肠道感染气单胞菌、邻单胞菌的流行病学分布与耐药性分析

doi:10.3969/j.issn.1673-8640.2018.08.009

摘要/Abstract

摘要：

目的了解临床肠道感染的气单胞菌和邻单胞菌的流行病学特点及耐药率,为临床治疗提供参考。方法对2007—2016年分离自粪便样本的46株气单胞菌和10株邻单胞菌的流行病学分布及耐药性进行回顾性分析。结果 10年间在粪便样本中共分离出气单胞菌46株,占所有肠道分离株的22.0%,居肠道内细菌性病原菌第3位,其中嗜水气单胞菌27株（58.7%）,温和气单胞菌10株（21.7%）,维也纳气单胞菌9株（19.6%）。邻单胞菌10株,占所有肠道分离株的4.8%。56株气单胞菌和邻单胞菌中有27株来自于肠道门诊,10株来自于消化科,19株来自于其他科室;男女检出率分别为42.9%和57.1%;全年均能够分离到气单胞菌和邻单胞菌,其中7—10月分离率最高,达71.4%。气单胞菌对大部分抗菌药物已经出现了不同程度的耐药,对阿米卡星、庆大霉素、头孢他啶、氨曲南、环丙沙星、复方磺胺甲噁唑、哌拉西林-他唑巴坦和头孢吡肟的耐药率分别为2.2%、6.5%、6.5%、4.3%、6.5%、10.7%、19.6%和6.5%,对美罗培南全敏感,对亚胺培南有2株中介。邻单胞菌对头孢他啶、氨曲南、亚胺培南、美罗培南、哌拉西林-他唑巴坦和头孢吡肟全敏感,对阿米卡星、庆大霉素、环丙沙星和复方磺胺甲噁唑存在不同程度的耐药,耐药率分别为10.0%、20.0%、30.0%和40.0%。结论复旦大学附属华山医院肠道内气单胞菌和邻单胞菌的分离率均较高,出现了对喹诺酮类、三代和四代头孢菌素、磺胺类、氨基糖苷类和单环β-内酰胺类等抗菌药物不同程度的耐药,甚至出现了对亚胺培南中介的菌株,临床医师应高度重视。

关键词: 肠道感染, 气单胞菌属, 邻单胞菌属, 流行病学, 耐药率

Abstract:

Objective To study the epidemiological distribution and drug resistance of Aeromonas and Plesiomonas in the intestine infection,and to provide a reference for clinical treatment.Methods The epidemiological distribution and drug resistance of Aeromonas（46 isolates） and Plesiomonas（10 isolates） isolated from feces specimens from 2007 to 2016 were analyzed retrospectively.Results A total of 46 isolates of Aeromonas were isolated from feces specimens,accounting for 22.0% and ranking No.3 in all intestinal isolates. There were 27 isolates of Aeromonas hydrophila（58.7%）,followed by Aeromonas sobria（10 isolates,21.7%） and Aeromonas vienna（9 isolates,19.6%）. There were 10 isolates of Plesiomonas,accounting for 4.8% of all intestinal isolates. There were 27 of 56 isolates isolated from Department of Intestine,10 isolates from Department of Gastroenterology and 19 isolates from other departments. The determination rates for males and females were 42.9% and 57.1%,respectively. It was able to isolate Aeromonas and Plesiomonas all the year round,and the highest isolation rate was 71.4% from July to October. Aeromonas had various degrees of drug resistance to most antibiotics. The drug resistance rates to amikacin,gentamycin,ceftazidime,aztreonam,ciprofloxacin,sulfamethoxazole-trimethoprim,piperacillin-tazobactam and cefepime were 2.2%,6.5%,6.5%,4.3%,6.5%,10.7%,19.6% and 6.5%,respectively. The isolates of Aeromonas were sensitive to meropenem,and 2 isolates were intermediate drug resistant to imipenem. Plesiomonas had various degrees of drug resistance to amikacin,gentamycin,ciprofloxacin and sulfamethoxazole-trimethoprim. The drug resistance rates were 10.0%,20.0%,30.0% and 40.0%,respectively,while Plesiomonas were sensitive to ceftazidime,aztreonam,imipenem,meropenem,piperacillin-tazobactam and cefepime.Conclusions The isolation rates of Aeromonas and Plesiomonas are high,and there were different degrees of drug resistance to various antibiotics,such as quinolones,the 3rd generation and the 4th generation cephalosporins,sulfonamides,aminoglycosides and monocyclic beta-lactams. There exists intermediate drug resistance to imipenem.

Key words: Intestine infection, Aeromonas, Plesiomonas, Epidemiology, Drug resistance rate

中图分类号:

R446.5

李世荣, 蒋晓飞. 肠道感染气单胞菌、邻单胞菌的流行病学分布与耐药性分析[J]. 检验医学, 2018, 33(8): 707-710.

LI Shirong, JIANG Xiaofei. Epidemiological distribution and drug resistance of Aeromonas and Plesiomonas in the intestine infection[J]. Laboratory Medicine, 2018, 33(8): 707-710.

图/表 3

参考文献 13

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