2010-2019年北京市副溶血性弧菌临床分离株血清型和耐药性分析

Serotype distribution and drug resistance analysis on clinical isolates of Vibrio parahaemolyticus in Beijing,2010-2019

目的了解副溶血性弧菌(vibrio parahaemolyticus,VP)感染在北京市的流行趋势、血清群分布和耐药情况,为预防和治疗副溶血性弧菌感染性腹泻提供理论依据。方法回顾性分析北京市2010-2019年肠道门诊腹泻患者中分离的副溶血性弧菌;采用玻片凝集法进行血清型检测;纸片扩散法(KB)或最小抑菌浓度(MIC)法进行抗生素的药敏试验。结果2010-2019年从46249份临床样本中共检出1853株副溶血性弧菌,检出率4.0%。20~39岁青壮年感染率最高,为6.1%。共分出9个O血清群,59种血清型。其中O3∶K6血清型共检出1254株(67.7%),是引起腹泻的最主要血清型。前2~10位血清型依次为O4∶KUT、O4∶K8、O1∶KUT、O2∶K3、O4∶K9、O3∶KUT、O10∶K60、O1∶K36和O4∶K6。随着年代的推移,会出现血清型的交替变迁及新血清型的不断涌现。菌株对氨苄西林和多粘菌素E的耐药率最高,分别为51.5%和47.8%;对头孢唑林和链霉素也存在一定程度耐药,耐药率为22.9%和10.5%;对头孢菌素、氯霉素及其他各类抗生素均有少量菌株耐药;对环丙沙星、左氧氟沙星和美洛培南无耐药。伴随着对抗生素敏感率的逐渐降低,耐药率总体呈现逐渐增高趋势,且有多重耐药菌株和ESBLs菌株。结论北京市腹泻人群副溶血性弧菌十年间血清型构成在不断演变,对常用抗菌药物耐药率呈逐年增长趋势,需要加强对血清型和耐药性的持续系统监测及重点人群的监督管理。

Objective To analysis epidemiological trend,serotype distribution and drug resistance of Vibrio parahaemolyticus(VP)infections in Beijing,so as to provide scientific basis for the prevention and control of diarrheal disease caused by VP infection.Methods A retrospective study was conducted for VP strains isolated from diarrheal patients in gastrointestinal clinics from 2010 to 2019.The serotype detection was performed by slide agglutination test.The antimicrobial resistance was tested Kirby-Bauer disk diffusion(KB)method and by minimal inhibition concentration(MIC)method.Results From 46249 clinical specimens,1853 strains of Vibrio parahaemolyticus were isolated with the detection rate of 4.0%.The highest infection rate was in the age group of 20-39 years old,accounting for 6.1%.A total of 59 serotypes in 9 O serogroups were detected.The dominant serotype was O3∶K6 and was detected in 1254 strains(67.7%).The other top ten serotypes were O4∶KUT,O4∶K8,O1∶KUT,O2∶K3,O4∶K9,O3∶KUT,O10∶K60,O1∶K36 and O4∶K6,respectively.The alternations in serotypes existed in different years along with appearance of new serotypes.The rates of resistance to ampicillin and polymyxin E were the highest,accounting for 51.5%and 47.8%,respectively.The resistance to cefazolin and streptomycin existed in some extend,accounting for 22.9%and 10.5%,respectively.A small number of strains were resistant to cephalosporin,chloramphenicol and other types of antibiotics while no resistance to ciprofloxacin,levofloxacin and meropenem was observed.Along with the decreasing in the sensitivity rate to antibiotics,the resistance rate showed trend of increasing in general,and there were multi-resistant strains and ESBL strains.Conclusions The serotype composition of Vibrio parahaemolyticus from the diarrhea patients in Beijing changed over the past decade.The rate of resistance to commonly used antimicrobial drugs increased gradually.It is necessary to strengthen the continuous systematic surveillance of serotypes and drug resistance as well as the management of key populations.