2013年东莞市沙门菌感染流行病学特征及耐药性分析

Analysis of the epidemiological characteristics and drug resistance of Salmonella infection in Dongguan in 2013

目的分析2013年东莞市感染性腹泻患者中沙门菌感染的流行病学特征和耐药情况,为本地区的沙门菌感染临床合理用药提供依据。方法收集东莞市四家定点医院的感染性腹泻患者的粪便或直肠拭子培养,进行沙门菌的生化鉴定及血清学分型,同时采用Kirby-Bauer法进行药物敏感性试验,并统计相关流行病学资料。结果共收集了9 847份培养样本,分离出沙门菌329株,11个群49个血清型,其中肠炎沙门菌、鼠伤寒沙门菌、斯坦利沙门菌检出率最高,分别占26.4%、21.9%、11.9%;男、女检出比为1.72∶1,<12岁占75.7%,>12岁占24.3%。药物敏感试验结果显示,所分析的菌株对头孢他啶、头孢吡肟、头孢曲松的敏感性较高,分别为89.7%、88.2%、83.6%。对氨苄西林、链霉素、四环素的耐药率均在60%以上。结论东莞市腹泻患者中沙门菌感染以<12岁儿童为主,男性高发,病原菌优势血清型为肠炎沙门菌、鼠伤寒沙门菌,以第三、四代头孢菌素类抗生素较为敏感;故临床治疗时应根据药敏结果,合理使用抗生素。

ObjectiveTo analyze the epidemiological characteristics and drug resistance of Salmonella infection among sufferers in Dongguan in 2013, provide reliable evidence for clinical treatment. MethodsFecal specimens or rectum swabs were collected from sufferers with infectious diarrhea via four gastroenterology surveillance system in Dongguan cultured and subjected to biochemical testing and serotyping. An antimicrobial resistance test was also performed on isolated strains via the Kirby-Bauer method.ResultsCollected 9 847 strains, 329 salmonella strains were isolated. The strains represented 11 groups 49serotypes. Of the strains, 26.4% wereS.enteritidis, 21.9% wereS.typhimurium, 11.9% were S.stanley. The male-to-female ratio was 1.72∶1,children under the age of 12 years were 75.7% while 24.3% were 12 years old and older. Susceptibility results for the salmone strains indicated that susceptibility to Ceftazidime was 89.7%, susceptibility to Cefepime was 88.2%, susceptibility to Ceftriaxome was 83.6%, resistant to Ampicillin, Straptomycin and Tetracycline wereup 60%.ConclusionsMost sufferers with Salmonella infection in Dongguan were under the age of 12 years, and male had a high incidence of infection. The predominant pathogens wereS.enteritidisandS.typhimurium. Analysis of antibiotic resistance revealed that strains were highly susceptible to third/fourth-generation cephalosporins. So clinical use of antibiotics should be based on the drug sensitive test.