2017年宁波市食源性疾病主动监测特定病原学和耐药特征分析

Analysis of specific bacterial etiology and drug resistance for active monitoring of foodborne diseases in Ningbo in 2017

目的了解宁波市食源性疾病主动监测中沙门菌、志贺菌、副溶血性弧菌和致泻性大肠埃希菌的感染情况、血清型别和耐药特征。方法对哨点分离的菌株进行复核、血清分型、PCR确认分型和药敏试验。结果 2017年共检测粪便和肛拭子标本3 467份,阳性率为9. 17%,副溶血性弧菌检出率最高(4. 87%),其次是沙门菌(4. 00%);未检出志贺菌。副溶血性弧菌分为18种血清型,以O3∶K6(28. 99%)、O4∶K44(22. 49%)和O4∶KUT(21. 30%)为主;对大部分抗生素敏感,对头孢唑林的耐药率高达98. 82%;检出14株耐药株。沙门菌可分为30种血清型,以鼠伤寒、肠炎和伦敦常见;对头孢唑林敏感率略低,对常用头孢类药物敏感;检出多株多重耐药株。致泻性大肠埃希菌以肠黏附性大肠埃希菌(EAEC)为主;对常用药物耐药率较高,对亚胺培南和复合制剂敏感。结论 2017年宁波地区副溶血性弧菌检出率最高,以O3:K6血清型占优势;致泻性大肠埃希菌以EAEC为主。副溶血性弧菌和沙门菌对除头孢唑林以外的其他常用头孢类药物敏感;致泻性大肠埃希菌对常用药物耐药率较高。

Objective To study the infection status,serotypes and drug resistance of Salmonella( S.),Shigella,Vibrio( V.) parahemolyticus and diarrheagenic Escherichia( E.) coli collected from foodborne diseases surveillance in Ningbo. Methods Bacteria identification,serotype,PCR confirmation typing and drug sensitivity tests were performed on isolates from sentinel hospitals.Results A total of 3 467 stool samples or anal swabs were detected during 2017. The overall positive rate was 9. 17% and the positive rate of V. parahemolyticus was the highest( 4. 87%),followed by that of Salmonella( 4. 00%). No Shigella strain was isolated. V. parahemolyticus was divided into 18 serotypes. O3 ∶K6( 28. 99%) was the most epidemic serotype,followed by O4∶K44( 22. 49%) and O4∶KUT( 21. 30%). V. parahemolyticus was sensitive to most antibiotics. The drug resistance rate of cefazolin was as high as 98. 82%. 14 drug-resistant strains were detected. Salmonella can be divided into 30 serotypes. The most common serotype was S. typhoid,followed by S. enteritis and S. london. In addition to a slightly lower sensitivity to cefazolin,it is sensitive to commonly used cephalosporins. Multiple resistant strains were detected. Intestinal adhesion E. coli( EAEC) was the predominant of diarrheagenic E. coli. The isolated strains had a high resistance rate to basic drugs,and were sensitive to imipenem and compound antibiotics. Conclusion In 2017,the detection rate of V. parahaemolyticus was the highest in Ningbo,with O3∶K6 serotype dominant. In diarrheagenic E. coli,EAEC was the dominant. V. parahaemolyticus and Salmonella are sensitive to other cephalosporins other than cefazolin. The resistance rate of diarrheagenic E. coli to basic drugs was high.