摘要目的 了解河南省腹泻患者肠炎沙门菌分离株的病原学、耐药特征与脉冲场凝胶电泳(PFGE)型别.方法 收集2013年4月至2015年12月河南省7家腹泻病多病原监测哨点医院腹泻患者82株肠炎沙门菌,参照美国临床与实验室标准化协会(2015)的纸片法(Kirby-Bauer,K-B)药物敏感测试方案与判定标准,进行7类11种抗菌药物的药物敏感试验.根据国际细菌性传染病分子分型监测网络实验室公布的非伤寒沙门菌PFGE分子分型与BioNumerics6.0聚类分析方法对82株肠炎沙门菌进行分型.结果 82株肠炎沙门菌47株分离自男性,35株分离自女性.0～5岁低龄儿童共分离到56株,其中6月龄至2岁婴幼儿分离到29株.分离时间集中于每年的5至11月份,其中3至4月份15株(18.3％),5至7月份27株(32.9％),8至10月份34株(41.5％),其余月份6株(7.3％),具有较典型的夏秋季节特征.82株肠炎沙门菌对氨苄西林耐药64株(78.0％),对头孢他啶耐药23株(28.0％),对头孢噻肟耐药39株(47.6％),对头孢吡肟耐药13株(15.9％),对萘啶酸耐药55株(67.1％),对环丙沙星耐药24株(29.3％),对庆大霉素耐药32株(39.0％),对氯霉素耐药14株(17.1％),对甲氧苄氨嘧啶耐药47株(57.3％),对复方新诺明耐药13株(15.9％),对四环素耐药21株(25.6％).82株肠炎沙门菌均对2种以上抗菌药物耐药,其中耐3～4种的为21株(25.6％),耐5～6种的为32株(39.0％),耐7～8种的为29株(35.4％).经XbaⅠ酶切和PFGE后82株肠炎沙门菌共分为25种带型(EN1～EN25),各带型包含菌株数为1～26株不等,带型相似度为59.33％～100.00％,EN1、EN2分别包含26和16株菌,为该血清型主要优势带型.结论 河南省临床分离的肠炎沙门菌耐药状况较严重,PFGE带型呈现出多样性的同时又具有一定的优势带型特点,部分带型与其对应的耐药谱具有一定的关联性及相同的聚集性.

abstractsObjective To investigate the etiological,antimicrobial resistance status and pulsed field gel electrophoresis (PFGE) patterns of S.enteritidis strains in Henan Province.Methods Totally 82 strains of S.enteritidis strains were isolated from seven sentiel hospitals which were able to detect multiple pathogens from April,2013 to December,2015.According to Salmonella K-B drug susceptibility testing and molecular typing method published by the USA clinical and Laboratory Standards Institute (2015),the drug sensitivity to 7 kinds of antimicrobial agents and PFGE molecule characteristics of 82 S.enteritidis strains were tested.The PFGE patterns were analyzed by BioNumerics 6.0 software based on international PulseNet bacterial infectious disease monitoring network.Results Forty-seven strains of S.enteritidis were isolated from male patients,35 strains isolated from female patients.A total of 56 S.enteritidis strains were isolated from young children aged from 0 to 5 years old,including 29 strains isolated from 6 months to 2 years old.The strains were mainly isolated between May and November of the year,and 15 (18.3％) strains were isolated between March and April,27(32.9％) strains between May and July,34 (41.5％) strains between August and October,6 (7.3％) strains were isolated in the rest time of the year,with a typical seasonal characteristics of summer and autumn.Sxity-four (78.0％)strains of S.enteritidis were resistant to ampicillin;23 (28.0％) strains were resistant to ceftazidime;39 (47.6％) strains were resistant to cefotaxime:13 (15.9％) strains were resistant to cefepime;55 (67.1％) strains were resistant to nalidixic acid;24 (29.3％) strains were resistant to ciprofloxacin;32 (39.0 ％) strains were resistant to gentamicin;14 (17.1 ％) strains were resistant to chloramphenicol;47 (57.3％) strains were resistant to methicillin benzyl ammonium;13 (15.9％) strains were resistant to sulfamethoxazole and trimethoprim;21 (25.6 ％) strains were resistant to tetracycline.All strains weremuhi-drug resistant,and 21 (25.6％) isolates were resistant to 3-4 kinds of antibiotics,32 (39.0％)isolates were resistant to 5-6 kinds of antibiotics, 29 (35.4 ％) isolates were resistant to 7-8 kinds ofantibiotics.These 82 strains of S.enteritidis were divided into 25 molecular patterns by digestion withXba Ⅰ enzyme.Each pattern contained 1 to 26 strains with similarity ranged from 59.33％-100.00％.EN1 and EN2 were the main PFGE belt types and included 26 and 16 strains,respectively.Conclusions The drug resistance of clinical isolates of S.enteritidis in Henan province is serious.PFGE patterns show polymorphism and the dominant patterns,part of which are associated with drug-resistance spectrum and show aggregation.