20192023年上海市闵行区食源性腹泻沙门菌流行及耐药特征分析

Epidemiology and antimicrobial resistance characteristics of foodborne Salmonella diarrhea in Minhang DistrictShanghai2019‒2023

  • 摘要:
    目的 了解上海市闵行区感染性腹泻病例中食源性沙门菌的血清型分布及耐药特征,为沙门菌感染的诊治和防控提供依据。
    方法 收集2019—2023年闵行区监测哨点医院食源性腹泻病例的粪便或肛拭子样本,进行沙门菌分离、生化鉴定和血清分型,并通过微量肉汤稀释法开展药敏试验。
    结果 共收集4 294份样本,分离到224株沙门菌,分离率为5.22%。沙门菌阳性率无性别差异。阳性率呈季节性波动(χ²=160.475,P<0.001),夏秋季阳性率高于春秋季;不同职业人群中,离退休人员阳性率最高(7.30%)(χ²=20.023,P=0.001);不同年龄组中,≥80岁阳性率最高(7.33%)(χ²=13.491,P=0.009)。共鉴定出28种血清型,肠炎沙门菌最多,其次是鼠伤寒沙门菌。其中154株为3类及3类以上抗菌药物耐药的多重耐药菌(68.75%)。多重耐药菌株中最常见的耐药谱为氨苄西林(AMP)⁃氨苄西林/舒巴坦(AMS)⁃甲氧苄啶/磺胺甲噁唑(SXT)⁃氯霉素(CHL)⁃四环素(TET)⁃链霉素(STR)、AMP⁃TET⁃STR和AMP⁃AMS⁃TET⁃STR,均检出9株。
    结论 上海市闵行区食源性沙门菌感染在夏秋季高发,离退休人员感染率较高,≥60岁人群为高危群体。建议加强高危人群防护,可在夏秋季实行针对性防控措施,降低感染的风险,注意指导临床用药和防控。

     

    Abstract:
    Objective To investigate the serotype distribution and antimicrobial resistance characteristics of foodborne Salmonella in infectious diarrhea cases in Minhang District, Shanghai, and to provide evidence for clinical diagnosis, treatment, prevention, and control of salmonellosis.
    Methods Fecal or anal swab samples were collected from foodborne diarrhea cases at sentinel hospitals between 2019 and 2023 in Minhang District of Shanghai. Salmonella was isolated, biochemically identified, and serotyped. Antimicrobial susceptibility testing was performed via the microbroth dilution method.
    Results A total of 4 294 samples were collected, from which 224 Salmonella strains were isolated, with an isolation rate of 5.22%. There was no gender difference in the positive rate of Salmonella. The positive rate showed seasonal fluctuations (χ²=160.475, P<0.001), with a higher positive rate in summer and autumn than in spring and autumn. Among different occupational groups, the positive rate was the highest among retired people (7.30%) (χ²=20.023, P=0.001). Among different age groups, the positive rate was the highest among those aged 80 years and above (7.33%) (χ²=13.491, P=0.009). A total of 28 serotypes were identified, with Salmonella Enteritidis being the most predominant, followed by Salmonella Typhimurium. Among them, 154 strains were multi-drug resistant to three or more types of antibiotics (68.75%). The most common drug resistance patterns among multi-drug resistant strains were ampicillin (AMP)-ampicillin/sulbactam (AMS)-sulfamethoxazole/trimethoprim (SXT)-chloramphenicol (CHL)-tetracycline (TET)-streptomycin (STR), AMP-TET-STR and AMP-AMS-TET-STR, with 9 strains being detected in each isolates.
    Conclusion The positive rate of foodborne Salmonella in Minhang District, Shanghai, is high in summer and autumn, with a higher infection rate among retired people and those aged 60 years and above being the high-risk group. It is recommended to strengthen the protection for high-risk groups, implement targeted prevention and control measures in summer and autumn to reduce the risk of infection, and pay attention to guiding clinical medication and infection control.

     

/

返回文章
返回