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2015—2016年北京市房山区腹泻患者沙门菌耐药性及飞行质谱的聚类分析

Antimicrobial resistance of Salmonella in patients with diarrhea and clustering analysis by MALDI-TOF MS in Fangshan District of Beijing from 2015-2016
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摘要 目的了解2015—2016年北京市房山区沙门菌的血清型分布及耐药情况,建立数据库。为该地沙门菌感染提供临床用药依据及进行聚类分析,提高溯源能力。方法收集2家哨点医院感染性腹泻患者的粪便培养,进行沙门菌的生化鉴定和血清分型,用微量肉汤稀释法进行药物敏感性试验,利用基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)检测沙门菌及对其进行聚类分析。结果 2015—2016年共检出沙门菌31株,阳性率为4.23%,发现14种血清型,其中以肠炎沙门菌为主(13株),占41.93%。总的耐药率中萘啶酸最高为70.97%,总的敏感率中头孢他啶最高为96.77%。2016年检出的沙门菌与2015年检出的沙门菌进行比较,发现对氨苄西林/舒巴坦、复方磺胺和头孢唑林的耐药率明显增高,对萘啶酸和环丙沙星的耐药率降低。31株沙门菌中,有25株耐药并有12种耐药谱,总耐药率80.65%,17株菌同时耐药2种以上。2016年检出的一株旺兹沃思沙门菌与其余的沙门菌距离水平为1 000,差别较大。该文将距离水平选为350,发现这些沙门菌分为5类群。结论 2015—2016年北京市房山区的沙门菌优势血清型为肠炎沙门菌,对头孢他啶敏感率最高,临床治疗时可合理使用抗生素,聚类分析提示菌株存在不同来源,需进一步关注。 [Objective]To investigate the serotype distribution and antimicrobial resistance of Salmonella in Fangshan District of Beijing from 2015-2016,establish a database,provide clinical basis for the Salmonella infection in this area,and improve the traceability ability by clustering analysis. [Methods]Anal swab were collected form sufferers with infection diarrhea in two sentinel hospitals,to conduct the biochemical identification and serotyping of Salmonella. The micro broth dilution method was applied in the sensitivity test. Matrix-assisted laser desorption/ionization-time of ight mass spectrometry(MALDI-TOF MS) was used to detect Salmonella detection and clustering analysis. [Results]Totally 31 strains of Salmonella were isolated from 2015-2016,with the positive rate of 4.23%. There were 14 serotypes,and most were Salmonella enteritidis(13 strains,41.93%). The total antimicrobial resistance rate for nalidixic acid was the highest(70.97%) and the total sensitivity rate for ceftazidime was the highest(96.77%). The Salmonella detected in 2016 was compared with that in 2015,and the results revealed that the resistance rate for ampicillin/sulbactam,trimethoprim and cefazolin increased significantly higher,while the resistance rate for Naphthyl acid and ciprofloxacin decreased significantly. Among 31 strains of Salmonella,25 were resistant to antibiotics with the drug resistance spectrum of 12 antibiotics. The total resistance rate was 80.65%,while 17 strains were resistant to more than 2 antibiotics. In 2016,a new strain of wandsworth Salmonella was found and its distance level was 1 000. The paper set the distance level to 350,and then found that these Salmonella were divided into 5 groups. [Conclusion]The predominant pathogen is Salmonella enteritidis in Fangshan District of Beijing from 2015-2016,and the resistance rate for ceftazidime is the highest,which can guide the rational use of antibiotics in clinical treatment.Clustering analysis suggests that the sources of Salmonella are different and that
作者 董梅 刘海波 王云霞 史文凤 黄少平 阚震 DONG Mei, LIU Hai-bo, WANG Yun-xia, SHI Wen-feng, HUA NG Shao-ping,KAN Zhen (Microbiology Laboratory,Fangshan District Center for Disease Control and Prevention,Beijing, 102488 ,China)
出处 《职业与健康》 CAS 2018年第9期1170-1173,共4页 Occupation and Health
关键词 沙门菌 耐药性 聚类分析 Salmonella Antimicrobial Resistance Clustering analysis
作者简介 董梅,女,主管检验师,主要从事微生物检验工作。;通讯作者:刘海波,微生物检验师,E-mail:liuhaibo0917@126.com.
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