广西富川县2000-2018年三起甲型副伤寒疫情菌株药敏试验

Antimicrobial resistance profiles of Salmonella paratyphi A isolates collected from 3 outbreaks in Fuchuan County of Guangxi,2000-2018

目的通过体外药物敏感性试验,了解广西富川县不同年度甲型副伤寒沙门菌对15种抗生素的敏感性及耐药变迁,为甲型副伤寒的疾病监测及防治策略提供实验数据。方法采用微量肉汤稀释法对广西富川县2000—2018年三起甲型副伤寒疫情分离的122株甲型副伤寒沙门菌进行药敏试验,分析不同最低抑菌浓度(MIC)检测结果。结果122株甲型副伤寒沙门菌对氨苄西林(AMP)、氨苄西林/舒巴坦(AMS)、复方新诺明(SXT)、头孢噻肟(CTX)、头孢他啶(CAZ)、庆大霉素(GEN)、阿奇霉素(AZI)、亚胺培南(IMI)和磺胺异恶唑(SUL)等9种药物敏感率达100.00%,四环素(TET)、氯霉素(CHL)和头孢西丁(CFX)敏感率也达90.00%以上,头孢唑啉(CFZ)敏感率仅为71.31%;对喹诺酮类药物主要表现为耐药和中介:环丙沙星(CIP)中介率为97.54%,萘啶酸(NAL)100.00%耐药。CTX、CAZ和GEN三种药物抑菌效果最佳,多重耐药现象不严重,未出现耐三代头孢药物菌株。结论第三代头孢药物可作为治疗甲型副伤寒的首选药物,慎用喹诺酮类药物;同时应加强常用抗生素耐药监测,结合本地实际情况,合理选用治疗甲型副伤寒的首选和常规药物。

Objective To describe and compare the profiles and evolution of antimicrobial resistance in Salmonella paratyphi A isolates collected from different years in Fuchuan County of Guangxi,through in vitro drug sensitivity tests,and we provide scientific evidence for formulating surveillance programs and control policies.MethodsA panel of 122 isolates of Salmonella paratyphi A were obtained from 3 outbreaks in Fuchuan County of Guangxi,2000-2018,and tested for minimum inhibitory concentrations(MIC)of antibiotics by the broth dilution method.ResultsThe 122 strains were all susceptible(100.00%)to ampicillin,ampicilli/sulbactam,cotrimoxazole,cefotaxime,ceftazidime,gentamicin,azithromycin,imipenem and sulfamethoxazole.Over 90.00%of them were susceptible to tetracycline,chloramphenicol and cefoxitin.Only 71.31%of them were susceptible to cefazolin.They manifests as drug-resistance and intermediate to quinolones:The intermediate rate of ciprofloxacin is 97.54%;nalidixic acid is entirely 100.00%resistance.Cefotaxim,ceftazidime and gentamicin show the best antibacterial effects,and the phenomenon of multidrug resistance is not severity.No strains resistant to third-generation cephalosporin were detected.ConclusionThird-generation cephalosporins should be accepted as a drug of first choice for Salmonella paratyphi A.And quinolones should be used with caution.Enhanced surveillance of antimicrobial resistance in Salmonella paratyphi A is essential to provide an evidence base for empirical treatment protocols.