济南市第四医院186株志贺菌属菌群分布及耐药性分析

发布时间：2019-01-07 15:20

【摘要】：目的对临床分离的186株志贺菌引起的感染现状进行分析,研究其耐药性变化趋势,为临床医生医治细菌性痢疾提供参考依据。方法收集本医院2011年3月-2014年12月门诊与住院患者,大便培养中分离的186株志贺菌,采用确证试验、改良三维实验检测超广谱β-内酰胺酶(ESBLs)、头孢菌素酶(Amp C),并对两种酶的检出率进行统计分析,用K-B法(Kirby-Bauer method)检测菌株对抗菌药物的敏感性,分析志贺菌血清群分布规律及耐药性变化趋势。结果本次检测的186株志贺菌中,有156株为福氏志贺菌,血清型分别为f2a 100株、f4a 38株、f1a 18株,30株宋内志贺菌血清型全部为粗糙型(R);186株志贺菌中25株产ESBLs,检出比率13.4%(25/186),没有产Amp C菌株;福氏与宋内志贺菌对氨苄西林、阿莫西林/克拉维酸、氯霉素、庆大霉素的耐药性存在明显不同;产ESBLs(extendedspectrumβ-lactamases)志贺菌的耐药性比非产ESBLs志贺菌耐药性明显增高。结论 186株志贺菌中,福氏志贺菌分离率最高(156株),宋内志贺菌次之(30株),有13.4%(25/186)的志贺菌株产生ESBLs,耐药性呈现福氏志贺菌强于宋内志贺菌以及产ESBLs菌强于非产ESBLs菌趋势,临床医生应根据菌株流行规律及细菌耐药谱慎重选择抗菌药物,用于菌痢的医治。
[Abstract]:Objective to analyze the infection status of 186 Shigella strains isolated in clinic, to study the trend of drug resistance, and to provide reference for clinicians to treat bacillary dysentery. Methods 186 Shigella strains isolated from outpatients and inpatients in our hospital from March 2011 to December 2014 were collected. The extended spectrum 尾 -lactamase (ESBLs), cephalosporinase (Amp C), was detected by confirmatory test and modified three-dimensional test. The detection rate of the two enzymes was statistically analyzed. The susceptibility of the strains to antimicrobial agents was detected by K-B method (Kirby-Bauer method), and the distribution of serum groups of Shigella and the trend of drug resistance were analyzed. Results of the 186 Shigella strains tested, 156 were Shigella flexneri. The serotypes were f2a 100, f4a 38, f1a 18, and 30 Shigella sonnei serotypes were all rough (R);. 25 strains of Shigella spp. The detection rate of ESBLs, production was 13.4% (25 / 186), and no Amp C production was found, and the resistance of Shigella flexneri to ampicillin, amoxicillin / clavulanic acid, chloramphenicol and gentamicin was significantly different. The resistance of Shigella producing ESBLs (extendedspectrum 尾-lactamases was significantly higher than that of non-ESBLs producing Shigella. Conclusion among the 186 Shigella strains, Shigella flexneri has the highest isolation rate (156), followed by Shigella sonnei (30), with 13.4% (25 / 186) of Shigella producing ESBLs,. The drug resistance of Shigella flexneri was stronger than that of Shigella sonnei and that of ESBLs producing bacteria was stronger than that of non-producing ESBLs bacteria. The clinicians should carefully select antimicrobial agents according to the epidemic pattern of the strains and the spectrum of bacterial resistance to be used for the treatment of dysentery.
【作者单位】：济南市第四人民医院检验科;
【基金】：基金项目:济科合字(2008)07039-3号济卫科发(2008)10号
【分类号】：R446.5

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