河南省德尔卑沙门菌和阿贡纳沙门菌耐药与分子分型研究

Characteristics of drug resistance and molecular typing research for Salmonelladerby and Salmonella agonaisolated in Henan Province

目的分析2009-2012年河南省德尔卑沙门菌和阿贡纳沙门菌临床分离株的耐药状况与脉冲场凝胶电泳（PFGE）带型,为以德尔卑沙门菌、阿贡纳沙门菌等非伤寒沙门菌为代表的食源性疾病暴发预警、调查、溯源及公共卫生意义上的抗生素使用策略提供基线与参考数据。方法根据国际PulseNet细菌性传染病分子分型监测网络公布的非伤寒沙门菌PFGE分型技术与美国临床与实验室标准协会（CLSI）沙门菌K-B法药敏测试方案,对2009-2012年分离自河南省5个哨点医院的德尔卑沙门菌与阿贡纳沙门菌进行13种抗生素的药敏测试及PFGE脉冲场凝胶电泳分子分型分析。结果 76株德尔卑沙门菌与84株阿贡纳沙门菌对8类13种抗生素均有不同程度的耐药,耐3种以上抗生素的有141株（88.13%）。其中耐3～5种抗生素38株（占23.75%）,耐6～8种抗生素66株（占41.25%）,耐9～10种抗生素22株（占13.75%）,耐11～12种抗生素15株（占9.38%）。84株阿贡纳沙门菌经XbaⅠ酶切与脉冲场凝胶电泳后获得36种带型,每种带型包含1～9个菌株,相似度50.77%～100%,以AGN27与AGN33为主要优势带型。76株德尔卑沙门菌经XbaⅠ酶切与脉冲场凝胶电泳后获得41种带型,每种带型包含菌株数1～12个菌株,相似度43.25%～100%,以DER17与DER34为主要优势带型。结论河南省临床分离株德尔卑沙门菌和阿贡纳沙门菌耐药状况较严重,PFGE带型呈现出多样性的同时又具有较显著的优势带型特点,部分带型与其对应的耐药谱具有一定的关联性及相同的聚集性。

Objective To investigate the antimicrobial resistance and pulsed field gel electrophoresis （PFGE） patterns of S. derby and S. agona strains in Henan Province isolates from five sentinel hospitals in 2009-2012, provide baseline and reference data for the early warning, investigation, traceability as well as formulating reasonable antibiotic use strategy. Methods According to molecular typing and Salmonella K-B drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA clinical and Laboratory Standards Institute （CLSI） ,we analyzed drug sensitivity and PFGE molecule characteristics of 160 S. derby and S. agona strains isolates from five sentinel hospitals. Results In 76 strains of Salmonella derby, 13 strains were isolated from food （pork, beef, poultry~ and aquatic products）, 15 strains were isolated from animal feces （pig manure）, 29 strains were isolated from patients. In 84 strains of Salmonella agona, 9 strains were isolated from food （pig beef, poultry）, 3 strains were isolated from animal feces （chicken）, and 72 strains were isolated from patients. Two serotypes of Salmonella strains were isolated mainly between 5-10 month annually, with the typical summer season characteristics. 160 strains of S. derby and S. agona have different levels of resistance to 8 types（13 kinds） of antibiotics, 141 isolates were resistant to more than 3 kinds antibiotics（88.13%）. 38 isolates were resistant to 3-5 kinds of antibiotics （23.75%）, 66 isolates were resistant to 6-8 kinds of antibiotics （41.25%）, 22 isolates were resistant to 9-10 kinds of antibiotics（13.75%）. 15 isolates were resistant to 11-12 kinds of antibiotics（9.38%）. 76 strains of Salmonella S. derby were divided 41 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis, each pattern contains 1-12 strains with similarity ranged from 43.25%-100%. DER17 and DER34 were the main PFGE belt type. 84 strains of S. agona were divided 36 molecular patterns by digestion with Xba I and pulsed field gel electrophoresis. Each pattern contains 1-9 strains with similarity ranged from 50.77%-100% AGN27 and AGN33 were the main PFGE belt type. Conclusion The status of drug re- sistance of clinical isolates of S. derby and S. agona in Henan province was rather serious, PFGE patterns showed diversity and advantages characteristics. The PFGE patterns of partial strains and its corresponding antidrug spectrum have certain relevance and the same aggregation relationship.