产超广谱β-内酰胺酶沙门氏菌的分布与基因型研究

Distribution and genotype of extended-spectrum β-lactamase- producing Salmonella

中文关键词:  超广谱β-内酰胺酶  沙门氏菌  耐药  基因型  食品样本  临床样本

英文关键词:extended-spectrum β-lactamase  Salmonella  drug resistance  genotype  food sample  clinical sample

中文摘要:

      目的 了解不同来源的产超广谱β-内酰胺酶(extended-spectrum β-lactamase, ESBLs)沙门氏菌的分布特征以及耐药特点。方法 分离来自食品与食物中毒患者体内的沙门氏菌, 用双纸片法筛选产ESBLs沙门氏菌; 采用最低抑菌浓度(minimum inhibitory concentration, MIC)检测14种临床常用抗生素的耐药率。结果 食品中分离沙门氏菌89株, 食物中毒患者体内分离沙门氏菌77株, 其中产ESBLs菌株阳性率为13.3% (22/166)。34株从水产品中分离的沙门氏菌中ESBLs阳性率为5.9% (2/34), 55株从肉制品中分离的沙门氏菌中ESBLs阳性率为21.8% (12/55), 二者有显著差异(P<0.05, α=4.025); 77株从临床样本分离的沙门氏菌中ESBLs阳性率为10.4%。沙门氏菌多重耐药情况严重, 平均多重耐药率为42.8% (71/166), 产ESBLs沙门氏菌更容易产生交叉耐药, 多重耐药率100%, 明显高于非产ESBLs多重耐药率34.0% (P<0.05, α=7.011)。22株ESBLs沙门氏菌中, 包含TEM基因型5株, CTX-M基因型5株, TEM合并CTX-M双基因型5株, 未检出SHV基因型。产ESBLs沙门氏菌对庆大霉素、复方磺胺、环丙沙星、萘啶酸等均表现出较强耐药性, 对亚胺培南、头孢西丁敏感。结论 产ESBLs沙门氏菌在东北分布较广, 基因型以TEM和CTX-M为主, 家畜家禽饲养环节抗生素滥用相对严重。ESBLs阳性菌更容易产生多重耐药, 对于治疗产ESBLs沙门氏菌引起的感染可以选择亚胺培南、头孢西丁。

英文摘要:

      Objective To investigate the distribution characteristics and drug resistance characteristics of extended-spectrum β-lactamase (ESBLs)-producing Salmonella from different sources. Methods The Salmonella from food and food poisoning patients were isolated, and the Salmonella producing ESBLs was screened by double disk method; the minimum inhibitory concentration (MIC) was used to detect the resistance rates of 14 kinds of clinically commonly used antibiotics. Results Eighty-nine Salmonella strains were isolated from food, and 77 Salmonella strains were isolated from patients with food poisoning, and the positive rate of ESBLs-producing strain was 13.3% (22/166). The positive rates of ESBLs among 34 Salmonella isolates from aquatic products and 55 Salmonella isolates from meat products were 5.9% (2/34) and 21.8% (12/55), respectively, showing significant differences (P<0.05, α=4.025); the positive rate of ESBLs in 77 Salmonella strains isolated from clinical samples was 10.4%. The multi-drug resistance of Salmonella was serious, with an average multi-drug resistance rate of 42.8% (71/166), Salmonella producing ESBLs was more prone to cross-drug resistance, with a multi-drug resistance rate of 100%, which was significantly higher than that of non-ESBLs producing 34.0% (P<0.05, α=7.011). Among the 22 strains of Salmonella ESBLs, 5 strains were genotype-TEM, 5 strains were genotype-CTX-M, and 5 strains were genotype-TEM combined with CTX-M double, and no SHV genotype was detected. Salmonella ESBLs showed strong drug resistance to gentamicin, compound sulfanilamide, ciprofloxacin, nalidixic acid, and was sensitive to imipenem and cefoxitin. Conclusion ESBLs-producing Salmonella is widely distributed in northeast China, with TEM and CTX-M as the main genotypes, and the abuse of antibiotics in livestock and poultry feeding is relatively serious. ESBLs-positive bacteria are more likely to produce multi-drug resistance, imipenem and cefoxitin can be used to treat infections caused by ESBLs-producing Salmonella.