2021-2022年湖州市监测哨点医院感染性腹泻病例沙门菌病原学特征分析

Pathogenic characteristics of Salmonella in infectious diarrhea cases in Huzhou City from 2021 to 2022

目的 分析湖州市感染性腹泻患者分离沙门菌的血清型分布、耐药情况及分子分型特征,为沙门菌引起腹泻性疾病的防控、预警、溯源及临床治疗提供科学依据。方法 湖州市2021-2022年6家监测哨点医院分离出126株沙门菌,采用玻片凝集法、微量肉汤稀释法和脉冲场凝胶电泳(PFGE)法,分别进行血清学分型、抗生素最小抑菌浓度测定和分子分型。结果 126株沙门菌可分为28种血清型,优势血清型为鼠伤寒沙门菌单相变种(32.5%,41/126),肠炎沙门菌(24.6%,31/126)及鼠伤寒沙门菌(15.1%,19/126)。不同血清型沙门菌对15种抗生素存在不同程度的耐药性,鼠伤寒沙门菌单相变种对四环素耐药率较高,分别为73.3%(44/60)其次氨芐西林和磺胺甲噁唑的耐药率为56.7%(34/60),鼠伤寒沙门菌对四环素和磺胺甲噁唑的耐药率较高,分别为68.4%(13/19)、52.6%(10/19),肠炎沙门菌对氨苄西林/舒巴坦的耐药率最高为54.8%(17/31),其他沙门菌对四环素的耐药率最高为51.4%(18/35),总体多重耐药率达62.7%(79/126),呈现出20种多重耐药谱。鼠伤寒沙门菌单相及鼠伤寒沙门菌、肠炎沙门菌经XbaⅠ酶切后分别获得46种和15种不同PFGE指纹图谱。结论 湖州市沙门菌感染优势血清型以鼠伤寒沙门菌单相变种和肠炎沙门菌为主,沙门菌多重耐药现象严重,PFGE带型既有多样性又具有优势带型。

Objective To provide scientific basis for the prevention and control,early warning,tracing and clinical treatment of diarrheal diseases caused by Salmonella,the serotype distribution,drug resistance and molecular typing characteristics of Salmonella isolates from infectious diarrhea patients in Huzhou City were analyzed.Methods A total of 126 isolates of Salmonella were collected from 6 sentinel hospitals in Huzhou City from 2021 to 2022.The isolates were characterized by serovar determination,antimicrobial susceptibility tests,and pulsed-field gel electrophoresis(PFGE)typing.Results The 126 strains of Salmonella could be divided into 28 serotypes.The dominant serotypes were Salmonella typhimurium monophasic variant(32.5%,41/126),Salmonella enteritidis(24.6%,31/126)and Salmonella typhimurium(15.1%,19/126).Salmonella typhimurium had different resistance characteristics to 15 antibiotics.The resistance rate of Salmonella typhimurium monophasic variant to tetracycline was 73.3%(44/60),ampicillin and sulfamethoxazole were all 56.7%(34/60).The resistance rate of Salmonella typhimurium to tetracycline and sulfamethoxazole was higher with 68.4%(13/19)and 52.6%(10/19),respectively.The highest resistance rate of Salmonella enteritidis to ampicillin/sulbactam was 54.8%(17/31)and that of other Salmonella to tetracycline was the highest wih 51.4%(18/35).The overall multidrug resistance rate was 62.7%(79/126),showing 20 multidrug resistance spectra.The PFGE fingerprints of Salmonella typhimurium and Salmonella enteritidis were obtained 46 and 15 kinds types after digested by XbaⅠenzyme.Conclusion The predominant serotypes of Salmonella infection in Huzhou City are Salmonella typhimurium and Salmonella enteritidis.The multi-drug resistance of Salmonella bacteria is serious.PFGE zone types are both diverse and dominant.