2013—2016年泉州市感染性腹泻病例中沙门菌血清学鉴定及耐药性分析

Serotyping and drug-resistance analysis of Salmonella isolated from patients with infectious diarrhea in Quanzhou City from 2013 to 2016

目的分析2013—2016年泉州市食源性疾病监测哨点医院感染性腹泻病例中沙门菌的血清型及细菌耐药性,为临床合理用药提供参考。方法对送检的腹泻患者标本进行沙门菌增菌培养和分离鉴定,采用传统玻片凝集法和液相悬浮芯片技术(xMAP)法进行血清学分型,微量肉汤稀释法进行药敏试验,用Excel软件处理数据。结果 460份标本中有73份检出沙门菌,共分离到沙门菌73株(15.87%),检出11个血清型,主要血清型为圣保罗沙门菌(42.47%,31/73)、阿雷查瓦莱塔沙门菌(16.44%,12/73)和布利丹沙门菌(12.33%,9/73)。玻片凝集法检出61株(83.56%,61/73)完整血清型,12株不确定血清型,液相悬浮芯片技术法确定了71株(97.26%,71/73)完整血清型,仅2株未确定。药敏试验显示沙门菌对头孢唑林、头孢替坦和妥布霉素3种抗生素的耐药率高达100.00%(73/73),其次为阿米卡星(95.89%,70/73)和庆大霉素(84.93%,62/73),对厄他培南、环丙沙星、左氧氟沙星、呋喃妥英这4种抗生素不具有耐药性。结论泉州市感染性腹泻病例中沙门菌已对多种抗生素产生较高的耐药性,临床上应及时了解沙门菌的血清型分布及其耐药情况,合理选择抗菌药物。

Objective To analyze the serotype and drug-resistance of Salmonella isolated from patients with infectious diarrhea in the sentinel hospital of Quanzhou City from 2013 to 2016, and provide references for the rational clinical medication. Methods Traditional glass agglutination and liquid suspension array were used for the serotyping of Salmonella isolated from patients with infectious diarrhea,and micro broth dilution method was used for the analysis of drug-resistance. Data was analyzed with Excel software. Results A total of 73 Salmonella strains were isolated from460 specimens and divided into 11 serotypes,among which the prevalent serotypes were Salmonella saintpaul（ 42. 47%,31/73）,Salmonella arechavaleta（ 16. 44%,12/73） and Salmonella blegdan（ 12. 33%,9/73）. For the traditional glass agglutination assay,61 serotypes（ 83. 56%,61/73） were identified,with 12 undetermined,while for the liquid suspension array,71 serotypes（ 97. 26%,71/73） were identified,with only two undetermined. Analysis of the drugresistance showed that all the isolated strains were resistant to cefazolin,cefotetan and tobramycin,95. 89%（ 70/73） to the amikacin,and 84. 93%（ 62/73） to the gentamicin. In contrast,all the strains were sensitive to ertapenem,ciprofloxacin,levofloxacin and nitrofurantoin. Conclusion Clinical isolates of Salmonella from patients with infectious diarrhea in Quanzhou City from 2013 to 2016 were resistant to multiple antibiotics. Early identification of the serotypes and drug-resistance would contribute to the rational clinical medication