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目的分析杭州地区腹泻患儿沙门菌的血清型、耐药性、产超广谱β-内酰胺酶(ESBLs)表型及耐药基因型,为本地区腹泻患儿的流行病学研究、临床用药提供依据。方法对116株沙门菌进行血清分型、MIC法和K-B纸片法药物敏感性试验、PCR方法检测ESBLs基因型。结果鼠伤寒沙门菌为主要血清型,占44.0%;其次是肠炎沙门菌,占18.10%。沙门菌对氨苄西林的耐药率最高,为71.13%;哌拉西林/他唑巴耐药率最低,为0.94%。产ESBLs检出率为16.38%。不同ESBLs表型对β-内酰胺类抗生素及其抑制剂复合物耐药率(除哌拉西林/他唑巴坦、亚胺培南外)差异均有统计学意义,P<0.05。检出基因型blaCTX-M型6株,blaTEM型6株,blaCTX-M型合并blaTEM型2株,blaSHV型未检出。结论鼠伤寒沙门菌和肠炎沙门菌是导致沙门菌肠炎患儿主要病原菌,沙门菌对抗生素耐药现象较严重,ESBLs阳性菌株耐药性主要由blaCTX-M基因型介导。
Objective To analyze the serotype and drug resistance of Salmonella in pediatric patients with diarrhea in Hangzhou and the phenotypes and resistant genotypes of extended-spectrum β-lactamases (ESBLs) in children with diarrhea in this area. Drugs provide the basis. Methods 116 strains of Salmonella were detected by serological typing, MIC method and K-B disk method, and the genotypes of ESBLs were detected by PCR. The results of Salmonella typhimurium as the main serotype, accounting for 44.0%; followed by Salmonella enteritidis, accounting for 18.10%. The highest rate of Salmonella resistance to ampicillin was 71.13%, and the lowest rate of piperacillin / tazobact was 0.94%. The detection rate of ESBLs production was 16.38%. The resistance rates of different ESBLs phenotypes to β-lactam antibiotics and its inhibitor complex (except piperacillin / tazobactam and imipenem) were statistically significant (P <0.05). 6 strains of blaCTX-M genotypes, 6 strains of blaTEM type, 2 strains of bla CTX-M type and 2 strains of blaTEM gene were detected, blaSHV type was not detected. Conclusion Salmonella typhimurium and Salmonella enteritidis are the major pathogenic bacteria in children with Salmonella enterica. Salmonella is more resistant to antibiotics, and the drug resistance of ESBLs-positive strains is mainly mediated by blaCTX-M genotype.