2020-2022年贵州省遵义市非伤寒沙门菌感染流行特征及耐药性研究

Epidemiological characteristics and antimicrobial resistance of non-typhoidal Salmonella infection in Zunyi, Guizhou, 2020−2022

  • 摘要:
    目的 了解贵州省遵义市非伤寒沙门菌(NTS)感染的流行特征、血清型分布、耐药性,为本地区的预防及治疗提供依据。
    方法 对2020—2022年在遵义市第一人民医院分离到的NTS进行血清学分型、抗菌药物敏感试验,并进行流行特征分析。
    结果 2020—2022年共分离到255株NTS,其中33株(12.94%, 33/255)分离自血液样本,其余222株均为粪便样本分离,5—9月分离率较高(76.86%, 196/255),1岁以下婴幼儿是易感人群(59.22%, 151/255)。 鉴定出24种血清型,主要为鼠伤寒沙门菌(50.59%, 129/255)、肠炎沙门菌 (10.59%, 27/255)、都柏林沙门菌(6.67%, 17/255)。 NTS对氨苄西林、氨苄西林/舒巴坦耐药率较高,分别为79.22%、68.63%;对哌拉西林/他唑巴坦、头孢吡肟、亚胺培南、厄他培南耐药率较低,分别为3.14%、5.88%、0.39%、0.39%。 鼠伤寒沙门菌对氨曲南、头孢曲松、左氧氟沙星的耐药率分别为20.16%、23.26%、17.05%,比肠炎沙门菌高,差异具有统计学意义(P<0.05)。 粪便分离到的NTS对氨苄西林、氨苄西林/舒巴坦的耐药率分别为83.33%、71.75%,比血液分离到的NTS高,差异有统计学意义(P<0.001, P=0.002)。
    结论 遵义市NTS感染以夏秋季高发,主要分离自1岁以下婴幼儿,以鼠伤寒沙门菌为主,不同标本类型和血清型的NTS对抗生素耐药率有所差异,应结合血清型、标本类型及药敏结果综合慎重选择抗菌药物治疗。

     

    Abstract:
    Objective To investigate the epidemiological characteristics, serotype distribution and antimicrobial resistance of non-typhoidal Salmonella (NTS) infection in Zunyi, Guizhou province, and provide evidence for the prevention and treatment NTS infection in this area.
    Methods The serotyping, antimicrobial susceptibility test and epidemiological characteristics of NTS isolated in the First People's Hospital of Zunyi from 2020 to 2022 were analyzed.
    Results A total of 255 strains of NTS were isolated from 2020 to 2022, of which 33 (12.94%, 33/255) were isolated from blood samples and 222 were isolated from feces samples. The infection rate was higher from May to September (76.86%, 196/255), and infants under 1 year old were susceptible to the infection (59.22%, 151/255). A total of 24 serotypes were detected from 255 NTS isolates, and the predominant serotypes were Salmonella typhimurium (50.59%, 129/255), Salmonella Enteritidis (10.59%, 27/255) and Salmonella Dublin (6.67%, 17/255). The resistance rates of NTS to ampicillin and ampicillin/sulbactam were 79.22% and 68.63%, respectively. The resistance rates to piperacillin/tazobactam, cefepime, imipenem and ertapenem were 3.14%, 5.88%, 0.39% and 0.39%, respectively. The resistance rates of S. Typhimurium to aztreonam, ceftriaxone and levofloxacin were 20.16%, 23.26% and 17.05%, respectively, which were higher than those of S. Enteritidis, the difference was significant (P<0.05). The resistance rates of NTS isolated from stool samples to ampicillin and ampicillin/sulbactam were 83.33% and 71.75%, respectively, which were higher than those of NTS isolated from blood samples, the differences were significant (P<0.001, P=0.002).
    Conclusion The incidence of NTS infection was high in summer and autumn in Zunyi during 2020-2022, and NTS was mainly isolated from infants under 1 year old, and S. typhimurium was predominant. The drug resistance of the NTD strains from different sample sources and with different serotypes varied. Antimicrobial agents should be used appropriately according to the serotype, sample type and drug susceptibility results.

     

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