昌平区近3年细菌性痢疾病原学监测结果分析

Analysis of pathogenic surveillance results of bacterial dysentery in Changping district during the last 3 years

目的了解和掌握近3年细菌性痢疾病原体菌群分布动态及耐药性特点,为指导基层医疗机构合理用药提供科学依据。方法依据《全国细菌性痢疾监测方案》进行样品采集、检验和分析。结果昌平区近3年志贺菌以D群宋内志贺菌为主,占54.65%;其次为B群福氏志贺菌占38.37%;A群痢疾志贺菌占5.81%;C群鲍氏志贺菌占1.16%。其中B群福氏志贺菌血清亚型以F4为主,占45.45%,其次为x亚型占24.24%,F2亚型占15.15%,F1亚型占12.12%,y亚型占3.03%;福氏志贺菌对头孢唑啉、头孢噻肟、庆大霉素、左氧氟沙星等药物敏感,宋内志贺菌对左氧氟沙星敏感率最高为97.87%,其次为氧氟沙星、环丙沙星、诺氟沙星、阿莫西林、头孢唑啉、头孢噻肟;痢疾志贺菌对氨苄西林、头孢唑啉、萘啶酸、四环素、头孢噻吩5种药物耐药。结论 D群宋内志贺菌取代了以往的B群福氏志贺菌;B群福氏志贺菌F4亚型取代了以往的福氏F2a亚型,成为新的流行血清型;基层医疗机构应根据本地区药敏结果合理选择抗菌药物。

Objective To investigate and master the dynamic distribution and drug resistance characteristics,in the nearly 3years,of bacillary dysentery pathogen flora,in order to provide a scientific basis for the rational use of drugs in the guidance of grassroots medical institutions. Methods In accordance with the National Monitoring Bacterial Dysentery Plan for the collection,inspection and analysis of the sample. Results In Changping district and in the nearly 3 years,Shigella was mainly the D group Shigella sonnei,accounting for 54. 65%; followed by the B group of Shigella flexneri,accounted for 38. 37%; group A of Shigella dysenteriae,accounted for 5. 81%; C group of Shigella boydii,accounted for 1. 16%,of which group B of Shigella flexneri was mainly serotype F4,accounted for 45. 45%,followed by x subtype F2 subtype,accounted for 24. 24%,F2 subtype accounted for 15. 15%,F1 subtype accounted for 12. 12%,y subtype accounted for 3. 03%; Shigella flexneri was sensitive to cefazolin,cefotaxime, gentamicin, levofloxacin, Shigella sonnei was susceptible to levofloxacin with the highest rate of97. 87%,secondly,to ofloxacin,norfloxacin,ciprofloxacin,amoxicillin,cefazolin,cefotaxime; Shigella dysenteriae were resistant to 5 agents,ampicillin,cefazolin,nalidixic acid,tetracycline,and cephalothin. Conclusion D group of Shigella sonnei was replaced with B group in the Shigella flexneri; Subtype B group＇s Shigella flexneri F4 replaced F2 a subtype＇s,and became the new popular serotype; Grassroots medical institutions should choose antimicrobial agents according to the result of drug susceptibility in this region.