2007-2013年广东省肠炎沙门菌耐药情况分析

Analysis on drug resistance of Salmonella enteritidis in Guangdong Province,2007-2013

目的掌握广东省内区域性肠炎沙门菌的耐药特征变化,为临床用药、科学防治提供参考依据。方法基于广东省疾病预防控制中心沙门菌监测网络收集2007-2013年广东省内34家哨点医院的散发病例肠炎沙门菌菌株,统计相关的流行病学资料,对菌株进行生化鉴定、血清分型,采用微量肉汤稀释法进行药敏检测,定量测定菌株的最小抑菌浓度(minimal inhibitory concentration,MIC)。结果共收集到386株肠炎沙门菌,男女比例为1∶0.70,以1~4岁的儿童为主(35.23%,136/386),流行季节为6~10月。药敏结果以耐萘啶酸(85.23%,329/386,MIC50=128μg/ml)的菌株最多。386株散发菌株共有27个耐药谱,耐3种以上抗生素的多重耐药菌占菌株总数的比例为16.32%(63/386)。结论肠炎沙门菌病例多重耐药现象应引起重视,应实时监测菌株耐药谱变化趋势,指导临床用药,控制多重耐药菌株的出现。

Objective To analyze the antibiotic resistant characteristics of Salmonella enteritidis,and to provide scientific evidence for development of prevention and control measures. Methods Isolates from 34 hospitals of the WHO Global Salmonella Surveillance( GSS) system were identified by biochemical tests and serotyping. Antimicrobial resistance was tested using the broth microdilution method to measure its minimal inhibitory concentration( MIC). Results 386 Salmonella enteritidis strains were isolated from the feces of patients. The ratio of male to female in the collections of strains was 1 ∶ 0. 70. Strains were mainly distributed in the age group of 1-4 years( 35. 23%,136 /386). Epidemic season were found to be from June to October. The resistant rate of nalidixic acid was the highest( 85. 23%,329 /386,MIC50 = 128μg /ml). The 386 sporadic strains had a total of 27 antibiograms. 63 strains were multidrug resistant( 16. 32%,63 /386).Conclusions It shows that the multidrug resistant patterns of Salmonella enteritis are diverse. Rational use of antibiotics and real-time monitoring on Salmonella resistance may contribute to reducing the multidrug resistant strains.