2019年北京市昌平区某医院腹泻患者阪崎克罗诺杆菌分子特征分析

Molecular characterization of Cronobacter sakazakii in patients with diarrhea in a hospital in Changping DistrictBeijing2019

  • 摘要:
    目的 了解北京市昌平区腹泻患者阪崎克罗诺杆菌(简称“克罗诺杆菌”)感染现状及其分子流行特征,为该地区克罗诺杆菌腹泻病的预防控制提供科学依据。
    方法 收集2019年北京市昌平区某哨点医院腹泻患者粪便样本760份,进行克罗诺杆菌、沙门菌、致泻性大肠埃希菌、副溶血弧菌检测,并对分离到的克罗诺杆菌进行药敏试验和脉冲场凝胶电泳(PFGE)分型分析。
    结果 760份样本中共检出20株(2.63%)克罗诺杆菌,其检出率低于沙门菌和副溶血弧菌(χ2=9.052,P=0.011),与致泻性大肠埃希菌的检出率差异无统计学意义(χ2=1.076,P=0.300)。季节特征分析显示,克罗诺杆菌在春(1.00%)、夏(4.17%)、秋(3.00%)、冬(1.67%)四季均有检出,差异有统计学意义(χ2=662.700,P<0.001)。PFGE分析显示,20株克罗诺杆菌具有20种PFGE带型,相似系数为56.30%~90.09%,其PFGE带型具有多样性。药敏试验结果显示,克罗诺杆菌对头孢唑林18株(90.00%)菌耐药,2株(10.00%)菌中介;对头孢西丁2株(10.00%)菌耐药, 5株(25.00%)菌中介;对其他11种抗生素100.00%敏感。
    结论 本研究中克罗诺杆菌四季检出,对头孢唑林耐药率高,无多重耐药菌出现,PFGE带型呈现多样性。

     

    Abstract:
    Objective To understand the current status of Cronobacter sakazakii (Cronobacter spp.) infection and its molecular epidemiological characteristics among patients with diarrhea, so as to provide evidence for the prevention and control of diarrhea disease caused by infection with Cronobacter spp. in Changping District, Beijing.
    Methods 760 stool samples were collected from the diarrhea patients in a sentinel hospital in 2019, for the detection of Cronobacter spp., Salmonella, diarrheogenic Escherichia coli (DEC), and Vibrio Parahaemolyticus. Meanwhile, drug sensitivity experiment and pulsed-field gel electrophoresis (PFGE) typing analysis were conducted on the Cronobacter spp. strains isolated.
    Results A total of 20 Cronobacter spp. strains (2.63%) were isolated, with a lower detection rate than that of Salmonella and Vibrio Parahaemolyticus (χ2=9.052, P=0.011). However, there were no statistically significant differences between the detection rates in Cronobacter spp. and DEC (χ2=1.076, P=0.300). Seasonal characterization analysis showed that Cronobacter spp. could be detected in spring (1.00%), summer (4.17%), autumn (3.00%) and winter (1.67%), and the differences were statistically significant (χ2=662.700, P<0.001). The PFGE analysis showed that 20 PFGE banding patterns were found in 20 Cronobacter spp. strains, with a similarity coefficient ranging from 56.30% to 90.09% and a diverse PFGE banding pattern. The drug sensitivity experiment results showed that 18 (90.00%) strains were resistant to cefazolin, and 2 (10.00%) strains were intermediate. While, as for cefoxitin, 2 (10.00%) strains were resistant to it, and 5 (25.00%) strains were intermediate. All the 20 strains were 100.00% sensitive to the other 11 antibiotics.
    Conclusion In the study, Cronobacter spp. is detected in all seasons through the year, with a high resistance rate to cefazolin, no multi-drug resistant bacteria appeared, and diverse PFGE banding patterns.

     

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