2007-2017年四川省宋内志贺菌分离株脉冲场凝胶电泳分型及耐药性分析
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摘要
目的了解2007—2017年四川省腹泻病例样本宋内志贺菌分离株耐药状况及脉冲场凝胶电泳(PFGE)型别分布。方法将腹泻病例监测中经过生化和血清学鉴定的30株宋内志贺菌进行PFGE分型分析,采用微量肉汤稀释法测定菌株对14种药物的最低抑菌浓度。结果宋内志贺菌分离株仅对头孢西丁敏感,多重耐药菌株占总数的96.67%。对环丙沙星、阿奇霉素的耐药率超过10%,对包括头孢噻肟在内的7种常见药物耐药率达到50%以上。分离株可分为16个PFGE型,有2个优势簇占总分离数的80%,其他型别占20%。在优势簇I中的SCSN-1和SCSN-3中各检测到一起疑似暴发事件。结论 2007—2017年四川省腹泻病例宋内志贺菌分离株PFGE优势带型明显,且部分带型存在聚集。菌株耐药情况严重,部分菌株对细菌性腹泻常用抗生素环丙沙星、阿奇霉素和三代头孢中的头孢噻肟耐受。
Objective To understand the drug resistance and pulsed-field gel electrophoresis(PFGE) patterns of Shigella sonnei strains isolated from sporadic diarrhea cases in surveillance in Sichuan province during 2007–2017. Methods A total of 30 S. sonnei strains isolated from diarrhea patients were analyzed by PFGE and tested for minimal inhibitory concentration of 14 antibiotics after the serological and biochemical identification. Results The antibiotic resistance test indicated all the isolates were only sensitive to cefoxitin, while 96.67% of the strains were multi-drug resistant. The resistance rates to azithromycin and ciprofloxacin were more than 10%. The resistance to 7 common antibiotics, including cefotaxime, reached more than 50%. PFGE typing showed that strains had 16 patterns and two predominant clusters which accounted for 80%, and other types accounted for 20%. A suspected outbreak caused by SCSN-1 and SCSN-3 from cluster I was detected respectively.Conclusion S. sonnei isolated in Sichuan from 2007 to 2017 had two predominant PFGE clusters and partial subtype showed clustering. The strains had high drug resistance, some of which showed resistance to common antibiotics used in the treatment of bacterial diarrhea, such as ciprofloxacin, azithromycin and cefotaxime.
Objective To understand the drug resistance and pulsed-field gel electrophoresis(PFGE) patterns of Shigella sonnei strains isolated from sporadic diarrhea cases in surveillance in Sichuan province during 2007–2017. Methods A total of 30 S. sonnei strains isolated from diarrhea patients were analyzed by PFGE and tested for minimal inhibitory concentration of 14 antibiotics after the serological and biochemical identification. Results The antibiotic resistance test indicated all the isolates were only sensitive to cefoxitin, while 96.67% of the strains were multi-drug resistant. The resistance rates to azithromycin and ciprofloxacin were more than 10%. The resistance to 7 common antibiotics, including cefotaxime, reached more than 50%. PFGE typing showed that strains had 16 patterns and two predominant clusters which accounted for 80%, and other types accounted for 20%. A suspected outbreak caused by SCSN-1 and SCSN-3 from cluster I was detected respectively.Conclusion S. sonnei isolated in Sichuan from 2007 to 2017 had two predominant PFGE clusters and partial subtype showed clustering. The strains had high drug resistance, some of which showed resistance to common antibiotics used in the treatment of bacterial diarrhea, such as ciprofloxacin, azithromycin and cefotaxime.
引文
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[8]吕冰,张新,黄瑛,等.北京地区2010-2015年宋内志贺菌脉冲场凝胶电泳分型及耐药特征分析[J].疾病监测,2016,31(10):870-874.DOI:10.3784/j.issn.1003-9961.2016.10.016.Lyu B,Zhang X,Huang Y,et al.Pulsed field gel electrophoresis typing and drug resistance detection of Shigella sonnei isolated in Beijing,2010-2015[J].Dis Surveill,2016,31(10):870-874.DOI:10.3784/j.issn.1003-9961.2016.10.016.
[9]张雯霞,陈敏,张曦,等.2010-2014年上海市志贺菌菌群分布及耐药性分析[J].现代预防医学,2016,43(5):896-899.Zhang WX,Chen M,Zhang X,et al.Distribution and antibiotics resistance of Shigella spp.in Shanghai China,2010-2014[J].Mod Prev Med,2016,43(5):896-899.
[10]赵嘉咏,张白帆,穆玉姣,等.河南省2011-2014年D群宋内志贺菌病原学监测与分子流行病学研究[J].中华流行病学杂志,2016,37(4):558-562.DOI:10.3760/cma.j.issn.0254-6450.2016.04.024.Zhao JY,Zhang BF,Mu YJ,et al.Surveillance on the etiology and molecular epidemiology of Shigella sonnei isolated in Henan province from 2011 to 2014[J].Chin J Epidemiol,2016,37(4):558-562.DOI:10.3760/cma.j.issn.0254-6450.2016.04.024.
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[12]余华丽,常昭瑞,张立实,等.国家监测点2005年志贺菌菌型分布和药敏结果分析[J].中华流行病学杂志,2007,28(4):370-373.DOI:10.3760/j.issn:0254-6450.2007.04.016.Yu HL,Chang ZR,Zhang LS,et al.Analysis on the status of Shigella spp.antimicrobial resistance through data from the national shigellosis surveillance system in China,in 2005[J].Chin J Epidemiol,2007,28(4):370-373.DOI:10.3760/j.issn:0254-6450.2007.04.016.
[13]李柏生,陈柳军,柯碧霞,等.广东省和广西壮族自治区部分地区2014-2016年宋内志贺菌病原学特征分析[J].中华流行病学杂志,2017,38(11):1541-1545.DOI:10.3760/cma.j.issn.0254-6450.2017.11.021.Li BS,Chen LJ,Ke BX,et al.Etiologic characteristics of Shigella sonnei strains isolated from some areas of Guangdong province and Guangxi Zhuang Autonomous Region of China,2014-2016[J].Chin J Epidemiol,2017,38(11):1541-1545.DOI:10.3760/cma.j.issn.0254-6450.2017.11.021.
[14]夏昕,覃迪,贺子翔,等.湖南省2013-2016年宋内志贺菌疫情分离株的耐药性及分子流行病学溯源分型分析[J].实用预防医学,2017,24(11):1285-1288,1295.DOI:10.3969/j.issn.1006-3110.2017.11.002.Xia X,Qin D,He ZX,et al.Antibiotic resistance and molecular epidemiology tracing classification of Shigella sonnei epidemic strains isolated in Hunan province,2013-2016[J].Pract Prev Med,2017,24(11):1285-1288,1295.DOI:10.3969/j.issn.1006-3110.2017.11.002.
[15]Holt KE,Baker S,Weill FX,et al.Shigella sonnei genome sequencing and phylogenetic analysis indicate recent global dissemination from Europe[J].Nat Genet,2012,44(9):1056-1059.DOI:10.1038/ng.2369.
[16]Hao CT,Rabaa MA,Thanh DP,et al.South Asia as a reservoir for the global spread of ciprofloxacin-resistant Shigella sonnei:a cross-sectional study[J].PLo S Med,2016,13(8):e1002055.DOI:10.1371/journal.pmed.1002055.
[17]Holt KE,Nga TVT,Thanh DP,et al.Tracking the establishment of local endemic populations of an emergent enteric pathogen[J].Proc Natl Acad Sci USA,2013,110(43):17522-17527.DOI:10.1073/pnas.1308632110.
[18]Gu B,Zhou M,Ke X,et al.Comparison of resistance to thirdgeneration cephalosporins in Shigella between Europe-America and Asia-Africa from 1998 to 2012[J].Epidemiol Infect,2015,143(13):2687-2699.DOI:10.1017/S0950268814003446.
[19]Gu B,Cao Y,Pan SY,et al.Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe-America and Asia-Africa from 1998 to 2009[J].Int J Antimicrob Agents,2012,40(1):9-17.DOI:10.1016/j.ijantimicag.2012.02.005.
[2]Thompson CN,Duy PT,Baker S.The rising dominance of Shigella sonnei:an intercontinental shift in the etiology of bacillary dysentery[J].PLo S Negl Trop Dis,2015,9(6):e0003708.DOI:10.1371/journal.pntd.0003708.
[3]杨小蓉,何树森,赵晋,等.2006年四川省菌痢暴发疫情分子流行病学分析[J].预防医学情报杂志,2008,24(2):125-128.DOI:10.3969/j.issn.1006-4028.2008.02.015.Yang XR,He SS,Zhao J,et al.Shigella molecular epidemic characteristics from outbreaks of Sichuan province in 2006[J].JPrev Med Inf,2008,24(2):125-128.DOI:10.3969/j.issn.1006-4028.2008.02.015.
[4]黄伟峰,颜雯雯,张红,等.一起菌痢疫情实验室检测分析[J].预防医学情报杂志,2015,31(5):356-360.Huang WF,Yan WW,Zhang H,et al.Laboratory detection of pathogens in a bacillary dysentery outbreak[J].J Prev Med Inf,2015,31(5):356-360.
[5]Centers for Disease Control and Prevention.Standard operating procedure for Pulse Net PFGE of Escherichia coli O157∶H7,Escherichia coli non-O157(STEC),Salmonella serotypes,Shigella sonnei and Shigella flexneri[S].USA:Centers for Disease Control and Prevention,2017.
[6]Clinical and Laboratory Standards Institute.CLSI M100.Performance standards for antimicrobial susceptibility testing[S].USA:Clinical and Laboratory Standards Institute,2017.
[7]Bangtrakulnonth A,Vieira AR,Lo Fo Wong DMA,et al.Shigella from humans in thailand during 1993 to 2006:spatial-time trends in species and serotype distribution[J].Foodb Pathog Dis,2008,5(6):773-784.DOI:10.1089/fpd.2008.0109.
[8]吕冰,张新,黄瑛,等.北京地区2010-2015年宋内志贺菌脉冲场凝胶电泳分型及耐药特征分析[J].疾病监测,2016,31(10):870-874.DOI:10.3784/j.issn.1003-9961.2016.10.016.Lyu B,Zhang X,Huang Y,et al.Pulsed field gel electrophoresis typing and drug resistance detection of Shigella sonnei isolated in Beijing,2010-2015[J].Dis Surveill,2016,31(10):870-874.DOI:10.3784/j.issn.1003-9961.2016.10.016.
[9]张雯霞,陈敏,张曦,等.2010-2014年上海市志贺菌菌群分布及耐药性分析[J].现代预防医学,2016,43(5):896-899.Zhang WX,Chen M,Zhang X,et al.Distribution and antibiotics resistance of Shigella spp.in Shanghai China,2010-2014[J].Mod Prev Med,2016,43(5):896-899.
[10]赵嘉咏,张白帆,穆玉姣,等.河南省2011-2014年D群宋内志贺菌病原学监测与分子流行病学研究[J].中华流行病学杂志,2016,37(4):558-562.DOI:10.3760/cma.j.issn.0254-6450.2016.04.024.Zhao JY,Zhang BF,Mu YJ,et al.Surveillance on the etiology and molecular epidemiology of Shigella sonnei isolated in Henan province from 2011 to 2014[J].Chin J Epidemiol,2016,37(4):558-562.DOI:10.3760/cma.j.issn.0254-6450.2016.04.024.
[11]Lappe ND,O′Connor J,Garvey P,et al.Ciprofloxacin-resistant Shigella sonnei associated with travel to India[J].Emerg Infect Dis,2015,21(5):894-896.DOI:10.3201/eid2105.141184.
[12]余华丽,常昭瑞,张立实,等.国家监测点2005年志贺菌菌型分布和药敏结果分析[J].中华流行病学杂志,2007,28(4):370-373.DOI:10.3760/j.issn:0254-6450.2007.04.016.Yu HL,Chang ZR,Zhang LS,et al.Analysis on the status of Shigella spp.antimicrobial resistance through data from the national shigellosis surveillance system in China,in 2005[J].Chin J Epidemiol,2007,28(4):370-373.DOI:10.3760/j.issn:0254-6450.2007.04.016.
[13]李柏生,陈柳军,柯碧霞,等.广东省和广西壮族自治区部分地区2014-2016年宋内志贺菌病原学特征分析[J].中华流行病学杂志,2017,38(11):1541-1545.DOI:10.3760/cma.j.issn.0254-6450.2017.11.021.Li BS,Chen LJ,Ke BX,et al.Etiologic characteristics of Shigella sonnei strains isolated from some areas of Guangdong province and Guangxi Zhuang Autonomous Region of China,2014-2016[J].Chin J Epidemiol,2017,38(11):1541-1545.DOI:10.3760/cma.j.issn.0254-6450.2017.11.021.
[14]夏昕,覃迪,贺子翔,等.湖南省2013-2016年宋内志贺菌疫情分离株的耐药性及分子流行病学溯源分型分析[J].实用预防医学,2017,24(11):1285-1288,1295.DOI:10.3969/j.issn.1006-3110.2017.11.002.Xia X,Qin D,He ZX,et al.Antibiotic resistance and molecular epidemiology tracing classification of Shigella sonnei epidemic strains isolated in Hunan province,2013-2016[J].Pract Prev Med,2017,24(11):1285-1288,1295.DOI:10.3969/j.issn.1006-3110.2017.11.002.
[15]Holt KE,Baker S,Weill FX,et al.Shigella sonnei genome sequencing and phylogenetic analysis indicate recent global dissemination from Europe[J].Nat Genet,2012,44(9):1056-1059.DOI:10.1038/ng.2369.
[16]Hao CT,Rabaa MA,Thanh DP,et al.South Asia as a reservoir for the global spread of ciprofloxacin-resistant Shigella sonnei:a cross-sectional study[J].PLo S Med,2016,13(8):e1002055.DOI:10.1371/journal.pmed.1002055.
[17]Holt KE,Nga TVT,Thanh DP,et al.Tracking the establishment of local endemic populations of an emergent enteric pathogen[J].Proc Natl Acad Sci USA,2013,110(43):17522-17527.DOI:10.1073/pnas.1308632110.
[18]Gu B,Zhou M,Ke X,et al.Comparison of resistance to thirdgeneration cephalosporins in Shigella between Europe-America and Asia-Africa from 1998 to 2012[J].Epidemiol Infect,2015,143(13):2687-2699.DOI:10.1017/S0950268814003446.
[19]Gu B,Cao Y,Pan SY,et al.Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe-America and Asia-Africa from 1998 to 2009[J].Int J Antimicrob Agents,2012,40(1):9-17.DOI:10.1016/j.ijantimicag.2012.02.005.