上海市嘉定区腹泻患者沙门菌流行病学特征及耐药性分析

Epidemiological characteristics and drug resistance of Salmonella isolated from diarrhea patients in Jiading District of Shanghai

【目的】分析上海市嘉定区食源性腹泻患者沙门菌的流行病学特征和耐药情况。【方法】选取5家监测点医院,于2018年1月—2019年12月采集食源性腹泻患者粪便或肛拭子标本共1810份,采用微量肉汤稀释法进行药敏试验。【结果】沙门菌总检出率7.85%(142/1810),0岁~、7岁~、18岁~、41岁~和>65岁的检出率分别为8.97%(13/145)、6.94%(5/72)、7.58%(75/989)、8.69%(41/472)、6.06%(8/132)。罗森沙门菌是本地区新出现的优势血清型,出现多株对第三、四代头孢菌素和氟喹诺酮类、甚至阿奇霉素同时耐药的菌株;鼠伤寒沙门菌对头孢噻肟、头孢吡肟的敏感率为84.85%,对氟喹诺酮类药物的耐药率为12%~16%;沙门菌和肠炎沙门菌对氟喹诺酮类药物中介率分别为56%~60%和95.56%。【结论】沙门菌感染在各年龄段都有较高的检出率;需要对新的优势血清型加强关注;鼠伤寒沙门菌对第三、四代头孢菌素和氟喹诺酮类药物已产生较高耐药性,沙门菌、尤其是肠炎沙门菌对氟喹诺酮类药物的敏感性已大幅下降。

[Objective]To analyze the epidemiological characteristics and drug resistance of Salmonella in patients with food-borne diarrhea in Jiading District.[Methods]From January 2018 to December 2019,feces or anal swabs of patients were collected from five hospitals in monitoring sites,and the drug sensitivity test was conducted using the micro broth dilution method.[Results]The total detection rate of Salmonella was 7.85%(142/1810),and the detection rates of 0-6,7-17,18-40,41-65 and over 65 years old were 8.97%(13/145),6.94%(5/72),7.58%(75/989),8.69%(41/472)and 6.06%(8/132),respectively.Salmonella rosenbergii was a new dominant serotype in this area.Many strains were resistant to the third and fourth generation cephalosporins,fluoroquinolones and even azithromycin.The sensitivity rate of Salmonella typhimurium to cefotaxime and cefepime was 84.85%,and the resistance rate to fluoroquinolones was 12%to 16%.The mediating rates of Salmonella and Salmonella enteritidis to fluoroquinolones were 56%to 60%and 95.56%,respectively.[Conclusion]The detection rate of Salmonella infection is high in all age groups.It is necessary to pay more attention to new dominant serotypes.Salmonella typhimurium is highly resistant to the third and fourth generation cephalosporins and fluoroquinolones,while the sensitivity of Salmonella,especially Salmonella enteritidis to fluoroquinolones has decreased significantly.