2016—2023年北京市丰台区食源性疾病中沙门氏菌流行特征及耐药分析

Epidemiological characteristics and drug resistance of Salmonella isolated from foodborne diseases in Fengtai District, Beijing from 2016 to 2023

中文关键词:  食源性疾病  沙门菌  耐药分析

英文关键词:foodborne diseases  Salmonella  drug resistance analysis

中文摘要:

      目的 了解2016—2023年北京市丰台区食源性疾病沙门氏菌(Salmonella)的流行情况、血清型分布及耐药形势。方法 对食源性疾病病例粪便标本进行沙门氏菌的分离培养与鉴定, 采用玻片凝集法鉴定血清型, 采用微量肉汤稀释法和最小抑菌浓度法测定沙门氏菌耐药性。结果 沙门氏菌检出率为4.33%, 2016—2023年检出率从2.11%上升至9.28%。沙门氏菌感染呈秋季高峰, 0~9岁、40~49岁人群检出率较高, 病例伴有发热、恶心, 腹泻次数多在6次及以上, 食用肉及肉制品是感染沙门氏菌的危险因素。血清型排位前5位为肠炎沙门氏菌(Salmonella enteritidis)、鼠伤寒沙门氏菌(Salmonella typhimurium)、汤卜逊沙门氏菌(Salmonella thompson)、单相鼠伤寒沙门氏菌(Monophasic salmonella enterica serovar typhimurium)、山夫登堡沙门氏菌(Salmonella senftenberg), 其中汤卜逊沙门氏菌和单相鼠伤寒沙门氏菌的检出率有上升趋势。沙门氏菌对萘啶酸(nalidixic acid, NAL)、氨苄西林(ampicillin, AMP)和氨苄西林-舒巴坦(ampicillin-sulbactam, AMS)耐药率较高, 对环丙沙星(ciprofloxacin, CIP)中介率较高, 对庆大霉素(gentamicin, GEN)、亚胺培南(imipenem, IMI)、阿奇霉素(azithromycin, AZI)敏感度较高。肠炎沙门氏菌耐药情况最严重, 对四环素(tetracycline, TET)、头孢他啶(ceftazidime, CAZ)耐药率有上升趋势, 对CIP中介率有下降趋势。沙门氏菌多重耐药率为44.00%, 共包含31个耐药谱。结论 不同季节、不同年龄、症状及食物暴露使沙门氏菌检出率不同。沙门氏菌以肠炎沙门氏菌为主, 血清分布广泛。沙门氏菌对喹诺酮类和β-内酰胺类抗生素耐药严重, 多重耐药形势严峻。应加强食品安全宣传教育、加大肉类食品卫生监管、加强单相鼠伤寒等新型沙门氏菌监测、加强抗生素规范使用, 优化沙门氏菌防治措施。

英文摘要:

      Objective To understand the prevalence, serotype distribution and drug resistance of Salmonella from foodborne diseases in Fengtai District, Beijing from 2016 to 2023. Methods Salmonella was isolated and identified from the stool samples of foodborne diseases. Serotypes of Salmonella were identified by slide agglutination test. The antimicrobial resistance of Salmonella was determined by micro broth dilution method and minimum inhibitory concentration method. Results The detection rate of Salmonella was 4.33%, which increased from 2.11% to 9.28% from 2016 to 2023. Salmonella infection peaked in autumn. The detection rate of Salmonella was higher in people aged 0–9 old years and 40–49 old years, and people of fever, nausea and diarrhea more than 6. The consumption of meat and meat products was the risk factor of Salmonella infection. The top 5 serotypes were Salmonella enteritidis, Salmonella typhimurium, Salmonella thompson, Monophasic salmonella enterica serovar typhimurium and Salmonella senftenberg. There was an upward trend in the detection rate of Salmonella thompson, and Monophasic salmonella enterica serovar typhimurium. The resistance rate of Salmonella to nalidixic acid (NAL), ampicillin (AMP) and ampicillin-sulbactam (AMS) was higher, the intermediate rate of Salmonella to ciprofloxacin (CIP) was higher, and the sensitivity of Salmonella to gentamicin (GEN), imipenem (IMI) and azithromycin (AZI) was higher. The drug resistance of Salmonella enteritidis was the most serious, the drug resistance rate of tetracycline (TET) and ceftazidime (CAZ) was increasing, and the intermediate rate of CIP was decreasing. The multi-drug resistance rate of Salmonella was 44.00%, which included 31 drug resistance profiles. Conclusion The detection rates of Salmonella are different in different age, different symptoms and food exposure history of people, and different season. Salmonella enteritidis is the main serotype. The serum distribution of Salmonella is dispersive. The resistances of Salmonella to quinolones antibiotics and β-lactam antibiotics are serious, and the situation of multi-drug resistance is serious. We should enhance food safety education on Salmonella, strengthen surveillance on meat food safety, strengthen surveillance on new salmonella species such as Monophasic salmonella enterica serovar typhimurium, strengthen the use of antibiotics, and optimize measures for disease prevention and control of Salmonella.