2019年江苏省部分地区儿童腹泻沙门氏菌的感染率及耐药状况研究

Study on the infection rate and drug resistance of Salmonella in children with diarrhea in some areas of Jiangsu province in 2019

中文关键词:  沙门氏菌  抗生素耐药  腹泻  监测  血清型

英文关键词:Salmonella  antimicrobial resistance  diarrhea  surveillance  serotype

中文摘要:

      目的 了解江苏省部分地区2019年5岁以下食源性腹泻儿童中沙门氏菌感染的流行病学特征、血清分布及耐药性。方法 从江苏省各设区市哨点医院肠道门诊采集食源性腹泻患儿粪便标本, 按照GB 4789.4-2016《食品安全国家标准食品微生物学检验沙门氏菌检验》进行沙门氏菌的分离与鉴定、血清分型, 用微量肉汤稀释法进行药敏试验。结果 共收集3582份腹泻儿童粪便, 沙门氏菌的检出率为2.9%, 1～2岁患儿居多。全年均有检出, 夏季高发。共有24种血清型的沙门氏菌, 优势血清型为鼠伤寒沙门氏菌和肠炎沙门氏菌, 分别占41.9%和18.1%。耐药检测结果显示, 沙门氏菌对红霉素的耐药率最高, 达96.2%。其次为氨苄西林、氨苄西林/舒巴坦、萘啶酸和四环素, 分别为67.6%、57.1%、53.3%和51.4%; 沙门氏菌对甲氧苄氨嘧啶/磺胺甲噁唑、氯霉素和环丙沙星呈现中度耐药, 耐药率分别为33.3%, 31.4%和26.7%; 对一、二、三代头孢类抗生素的耐药率有显著性差异。对阿奇霉素和亚胺培南的耐药率较低, 为7.6%和2.9%。多重耐药率达72.4%。结论 江苏省部分地区腹泻儿童沙门氏菌感染以1～2岁高发, 男孩多于女孩。主要血清型是鼠伤寒沙门氏菌和肠炎沙门氏菌, 多重耐药现象严重, 在临床用药时应选择较为敏感的药物。

英文摘要:

      Objective To investigate the epidemiological characteristics, serum distribution and drug resistance of Salmonella infection in children under 5 years old with foodborne diarrhea in parts of Jiangsu province in 2019. Methods Fecal specimens were collected among children with diarrhea in intestinal outpatient clinics of sentinel hospitals set in Jiangsu province. The isolate and identification, serotyping was conducted according to GB 4789.4-2016 National food safety standard-Food microbiology test-Salmonella test and microdilution broth method was used to test drug sensitivity. Results A total of 3582 fecal specimens were collected from children with diarrhea, 2.9% of them were positive for Salmonella, Salmonella infection were more likely among children aged at one to two than others. It was detected all the year round with high incidence in summer. There were 24 serotypes of Salmonella, the dominant serotypes were Salmonella typhimurium and Salmonella enteritis, accounting for 41.9% and 18.1% respectively. The drug resistance test results showed that Salmonella had the highest resistance rate to erythromycin (96.2%). Ampicillin, ampicillin/sulbactam, naproxic acid and tetracycline were followed by 67.6%, 57.1%, 53.3% and 51.4%, respectively. Salmonella showed moderate resistance to trimethoprim-sulfamethoxazole, chloramphenicol, and ciprofloxacin, with drug resistance rates of 33.3%, 31.4%, and 26.7%, respectively. There were significant differences in drug resistance rates of first, second and third generation cephalosporins. The rates of resistance to azithromycin and imipenem were lower, at 7.6% and 2.9%. The multiple drug resistance rate was 72.4%. Conclusion In some areas of Jiangsu province, children with diarrhea have a high incidence of Salmonella infection at the age of 1 to 2 years, and more boys than girls. The main serotypes are Salmonella typhimurium and Salmonella enteritidis, and the phenomenon of multiple drug resistance is serious, so more sensitive drugs should be selected in clinical medication.