2010-2016年北京市昌平区细菌性痢疾监测与耐药性

Surveillance and drug resistance of bacterial dysentery in Changping district of Beijing from 2010-2016

目的分析2010—2016年北京市昌平区引发病痢疾的志贺菌菌群分布及耐药特点,为细菌性痢疾临床治疗和制定防控措施提供科学依据。方法志贺菌的分离鉴定按照WS 287-2008《细菌性和阿米巴性痢疾诊断标准》进行。药敏试验参照美国临床和实验室标准化协会推荐的Kirby-Bauer法进行。结果 2 656份感染性腹泻患者粪便标本,检出志贺菌92株,总阳性率为3.46%;以D群宋内志贺菌为主(77.17%),其次为福氏2 a志贺菌(14.13%)。志贺菌对甲氧苄氨嘧啶完全耐药,对氨苄西林、萘啶酸、利福平、复方新诺明、四环素的耐药率分别为96.74%、97.83%、92.31%、90.22%、94.34%;94.57%的菌株对3种或3种以上抗生素耐药。结论 2010—2016年北京市昌平区志贺菌粪便检出率较低,主要流行菌群是宋内志贺菌;菌株耐药性呈上升趋势且多重耐药严重,提示临床用药应合理且具有针对性。

[Objective]To analyze the distribution and resistance characteristics of Shigella spp. in Changping District of Beijing from2010 to 2016,provide the scientific basis for clinical treatment and development of prevention and control measures of bacillary dysentery.[Methods]Shigella spp. Strains were isolated and identified according to the Diagnostic criteria for bacterial and amebic dysentery（WS 287-2008）. The drug sensitivity test was performed by Kirby-Bauer method recommended by Clinical and Laboratory Standards Institute.[Results]92 Shigella spp. strains were isolated from 2 656 stools samples with the positive rate was 3.46%,and group D Shigella sonnei accounted for the highest proportion（77.17%）,followed by Shigella flexneri 2 a（14.13%）. Shigella spp. strains were completely resistant to trimethoprim,and the resistance rate to ampicillin,nalidixic acid,rifampicin,compound sulfamethoxazole and tetracyclines was 96.74%,97.83%,92.31%,90.22% and 94.34%,respectively. 94.57% of Shigella spp. strains were resistant to 3 kinds of antibiotics or more.[Conclusion]The detection rate of Shigella spp. in fecal specimens is low in Changping district of Beijing from 2010-2016,and the main serotype is group D Shigella sonnei. The drug resistance of Shigella spp. strains shows an increasing trend,and multi-drug resistance is serious,which suggest that clinical medication should be reasonable and targeted.