2023—2024年上海市宝山区腹泻病沙门菌血清型及耐药性分析

Analyses of serotypes and antibiotic resistance of Salmonella in diarrheal diseases in Baoshan District of Shanghai from 2023 to 2024

  • 摘要:目的】 回顾性分析上海市宝山区2023—2024年腹泻病沙门菌血清型、耐药表型及耐药基因型之间的相关性,为沙门菌感染防控以及指导临床合理用药提供参考。【方法】 对2023—2024年上海市宝山区腹泻病监测样本中的沙门菌进行血清分型,采用微量肉汤稀释法检测沙门菌耐药表型,应用全基因组测序进行耐药基因分析。【结果】 64株沙门菌分属17种血清型,优势血清型为鼠伤寒沙门菌(25.00%)和肠炎沙门菌(18.75%)。测试菌株对氨苄西林、链霉素、氨苄西林/舒巴坦耐药率高,依次为60.94%、59.38%和45.31%;对头孢噻呋、头孢他啶/阿维巴坦均敏感;耐药谱有40种,多重耐药株有 39株,占60.94%。所有沙门菌共检出13类80种耐药基因,携带率最高的基因分别是blaTEM-1(57.81%)、aac(6')-Iy(54.69%)和aph(6)-Id(46.88%),碳青霉烯类及多粘菌素类耐药基因均未检出,不同血清型携带的耐药基因种类及数量差异明显。沙门菌对青霉素类(阳性预测值94.59%,Kappa值0.81)、头孢菌素类(阳性预测值90.91%,Kappa值0.46)、头霉素类(阳性预测值100.00%,Kappa值0.65)、大环内酯类(阳性预测值77.78%,Kappa值0.86)、四环素类(阳性预测值100.00%,Kappa值0.93)以及氯霉素类(阳性预测值95.83%,Kappa值0.93)抗生素的耐药基因型与表型相关性较高。【结论】 宝山区腹泻病沙门菌耐药情况较为严重,全基因组测序为耐药监测提供了重要依据,但仍需结合药敏试验进行综合判断,后续研究中应进一步解析沙门菌耐药机制与传播规律。

     

    Abstract: Objective To retrospectively analyze the correlation among serotypes, antimicrobial resistance phenotypes, and resistance genotypes of Salmonella isolates from diarrheal cases in Baoshan District of Shanghai from 2023 to 2024, and to provide a reference for the prevention and control of Salmonella infections and the rational use of antibiotics in clinical practice. Methods Salmonella isolates collected from diarrhea surveillance in Baoshan District from 2023 to 2024 were serotyped. The antimicrobial resistance phenotypes were determined using the broth microdilution method, and whole-genome sequencing was performed to analyze resistance genes. Results A total of 64 Salmonella isolates belonged to 17 serotypes, with the predominant ones being Salmonella Typhimurium (25.00%) and Salmonella Enteritidis (18.75%). The tested strains exhibited high resistance rates to ampicillin (60.94%), streptomycin (59.38%), and ampicillin/sulbactam (45.31%). All isolates remained susceptible to ceftiofur and ceftazidime/avibactam. Forty different resistance profiles were identified, and 39 isolates (60.94%) were multidrug-resistant. A total of 80 resistance genes belonging to 13 categories were detected, with the most prevalent being blaTEM-1 (57.81%), aac(6')-Iy (54.69%), and aph(6)-Id (46.88%). No carbapenem or polymyxin resistance genes were found. The types and numbers of resistance genes varied significantly across serotypes. A high concordance was observed between genotype and phenotype for penicillins (positive predictive value 94.59%, Kappa 0.81), cephalosporins (90.91%, 0.46), cephamycins (100.00%, 0.65), macrolides (77.78%, 0.86), tetracyclines (100.00%, 0.93), and chloramphenicol (95.83%, 0.93). Conclusion Salmonella isolates from diarrheal diseases in Baoshan District exhibit serious antimicrobial resistance. Whole-genome sequencing provides valuable support for resistance surveillance, but it still needs to be integrated with phenotypic susceptibility testing for comprehensive assessment. Further studies are warranted to elucidate the mechanisms and transmission patterns of resistance in Salmonella.

     

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