2013-2015年河南省甲型副伤寒沙门菌分子分型与耐药研究

Molecular typing of Salmonella Paratyphi A isolated in Henan Province from 2013 to 2015 and the characteristics of its drug resistance

目的了解河南省人群感染甲型副伤寒沙门菌的耐药状况与脉冲场凝胶电泳（PFGE）分子型别特征,为甲型副伤寒的疾病监测及其防治策略提供基线数据。方法对2013-2015年河南省监测哨点医院分离的67株甲型副伤寒沙门菌采用K-B纸片法检测对13种抗生素敏感性,并进行PFGE分子分型分析。结果 67株甲型副伤寒沙门菌对8类13种抗生素均有不同程度的耐药,有63株为多重耐药菌株（占94.0%）,其中耐2~3种9株（占13.4%）,耐5~8种42株（占62.7%）,耐9~10种8株（占11.9%）,耐11~12种4株（占5.9%）。菌株对头孢类、喹诺酮类等5类抗生素耐药率总体呈逐年上升趋势。经XbaI酶切与PFGE电泳分析,67株甲型副伤寒沙门菌共获得10种带型,每种带型包含菌株数1~48株不等,相似度94.31%~100%。结论河南省甲型副伤寒沙门菌分离株耐药状况严重,PFGE带型呈多样性且具有一定的优势带型特点,同一PFGE菌株的耐药谱较为接近。

Objective To investigate the antimicrobial resistance and pulsed field gel electrophoresis（PFGE）patterns of Salmonella entericaserovar Paratyphi A strains in Henan Province isolated from sentinel hospitals between 2013-2015 in order to provide a baseline and reference data for early warning,investigation,surveillance,and formulation of a strategy for rational antibiotic use. Methods Molecular characteristics of 67 S.Paratyphi A strains isolated from sentinel hospitals were determined with PFGE in accordance with the methods described by the international infectious disease surveillance network PulseNet.The drug susceptibility of Salmonella was tested using the K-B method as described by the US Clinical and Laboratory Standards Institute（CLSI）. Results The 67 strains of S.Paratyphi A had different levels of resistance to 13antibiotics;63strains were multidrug-resistant strains（94.0%）,9isolates were resistant to 2-3antibiotics（13.4%）,42 isolates were resistant to 5-8antibiotics（62.7%）,8isolates were resistant to 9-10antibiotics（11.9%）,and 4isolates were resistant to 11-12antibiotics（5.9%）.The rate of resistance to cephalosporins,quinolones,and 3other antibiotics tended to increase.The 67 strains of S.Paratyphi A produced 10 molecular patterns when digested with XbaI and examined with PFGE.Between 1and 48 strains produced each pattern with a similarity ranging from 94.31%-100%. Conclusion Clinical isolates of S.Paratyphi A from Henan Province have serious drug resistance.PFGE patterns indicated diversity and certain predominant characteristics.The PFGE pattern of a strain was closely associated with its drug resistance profile.