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目的了解河南省腹泻患者分离沙门菌的血清分型及耐药性变迁情况。方法以河南省2010年-2014年分离的877株沙门菌为研究对象,进行血清分型和药物敏感试验,以了解沙门菌菌型分布及药物敏感性情况。结果沙门菌在各年龄组均有检出,以0岁~5岁儿童为主,检出率为66.2%;且7月-10月是检出的高发季。877株沙门菌血清型共分为8个群、46种血清型,其中以B群检出为主。每年血清型的分布及种类也不同,但主要血清型为肠炎沙门菌、鼠伤寒沙门菌、阿贡纳沙门菌、科瓦利斯沙门菌、汤卜逊沙门菌。沙门菌菌株对各类抗生素均有不同程度的耐药,对氨苄西林和三代头孢类抗生素(头孢他啶、头孢噻肟、头孢吡肟)的耐药率有逐年上升趋势,而对诺氟沙星的耐药率表现为下降趋势,差异有统计学意义(P<0.05)。几乎50%以上的菌株对3种以上的抗生素产生耐药。结论河南省腹泻患者沙门菌血清型分布呈多样性,主要是肠炎沙门菌和鼠伤寒沙门菌。对目前常用的抗菌药物均有耐药菌株出现,应加强耐药性监测,对合理使用抗生素提供指导。
Objective To investigate the serotyping and drug resistance changes of Salmonella isolates from diarrhea patients in Henan Province. Methods A total of 877 strains of Salmonella isolated in Henan Province from 2010 to 2014 were selected for serological typing and drug susceptibility testing to understand the distribution of Salmonella and drug susceptibility. Results Salmonella was detected in all age groups, with 0 to 5 years old prevalence, the detection rate was 66.2%; and July-October was the high incidence of seizures. 877 strains of Salmonella serogroups were divided into 8 groups and 46 serotypes, of which group B was detected mainly. The distribution and types of serotypes are also different each year, but the major serotypes are Salmonella Enteritidis, Salmonella typhimurium, Salmonella Agonis, Salmonella Corvallis and Salmonella Thompson. Salmonella strains have different levels of resistance to various antibiotics, the resistance rates to ampicillin and third generation cephalosporins (ceftazidime, cefotaxime, cefepime) have been increasing year by year, Resistance rate showed a downward trend, the difference was statistically significant (P <0.05). More than 50% of strains are resistant to more than three antibiotics. Conclusion The distribution of Salmonella serogroups in diarrhea patients in Henan Province is diversified, mainly Salmonella enteritidis and Salmonella typhimurium. Antibiotics commonly used at present have resistant strains appear, should strengthen the monitoring of drug resistance, to provide guidance for the rational use of antibiotics.