摘要
目的分析山西省2021—2022年食源性疾病主动监测病原学特征、血清型分布、耐药性结果及分子分型特征。方法采集2021—2022年山西省17家哨点医院食源性疾病病例粪便或肛拭子,检测志贺菌、沙门菌、副溶血性弧菌及5种致泻性大肠埃希菌,将分离到的阳性菌株用质谱或系统生化进行鉴定。玻片凝集法对沙门菌和志贺菌进行血清型分型,多重荧光PCR对致泻性大肠埃希菌进行分型,并对副溶血性弧菌进行tlh/tdh/trh毒力基因检测。所有菌株采用微量肉汤稀释法进行耐药试验。脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)进行分子分型。结果2021—2022年17家哨点医院共采集腹泻患者标本4481份,检出目标菌数555株,检出率为12.39%(555/4481)。其中沙门菌365株、致泻性大肠埃希菌175株及副溶血性弧菌15株,未检出志贺菌。沙门菌共32种血清型,优势血清型为肠炎沙门菌158株和鼠伤寒沙门菌124株。致泻性大肠埃希菌分型:肠聚集性大肠埃希菌79株、肠致病性大肠埃希菌72株、肠产毒性大肠埃希菌23株及肠出血性大肠埃希菌1株,未检出肠侵袭性大肠埃希菌。所有副溶血性弧菌均携带tlh,11株(73.33%,11/15)只携带tdh,2株(13.33%,2/15)只携带trh,1株(6.67%,1/15)同时携带tdh和trh,1株(6.67%,1/15)均不携带这两种毒力基因。沙门菌对氨苄西林的耐药率最高,为85.21%(311/365);其次为萘啶酸,耐药率为66.58%(243/365);多重耐药率为78.63%(287/365),产生135种耐药谱。致泻性大肠埃希菌对氨苄西林的耐药率最高,为81.71%(143/175);其次为四环素,耐药率为67.43%(118/175);多重耐药率为72.57%(127/175),产生81种耐药谱。副溶血性弧菌对头孢唑林的耐药率最高,为93.33%(14/15);其次为四环素,耐药率为26.67%(4/15);多重耐药率为20.00%(3/15),产生3种耐药谱。选取158株肠炎沙门菌、124株鼠伤寒沙门菌、13株伦敦沙门菌及175株致泻性大肠埃希菌进行PFGE分型,470株PFGE分型菌株中,有6株致泻性大肠埃希菌降解,其余菌株都得到有效PFGE带型:肠炎沙门菌经聚类分析可分为64个PFGE带型,鼠伤寒沙门菌分为115个,伦敦沙门菌分为13个,致泻性大肠埃希菌分为165个。结论山西省2021—2022年食源性疾病主动监测检出最多的菌株为沙门菌,未检出志贺菌;沙门菌和致泻性大肠埃希菌对氨苄西林耐药率最高,副溶血性弧菌对头孢唑林耐药率最高。PFGE分型呈多态性,优势带型不明显。菌株多重耐药严重,应加强耐药监测。
ObjectiveTo analyze the etiological characteristics,serotype distribution,drug resistance and molecular typing characteristics based on data collected by active surveillance of foodborne diseases in Shanxi Province from 2021 to 2022.MethodsFecal and anal swabs for foodborne disease tests were collected from 17 sentinel hospitals in Shanxi Province from 2021 to 2022.The pathogens included Shigella,Salmonella,Vibrio parahaemolyticus and 5 types of diarrheagenic Escherichia coli(E.coli).The positive strains were identified by mass spectrometry or systematic biochemistry.Salmonella and Shigella were serotyped by slide agglutination,and diarrheagenic E.coli was typed by multiplex fluorescence PCR.Vibrio parahaemolyticus was tested for tlh/tdh/trh virulence genes by multiplex fluorescent PCR.All strains were also tested for drug resistance by the microbroth dilution method.Molecular typing was performed by pulsed-field gel electrophoresis(PFGE).ResultsA total of 4481 samples were collected from patients with diarrhea,and 555 target strains were detected,with a detection rate of 12.39%(555/4481).Among them,there were 365 strains of Salmonella,175 strains of diarrheagenic E.coli,15 strains of Vibrio parahaemolyticus,and no Shigella.There were 32 serotypes of Salmonella,and the dominant serotypes were 158 strains of Salmonella senteritidis and 124 strains of Salmonella typhimurium.diarrheagenic E.coli classification:79 strains of enteroaggregative E.coli,72 strains of enteropathogenic E.coli,23 strains of enterotoxic E.coli,1 strain of enterohemorrhagic E.coli,and none of enteroinvasive E.coli.For Vibrio parahaemolyticus virulence gene carriage,all strains carried tlh;11 strains(73.33%,11/15)carried tdh only;2 strains(13.33%,2/15)carried trh;1 strain(6.67%,1/15)carried both tdh and trh genes;1 strain(6.67%,1/15)did not carry these two virulence genes.Antimicrobial resistance tests presented that Salmonella had the highest resistance rate to ampicillin(85.21%,311/365),followed by naphridic acid(66.58%,243/365),and multi-drug resistance(78.63%,287/365),resulting in 135 drug resistance spectrums.The resistance rate of diarrheagenic E.coli to ampicillin was the highest(81.71%,143/175),followed by tetracycline(67.43%,118/175),and multi-drug resistance(72.57%,127/175),resulting in 81 drug resistance spectrums.Vibrio parahaemolyticus had the highest resistance rate to cefazolin(93.33%,14/15),followed by tetracycline(26.67%,4/15)and multi-drug resistance(20.00%,3/15),resulting in 3 drug resistance spectrums.A total of 158 strains of Salmonella enteritidi,124 strains of Salmonella typhimurium,13 strains of Salmonella london and 175 strains of DEC were typed by PFGE.Among 470 strains of PFGE typing,6 strains of DEC were degraded by DNA,while the remaining strains obtained effective PFGE band.Salmonella enteritidi were divided into 64 PFGE band types,Salmonella typhimurium were divided into 115 PFGE band types,Salmonella london were divided into 13 PFGE band types and diarrheagenic E.coli were divided into 165 PFGE band types.Conclusions Shigella is not detected in the active surveillance,and Salmonella is detected most frequently.Salmonella and diarrheagenic E.coli have the highest resistance rates to ampicillin,and Vibrio parahaemolyticus has the highest resistance rates to cefazolin.The PFGE classification is polymorphic,and the dominant band type is not obvious.The evidence of multi-drug resistance suggests further strengthening monitoring and management of drug resistance.
作者
韩吉婷
杨红霞
张秋香
王洋
姚素霞
郝瑞娥
王尚敏
Han Jiting;Yang Hongxia;Zhang Qiuxiang;Wang Yang;Yao Suxia;Hao Rui′e;Wang Shangmin(Disease Inspection Laboratary,Shanxi Provincial Center for Disease Control and Prevention,Taiyuan 030012,China)
出处
《中华微生物学和免疫学杂志》
北大核心
2025年第6期519-528,共10页
Chinese Journal of Microbiology and Immunology
关键词
食源性疾病
血清型
毒力基因
耐药
Foodborne disease
Serotypes
Virulence gene
Drug resistance
