张阳, 兰光, 张璟, 申艳琴, 李欣颖, 闫静, 刘小菊. 2019-2021年甘肃省食源性疾病患者沙门菌感染状况和耐药性分析[J]. 疾病监测, 2023, 38(6): 707-713. DOI: 10.3784/jbjc.202211100486
引用本文: 张阳, 兰光, 张璟, 申艳琴, 李欣颖, 闫静, 刘小菊. 2019-2021年甘肃省食源性疾病患者沙门菌感染状况和耐药性分析[J]. 疾病监测, 2023, 38(6): 707-713. DOI: 10.3784/jbjc.202211100486
Zhang Yang, Lan Guang, Zhang Jing, Shen Yanqin, Li Xinying, Yan Jing, Liu Xiaoju. Salmonella infection and drug resistance in patients with foodborne disease in Gansu, 2019−2021[J]. Disease Surveillance, 2023, 38(6): 707-713. DOI: 10.3784/jbjc.202211100486
Citation: Zhang Yang, Lan Guang, Zhang Jing, Shen Yanqin, Li Xinying, Yan Jing, Liu Xiaoju. Salmonella infection and drug resistance in patients with foodborne disease in Gansu, 2019−2021[J]. Disease Surveillance, 2023, 38(6): 707-713. DOI: 10.3784/jbjc.202211100486

2019-2021年甘肃省食源性疾病患者沙门菌感染状况和耐药性分析

Salmonella infection and drug resistance in patients with foodborne disease in Gansu, 2019−2021

  • 摘要:
      目的   了解甘肃省食源性疾病患者沙门菌感染及菌株耐药情况,为食源性疾病防控及抗生素的科学使用提供依据。
      方法   按照《食源性疾病监测工作手册》对甘肃省15家哨点医院监测的食源性疾病患者标本中分离到的沙门菌进行血清分型和药敏试验,采用χ2检验对率进行比较。
      结果   2019—2021年共采集食源性疾病患者标本13 482份,检出189株沙门菌,检出率为1.40%,阳性患者男女性别比为1.55∶1。 沙门菌在各年龄组均有检出,0~5、6~17、18~60、>60岁组的检出率分别为1.45%、1.61%、1.43%和1.04%。 第一、二、三、四季度的检出率分别为0.67%、1.54%、1.76%和1.20%。 检出的189株菌共分为34种血清型,占比较高的血清型分别为肠炎沙门菌(30.69%)、鼠伤寒沙门菌(19.58%)、鼠伤寒单相变种沙门菌(8.99%)和斯坦利沙门菌(6.88%)。 引起沙门菌食源性疾病的可疑食物主要为粮食类及其制品(32.28%),家庭是引起沙门菌食源性疾病的主要场所。 189株沙门菌的多重耐药率为68.78%(130/189),多重耐药谱70种,对氨苄西林(83.60%)和四环素(62.96%)的耐药率较高,对阿奇霉素(9.52%)、头孢西丁(5.82%)和亚胺培南(1.59%)的耐药率较低。肠炎沙门菌、鼠伤寒沙门菌、鼠伤寒单相变种沙门菌、斯坦利沙门菌和其他血清型沙门菌对头孢噻肟、四环素、氯霉素、复方新诺明、环丙沙星和阿奇霉素的耐药性差异有统计学意义(P<0.05)。
      结论   甘肃省食源性疾病患者中沙门菌在各年龄组均有检出,多重耐药率较高,耐药情况严重,应加强食源性疾病主动监测和沙门菌耐药监测。 同时相关部门应加强对粮食类及其制品的市场监管和食品安全知识宣教,从源头预防和控制食源性疾病的发生。

     

    Abstract:
      Objective  To analyze the infection status and drug resistance of Salmonella in patients with foodborne disease in Gansu province and provide evidence for the prevention and control of foodborne disease and the rational use of antibiotics.
      Methods  Salmonella isolated from the samples of foodborne disease patients in 15 sentinel hospitals in Gansu were serotyped and tested for drug susceptibility according to the manual of foodborne disease surveillance, and χ2 test was used to compare the rates.
      Results  A total of 13 482 samples of patients with foodborne disease were collected in Gansu from 2019 to 2021, and 189 strains of Salmonella were detected with a detection rate of 1.40%, and the male to female ratio of the positive cases was 1.55∶1. Salmonella was detected in all age groups, and the detection rates in age groups 0–5 years, 6–17 years, 18–60 years and >60 years were 1.45%, 1.61%, 1.43% and 1.04%, respectively. The detection rates in the first, second, third and fourth quarters were 0.67%, 1.54%, 1.76% and 1.20%, respectively. The 189 strains of Salmonella belonged to 34 serotypes and the serotypes with high proportions were S. Enteritidis (30.69%), S. Typhimurium (19.58%), S. Typhimurium monophasic variant (8.99%) and S. Stanley (6.88%). Grains and their products (32.28%) were the mainly suspected food causing Salmonella foodborne diseases and household was the main place where Salmonella foodborne diseases occurred. The multidrug resistance rate of the 189 Salmonella strains was 68.78% (130/189) and there were 70 kinds of multidrug resistance spectrums. The resistance rate of Salmonella was higher to ampicillin (83.60%) and tetracycline (62.96%) and lower to azithromycin (9.52%), cefoxitin (5.82%) and imipenem (1.59%). There were significant differences in the drug resistance to cefotaxime, tetracycline, chloramphenicol, trimethoprim/sulfamethoxazole, ciprofloxacin and azithromycin among S. Enteritidis, S. Typhimurium, S. Typhimurium monophasic variant, S. Stanley and other serotypes of Salmonella (P<0.05).
      Conclusion  Salmonella was detected in patients with foodborne disease in all age groups in Gansu and the multidrug resistance rate of the Salmonella strains was high, indicating a serious drug resistance situation. Therefore, active surveillance for foodborne diseases and Salmonella drug resistance should be strengthened. At the same time, it is necessary to improve the market supervision of grains and their products and the health education about food safety to prevent and control the incidence of foodborne diseases.

     

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