王园园, 李颖, 张爽, 张彦春, 马红梅, 张茂俊. 2017年北京市顺义区腹泻患者弯曲菌流行特征及耐药性分析[J]. 疾病监测, 2018, 33(12): 1048-1053. DOI: 10.3784/j.issn.1003-9961.2018.12.018
引用本文: 王园园, 李颖, 张爽, 张彦春, 马红梅, 张茂俊. 2017年北京市顺义区腹泻患者弯曲菌流行特征及耐药性分析[J]. 疾病监测, 2018, 33(12): 1048-1053. DOI: 10.3784/j.issn.1003-9961.2018.12.018
Yuanyuan Wang, Ying Li, Shuang Zhang, Yanchun Zhang, Hongmei Ma, Maojun Zhang. Infection status and drug resistance of Campylobacter in diarrhea patients in Shunyi district of Beijing,2017[J]. Disease Surveillance, 2018, 33(12): 1048-1053. DOI: 10.3784/j.issn.1003-9961.2018.12.018
Citation: Yuanyuan Wang, Ying Li, Shuang Zhang, Yanchun Zhang, Hongmei Ma, Maojun Zhang. Infection status and drug resistance of Campylobacter in diarrhea patients in Shunyi district of Beijing,2017[J]. Disease Surveillance, 2018, 33(12): 1048-1053. DOI: 10.3784/j.issn.1003-9961.2018.12.018

2017年北京市顺义区腹泻患者弯曲菌流行特征及耐药性分析

Infection status and drug resistance of Campylobacter in diarrhea patients in Shunyi district of Beijing,2017

  • 摘要:
    目的 了解北京市顺义区弯曲菌引起腹泻的现状,探索弯曲菌分离检测方法及其耐药特征。
    方法 收集2017年顺义区2家医院成年人腹泻患者的粪便标本进行沙门菌、志贺菌、致泻大肠埃希菌和副溶血弧菌的分离培养。 用滤膜法分离培养弯曲菌并进行药敏试验。
    结果 372份粪便标本共检出39株弯曲菌,检出阳性率为10.48%,包括36株空肠弯曲菌(92.31%,36/39)和3株结肠弯曲菌(7.69%,3/39)。 沙门菌、志贺菌、致泻大肠埃希菌、副溶血弧菌的阳性率分别为6.99%(26/372)、0.27%(1/372)、9.14%(34/372)、12.63%(47/372)。 弯曲菌感染病例的临床症状以腹泻、腹痛、恶心、脱水为主,且多为水样便。春秋季检出率高于夏冬季,高峰出现在10月。弯曲菌感染病例以16 ~ 45岁青壮年居多;男、女性检出率差异无统计学意义(χ2=0.150,P=0.698);职业以学生、其他职业、商业服务居多。 可疑感染食品为蔬菜类、粮食类、水产及其制品。 3株结肠弯曲菌分离株仅对氯霉素敏感。 36株空肠弯曲菌分离株对喹诺酮类、四环素类和氯霉素类抗生素的耐药率最高,包含萘啶酸(97.22%)、环丙沙星(97.22%)、四环素(86.11%)、氟苯尼考(58.33%)。19株空肠弯曲菌(52.78%)存在多重耐药,多重耐药谱主要为喹诺酮类–氯霉素类–四环素类(47.37%,9/19)。
    结论 弯曲菌感染引起腹泻的比例较高,春秋季高发,耐药性严重且存在多重耐药现象,应引起重视。

     

    Abstract:
    Objectives To understand the incidence of diarrhea caused by Campylobacter in Shunyi district of Beijing and explore the detection methods for Campylobacter and analyze the drug resistance characteristics of Campylobacter.
    Methods A total of 372 stool samples were collected from patients with diarrhea in two hospitals in Shunyi in 2017 for Campylobacter, Salmonella, Shigella, Diarrheagenic E. coli and Vibrio parahaemolyticus isolation. The filter membrane method was used in the isolation of Campylobacter. The isolated Campylobacter strains were tested for drug sensitivity.
    Results Among 372 stool samples, a total of 39 strains of Campylobacter were isolated (10.48%), including 36 strains of C. jejuni (92.31%) and 3 strains of C. coli (7.69%). The positive rates of Salmonella, Shigella, E. coli and V. parahaemolyticus were 6.99%, 0.27%, 9.14%, and 12.63%, respectively. The clinical symptoms of 39 cases of Campylobacter infection were mainly diarrhea (watery stools), abdominal pain, nausea and dehydration. The detection rate of Campylobacter was higher in spring and autumn than in summer and winter, and the peak appeared in October. Campylobacter infection cases were mainly young and middle-aged adults aged 16 to 45 years; there was no significant difference in the detection rate between men and women (P=0.698, χ2=0.150). The infection cases were mainly distributed in students, people engaged in other occupations and in business services. Contaminated foods included vegetables, cereals and aquatic products. Three strains of C. coliwere only sensitive to chloramphenicol. The resistant rates of 36 C. jejuni isolates to quinolones, tetracyclines and chloramphenicol were high, including nalidixic acid (97.22%), ciprofloxacin (97.22%), tetracycline (86.11%), florfenicol (58.33%). Nineteen strains of C. jejuni (52.78%) were multi-drug resistant, and the multi-drug resistance spectrum was mainly quinolones-chloramphenicol-tetracyclines (47.37%, 9/19).
    Conclusions The proportion of diarrhea caused by Campylobacter was high in Shunyi. The isolated Campylobacter strains showed serious drug resistance, including multiple drug resistance, to which close attention should be paid.

     

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