2005—2016年宁波市3种来源的非伤寒沙门菌对β-内酰胺类抗生素耐药性
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(1.宁波市第二医院重症监护中心,浙江 宁波 315010;2.宁波市疾病预防控制中心微生物检验科,浙江 宁波 315010)

作者简介:

詹晔斐 女 主治医师 研究方向为医院感染控制 E-mail:zhancn@163.com通信作者:┣┣(中)通信作者┫┫宋启发 男 主任技师 研究方向为细菌基因组学 E-mail:songqf@nbcdc.org.cn

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浙江省医药卫生科技计划(2018KY688,2016KYB274)


Antimicrobial resistance of β-lactam antibiotics among nontyphoidal Salmonella enteric isolates recovered from Ningbo City, 2005-2016
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(1.Intensive Care Unit, Ningbo No.2 Hospital, Zhejiang Ningbo 315010,China;2.Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Zhejiang Ningbo 315010,China)

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    摘要:

    目的 采用氨苄青霉素和第三代头孢菌素耐药水平、产超广谱β-内酰胺酶水平和可能耐药分子机制等指标,评价非伤寒沙门菌对β-内酰胺类抗生素的耐药水平,为相关疾病控制和治疗提供数据支撑。方法 采用美国临床和实验室标准化研究所(CLSI)纸片法检测2005—2016年宁波市在临床患者、食品和河水中分离的非伤寒沙门菌菌株对氨苄青霉素、头孢曲松和头孢曲松/克拉维酸的耐药水平,并通过聚合酶链式反应(PCR)技术检测菌株中是否携带有blaTEM、blaCTX-M和blaOXA 3种编码β-内酰胺酶的耐药基因以及1类(IntI1)和2类整合子基因(IntI2)。结果 从临床患者、食品和河水中共分离893株非伤寒沙门菌,其对氨苄青霉素的耐药率为37.8%(338/893),对头孢曲松耐药和产超广谱β-内酰胺酶的菌株占比分别为7.7%(69/893)和7.3%(65/893)。检测菌株中耐氨苄青霉素最高的3种血清型为印第安纳沙门菌(100.0%,11/11)、德尔卑沙门菌(69.7%,23/33)和鼠伤寒沙门菌(57.4%,148/258)。其他检出对头孢曲松耐药和产超广谱β-内酰胺酶的非伤寒沙门菌血清型有阿贡那沙门菌(4株)、肯塔基沙门菌(2株)和明斯特沙门菌(2株)。blaTEM基因主要存在于只对氨苄青霉素有耐药性的菌株中,blaCTX-M和blaOXA基因主要存在于对头孢曲松有耐药性的菌株中。检出的IntI1基因均为完整的整合子结构,包含1类整合子3′端Sul1和qacEΔ1基因,未检出IntI2基因。结论 分离自临床患者、食品和河水中的非伤寒沙门菌对氨苄青霉素具有较高的耐药水平,对第三代头孢菌素表现一定程度的耐药性。在印第安纳沙门菌、德尔卑沙门菌和鼠伤寒沙门菌等血清型中存在高水平的β-内酰胺类抗生素耐药现象。对β-内酰胺类抗生素耐药的非伤寒沙门菌具有较复杂的的分子机制,增加了耐药扩散的风险,应加强对非伤寒沙门菌耐药水平的监测和耐药机制的分析。

    Abstract:

    Objective To assess the prevalence of β-lactam resistance among nontyphoidal Salmonella (NTS) isolates including ampcillin and third-generation cephalosporins, detect the production of ESBL and analyzing their molecular mechanisms, and to provide data basis for relevant diseases control and treatment. Methods NTS isolates were collected from patients, food and river water in Ningbo from 2005 to 2016 and were tested for resistance to ampicillin, cefotaxime and cefotaxime/clavulanate using the disc diffusion method specified in Clinical and Laboratory Standards Institute (CLSI). Among isolates resistant to β-lactam anbiotics, β-lactamase genes (blaCTX-M, blaTEM, and blaOXA) and two types of integrons, class 1 and class 2, were amplified. Results Overall, 893 NTS isolates were obtained from patients, food and river water with resistance rates to ampicillin and cefotaxime, and ESBL-production rate of 37.8%(338/893), 7.7%(69/893)and 7.3%(65/893), respectively. The top three β-lactam-resistant serotypes were Salmonella indiana (100.0%,11/11), Salmonella derby (69.7%,23/33) and Salmonella typhimurium (57.4%,148/258). Other serotypes that were tested positive for cefotaxime resistance and ESBL production were Salmonella agona (4 isolates), Salmonella kentucky (2 isolates) and Salmonella muenster (2 isolates). Ampicillin-resistant isolates mainly contained blaTEM gene. Cefotaxime-resistant isolates often contained blaCTX-M and blaOXA gene. Most β-lactam-resistant isolates were found to have class 1 integron with complete structure. Conclusion High prevalence of ampicillin resistance and moderate prevalence of third-generation cephalosporins resistance existed in NTS isolates from patients, food and river water. High level of β-lactam resistance was found in several NTS serotypes such as Salmonella indiana, Salmonella derby and Salmonella typhimurium. Complicated molecular mechanisms existed in β-lactam-resistant NTS isolates, which might pose great risk to the spread of antibiotic resistance. Strengthened surveillance on β-lactam resistance and exploration of relevant molecular mechanisms were required.

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詹晔斐,许兆军,宋启发.2005—2016年宁波市3种来源的非伤寒沙门菌对β-内酰胺类抗生素耐药性[J].中国食品卫生杂志,2018,30(3):239-244.

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  • 收稿日期:2018-04-18
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  • 在线发布日期: 2018-06-20
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