and imipenem.But in 2009,the resistance rates of Shigella flexneri to gentamicin,amikacin,third,four generation cephalosporins and quinolones resistance increased.Conclusion Superiority serotypes of Shigella have changed.Increased drug resistance of Shigella flexneri is higher than Shigella sonnei because a great variety of antibiotics has been applied.Shigella sonnei was 100.0% susceptible to four generation cephalosporins and quinolones.ERIC-PCR was a valid and rapid genotyping method for homology analyzing and tracing the source of infection during epidemic outbreak.