2009--2010年河南省志贺菌病原学监测分析

Analysis of etiological surveillance results of Shigella spp between 2009 and 2010 in Henan province

目的了解河南省2009--2010年细菌性痢疾的病原学特征。方法以河南省2009—2010年分离到的482株志贺菌为研究对象，采用血清分型、药物敏感试验及PCR检测毒力基因方法，对其进行病原学检测，以了解志贺菌菌型分布、药物敏感性及毒力基因携带情况．结果482株志贺菌经形态学与生化鉴定均为志贺菌，共分为两群、13种血清型，福氏志贺菌（B群）占72．0％（347／482），宋内志贺菌（D群）占28．0％（135／482），其中以F2a血清型为主的福氏志贺菌检出率2009年为43．4％（106／245），2010年下降至33．8％（80／237），宋内志贺菌检出率2009年为13．1％（32／245），2010年上升至43．5％（103／237）。进行药敏试验的185株志旋菌株对氦苄西林、甲氧苄嘧啶、四环素、链霉素、萘啶酸等抗生素耐药率两年均大于98％。进行毒力因子检测的182株志贺菌中，携带志贺菌肠毒素（set1B）、志贺菌肠毒素2（set2）、侵袭性质粒H抗原（ipaH）和侵袭相关毒力基因（ial）的菌株洲占67．6％（123／182），携带其中3种毒力因子的菌株洲占24．2％（44／182）。结论河南省近年来志贺菌流行菌型正在发生改变，对目前常用的抗菌药物表现较高的耐药性，分离菌株中普遍携带有毒力因子。

Objective To explore the etiologic characteristics of bacillary dysentery found in Henan province, between year 2009 and 2010. Methods In nrder to explore the distribution of bacterial types, drug susceptibility and the virulence gene can＇ier situation, 482 strains of Shigella isolated in Henan province between 2009 and 2010 were pathogen-detected and analyzed by serotype screening,anti-microbial sensitivity test and PCR methods. Results The 482 isolated strains were confirmed to be Shigella by both morphological and biochemical tests. The Shigella strains were divided into 13 serotypes in 2 groups, namely Shigella flexneri （ B group） accounting for 72. 0% （347/482） and Shigella sonnet （ D group）, accounting for 28.0% （135/482）. Tire detection rate of serotype F2a, as the dominant type of Shigellaflexneri, decreased from 43.4% （106/245） in 2009 to 33.8% （80/237） in 2010; while the detection rate of Shigella sonnet increased from 13. 1% （ 32/245 ） to 43.5% （ 103/237 ） in the same period. The results of microbial sensitivily tests carried out in year＇ 2009 and 2010, both showed that over 98% of the 185 studied strains were resistant to ampicillin （AMP） , trimethoprim-pyrimidine （TMP） , tetracycline （TE） , streptomycin （S） and nalidixic acid （NA）. 182 strains were recruited in the virulence factors detection, 67.6% （123/182） of which carried Shigella enterntoxin 1B （setlB）, Shigella enterotoxin 2 （set2）, invasive plasmid antigen H （ipaH） or invasion-related virulence factors （ial） and 24.2% （44/182） of which carried 3 virulence factors mentioned above. Conclusion The prevalent serotypes of Shigella in Henan province have changed in recent years. The isolated strains showed high resistance to common antibacterial drugs and generally carried virulence factors.