149株志贺菌血清型变化与耐药性分析

The change of serotypes and the drug-resistance analysis of 149 Shigella

目的了解宁波地区志贺菌流行血清型及其耐药性,为防控细菌性痢疾提供依据。方法从腹泻病人标本中分离志贺菌;鉴定采用API生化条;血清分型采用玻片凝集法;药敏试验采用纸片扩散法。结果 149株志贺菌生化结果与ATCC标准株一致,分出B群（福氏）与D群（宋内）2个志贺菌血清群,其中B群分为10个亚型,又以c亚型菌最多,占57.89%（55/95）。149株菌对碳青霉烯类抗生素敏感,其中2株B群志贺菌抗生素全敏感,菌株耐药范围在2种～15种;耐抗生素类别为2类～9类。有141株为产超广谱β-内酰胺酶（ESBLs）菌。结论 B群志贺菌仍是宁波地区主要流行血清型,血清群的亚型已发生变迁,由F2a为主转变为Fc型菌,尤其是F4c;菌株多为ESBLs株,血清群间耐药性存在差异,B群更严重些,给治疗和预防带来一定的困难,应加强对防控措施的分析与研究。

Objective To study the serotypes and drug resistance of Shigella in Ningbo, so as to provide basis for the preven- tion and control of bacterial dysentery. Methods Shigella isolates were seperated from stool of patients with diarrhoea and i- dentified with API biochemistry strip ; serotype was confirmed by slide agglutination; Drug sensitivity test was performed by pa- per diffusion method. Results The characteristics of biochemistry of the 149 isolates was as same as the ATCC standard strains. All of the strains belong to Shigella group B and group D. Group B was divided into 10 subtypes, and the c subtype was the dominant, accounting for 57.89% （55/95）. 2 Shigella strains of group B were sensitive to all antibiotics; all of the strains were sensitive to carbapenems antibiotics, among which 2 isolates were resistant to al1 antibiotics with the strains resistant to 2 kinds -15 kinds; and the antibiotics were 2 kinds -9 kinds. And 141 isolates were ESBLs. Conclusion Most isolates of Shigella in Ningbo are B serotype, but the serotype of Group B has changed a lot, the epidemic strain has changed from F2a to Fc, especially F4c, most of strains were ESBLs. There were great differences among different serological groups, antimicrobial resistance of B group was more serious and increased the difficulty of treatment and prevention, so we should pay more attention to the monitoring and control.