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目的 掌握江苏省伤寒/副伤寒流行现况、病原菌耐药性以及分子分型特征,以确定监测重点.方法 对2007-2011年江苏省伤寒/副伤寒疫情采用描述流行病学回顾性分析；210株伤寒/副伤寒沙门菌耐药性测定采用K-B纸片扩散法；81株伤寒沙门菌分子分型运用脉冲场凝胶电泳(PFGE).结果 近5年江苏省伤寒/副伤寒年均报告发病率为0.47/10万,呈总体下降趋势.人群年龄别发病以0岁组(1.70/10万)高发.病原谱以伤寒沙门菌为主(66.19％),其次为甲型副伤寒沙门菌(23.81％).伤寒/副伤寒沙门菌对萘啶酸耐药率最高(66.19％),对环丙沙星等6种抗生素耐药率低于10.00％,多重耐药率为30.00％.近3年伤寒沙门菌分属4个克隆群37个PFGE型,优势带型为JPPX01.JS0027(11.11％),JPPX0 1.JS0001为地区独特性菌型,JPPX01.JS0014、JPPX01.JS0018和JPPX01.JS0024为扩散性菌型.特征菌型成簇分析发现3起病例具有聚集性特征.结论 江苏省伤寒/副伤寒发病率维持在较低水平,婴儿高发.菌株对多数抗生素较敏感,但部分药物耐药性在增加.由于近年伤寒呈现高度散发状态,未出现占绝对优势的菌型,推测近期发生大规范流行的可能性较小.

Objective To explore the distribution of prevalence rates of typhoid and paratyphoid,with drug resistance and molecular types ofSalmonella(S.) typhi and S.paratyphi in Jiangsu province.Methods Data,collected by the national infectious disease reporting system in Jiangsu province from 2007 to 2011,was analyzed.K-B method was used to test the sensibility to 9 kinds of antibiotics among 210 stains of S.typhi and S.paratyphi.81 strains of S.typhi were classified by pulse-field gel electrophoresis (PFGE).Results The annual average incidence of typhoid and paratyphoid was 0.47 per 100 000 in the last five years,showing a decreasing trend.Highest incidence (1.70 per 100 000)was seen in the ＜ 1 year age group,with S.typhi and S.paratyphi A accounted for 66.19％ and 23.81％ among the 210 stains.The rate of drug resistance to nalidixic acid appeared to be the highest as 66.19％.The drug resistant rates to 6 kinds of antibiotics were on average,lower than 10.00％.The multi-drug resistant rate of S.typhi and S.paratyphi was 30.00％.In the last 3 years,37 types from 81 S.typhi strains had been classified into 4 clusters by PFGE.The predominant type was JPPX01.JS0027,accounted for 11.11％.JPPX01.JS0001 type had a specific regional distribution,but JPPX01.JS0014,JPPX01.JS0018 and JPPX01.JS0024 strains were widely spread.Results from the clustering analysis showed that cases in the 3 events tended to have a clustering nature.Conclusion The morbidity of typhoid and paratyphoid was in a relatively low level in Jiangsu province.Although S.typhi and S.paratyphi were sensitive to most of the commonly used antibiotics,the resistance rates to some kinds of antibiotics were increasing.The distribution of typhoid was sporadic in Jiangsu and without the dominant strain,it was unlikely that typhoid could become epidemic in the future,in Jiangsu.