临床分离非伤寒沙门菌耐药性及对头孢曲松耐药机制
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王玉宝

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R181.3+2R378.2

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天津市卫生局科研基金资助项目(2013KZ112)


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    摘要:

    目的了解临床分离非伤寒沙门菌(NTS)耐药情况及对头孢曲松的耐药机制,为防治NTS感染与合理使用抗菌药物提供依据。方法选取2014年5—10月天津医科大学第二医院和天津医科大学总医院肠道门诊急性腹泻患者粪便标本分离的108株NTS,对其进行药敏试验;对头孢曲松不敏感的NTS进行血清学分型、多位点序列分型(MLST)、脉冲场凝胶电泳(PFGE)分型以及超广谱β内酰胺酶(ESBLs)和AmpC基因检测。结果108株NTS对11种抗菌药物的单药耐药率为49.07%(53株),多重耐药率为17.59%。对萘啶酸、左氧氟沙星、环丙沙星、头孢曲松和厄他培南的敏感率依次为61.11%、66.67%、68.52%、97.22%和100.00%。共检出3株NTS对头孢曲松不敏感,其中2株为ST11型肠炎血清型(Sa8709、Sa8771),1株为ST34型鼠伤寒血清型(Sa8763)。PFGE聚类分析显示,Sa8709和Sa8771菌株相似度较高(91.70%),但与Sa8763菌株相似度较低,为55.80%;Sa8709菌株携带CTXM基因,Sa8771菌株携带CTXM和TEM基因,Sa8763菌株携带OXA基因。结论该地区临床分离NTS对氟喹诺酮类抗菌药物敏感率不高,出现了携带ESBLs基因的多重耐药菌株。

    Abstract:

    ObjectiveTo investigate antimicrobial resistance and ceftriaxone resistance mechanisms in clinically isolated  nontyphoidal Salmonella(NTS), and provide evidence for the prevention and control of NTS infection and rational  use of antimicrobial agents.Methods108 NTS isolates were isolated from stool specimens of outpatients with acute diarrhea in the Second Hospital of Tianjin Medical University and Tianjin Medical University General Hospital from May to October of 2014, NTS were performed antimicrobial susceptibility testing; nonceftriaxonesusceptible isolates were typed by  serological, multilocus sequence (MLST),  and pulsedfield gel electrophoresis (PFGE) methods, extendedspectrum βlactamase (ESBL) detection and AmpC genes were detection.ResultsAmong 108 NTS isolates, monodrug resistance rate to 11 antimicrobial agents was 49.07%(n=53), multidrug resistance rate was17.59%. Susceptibility rates to nalidixic acid, levofloxacin, ciprofloxacin, ceftriaxone, and ertapenem were 61.11%,66.67%,68.52%,97.22%, and 100.00% respectively.  Three nonceftriaxonesusceptible NTS isolates were detected,   2 were ST11 Salmonella enterica serotype (Sa8709,Sa8771),1 was ST34 Salmonella typhimurium serotype(Sa8763). Cluster analysis of PFGE revealed that Sa8709 was highly similar to Sa8771 strains(91.70%),but the similarity to  Sa8763 was low(55.80%); Sa8709 strain carried CTXM gene, Sa8771 strain carried CTXM and TEM genes, Sa8763 strain carried OXA gene. ConclusionClinically isolated NTS in this area are low resistant to fluoroquinolones, multidrug resistant strains  carrying ESBLs  have emerged.

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师伟,夏琳林,刘晓霞,等.临床分离非伤寒沙门菌耐药性及对头孢曲松耐药机制[J]. 中国感染控制杂志,2016,15(4):217-221. DOI:10.3969/j. issn.1671-9638.2016.04.001.
SHI Wei, XIA Linlin, LIU Xiaoxia, et al.[J]. Chin J Infect Control, 2016,15(4):217-221. DOI:10.3969/j. issn.1671-9638.2016.04.001.

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  • 收稿日期:2015-12-25
  • 最后修改日期:2016-02-23
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  • 在线发布日期: 2016-04-30
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