Laboratory Medicine ›› 2026, Vol. 41 ›› Issue (8): 793-798.DOI: 10.3969/j.issn.1673-8640.2026.08.012
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CHEN Xinxin1, ZHENG Yawen2, XU Ying1, WEI Jingjuan1, LI Yana1, CHEN Shuo1, LI Hanmei1, SUN Wei1(
)
Received:2025-01-18
Revised:2025-08-09
Online:2026-08-30
Published:2026-08-24
Contact:
SUN Wei
CLC Number:
CHEN Xinxin, ZHENG Yawen, XU Ying, WEI Jingjuan, LI Yana, CHEN Shuo, LI Hanmei, SUN Wei. Drug resistance and virulence characteristics of Salmonella isolated from sterile clinical sites[J]. Laboratory Medicine, 2026, 41(8): 793-798.
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URL: https://www.shjyyx.com/EN/10.3969/j.issn.1673-8640.2026.08.012
| 患者编号 | 性别 | 年龄/岁 | 科室 | 诊断 | 腹泻(有/无) | 粪便常规+潜血 | 样本来源 | 菌株鉴定 结果 | 抗菌药物治疗 方案 |
|---|---|---|---|---|---|---|---|---|---|
| 1号 | 男 | 49 | 血管外科 | 胸主动脉假性动脉瘤 | 无 | 黄褐色成型便,潜血阴性 | 胸腔积液 | 肠炎沙门菌 | 美罗培南→ 头孢吡肟 |
| 2号 | 男 | 74 | 血管外科 | 腹主动脉假性动脉瘤 | 无 | 黄褐色成型便,潜血阴性 | 静脉血 | 肠炎沙门菌 | 美罗培南 |
| 3号 | 女 | 89 | 急诊 | 菌血症 | 无 | 黄褐色成型便潜血阴性 | 静脉血 | 肠炎沙门菌 | 美罗培南→ 头孢唑肟 |
| 4号 | 女 | 65 | 急诊病房 | 菌血症、急性肠炎、重症肌无力 | 有 | 水样便,潜血阳性 | 静脉血 | 肠炎沙门菌 | 美罗培南→ 小檗碱 |
| 5号 | 男 | 71 | 急诊 | 菌血症、急性肠炎 | 有 | 稀便,潜血阳性 | 静脉血 | 曼哈顿沙门菌 | 美罗培南→ 利福昔明 |
| 6号 | 男 | 68 | 心脏中心 | 腹主动脉假性动脉瘤 | 无 | 软黄便,潜血阴性 | 静脉血 | 肠炎沙门菌 | 美罗培南 |
| 7号 | 女 | 62 | 重症医学科 | 胸主动脉假性动脉瘤 | 无 | 软黄便,潜血阴性 | 胸腔积液 | 肠炎沙门菌 | 头孢噻肟→ 左氧氟沙星 |
| 患者编号 | 性别 | 年龄/岁 | 科室 | 诊断 | 腹泻(有/无) | 粪便常规+潜血 | 样本来源 | 菌株鉴定 结果 | 抗菌药物治疗 方案 |
|---|---|---|---|---|---|---|---|---|---|
| 1号 | 男 | 49 | 血管外科 | 胸主动脉假性动脉瘤 | 无 | 黄褐色成型便,潜血阴性 | 胸腔积液 | 肠炎沙门菌 | 美罗培南→ 头孢吡肟 |
| 2号 | 男 | 74 | 血管外科 | 腹主动脉假性动脉瘤 | 无 | 黄褐色成型便,潜血阴性 | 静脉血 | 肠炎沙门菌 | 美罗培南 |
| 3号 | 女 | 89 | 急诊 | 菌血症 | 无 | 黄褐色成型便潜血阴性 | 静脉血 | 肠炎沙门菌 | 美罗培南→ 头孢唑肟 |
| 4号 | 女 | 65 | 急诊病房 | 菌血症、急性肠炎、重症肌无力 | 有 | 水样便,潜血阳性 | 静脉血 | 肠炎沙门菌 | 美罗培南→ 小檗碱 |
| 5号 | 男 | 71 | 急诊 | 菌血症、急性肠炎 | 有 | 稀便,潜血阳性 | 静脉血 | 曼哈顿沙门菌 | 美罗培南→ 利福昔明 |
| 6号 | 男 | 68 | 心脏中心 | 腹主动脉假性动脉瘤 | 无 | 软黄便,潜血阴性 | 静脉血 | 肠炎沙门菌 | 美罗培南 |
| 7号 | 女 | 62 | 重症医学科 | 胸主动脉假性动脉瘤 | 无 | 软黄便,潜血阴性 | 胸腔积液 | 肠炎沙门菌 | 头孢噻肟→ 左氧氟沙星 |
| 菌株 编号 | 头孢他啶 | 头孢哌酮/ 舒巴坦 | 头孢吡肟 | 氨曲南 | 亚胺培南 | 美罗培南 | 环丙沙星 | 左氧氟沙星 | 多西环素 | 米诺环素 | 复方磺胺甲噁唑 | 替卡西林/克拉维酸 | 哌拉西林舒巴坦 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 |
| 2号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 耐药 | 耐药 | 敏感 | 中介 | 敏感 |
| 3号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 耐药 | 中介 | 耐药 | 耐药 | 敏感 | 耐药 | 中介 |
| 4号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 |
| 5号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 敏感 | 敏感 | 敏感 |
| 6号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 耐药 | 敏感 |
| 7号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 敏感 |
| 菌株 编号 | 头孢他啶 | 头孢哌酮/ 舒巴坦 | 头孢吡肟 | 氨曲南 | 亚胺培南 | 美罗培南 | 环丙沙星 | 左氧氟沙星 | 多西环素 | 米诺环素 | 复方磺胺甲噁唑 | 替卡西林/克拉维酸 | 哌拉西林舒巴坦 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 |
| 2号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 耐药 | 耐药 | 敏感 | 中介 | 敏感 |
| 3号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 耐药 | 中介 | 耐药 | 耐药 | 敏感 | 耐药 | 中介 |
| 4号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 |
| 5号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 敏感 | 敏感 | 敏感 |
| 6号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 耐药 | 敏感 |
| 7号 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 敏感 | 中介 | 敏感 |
| 抗菌药物类别 | 耐药表型 | 耐药或中介菌株数/株 | 耐药基因型 | 耐药机制 | 携带耐药基因 菌株数/株 | 符合率/% |
|---|---|---|---|---|---|---|
| β-内酰胺酶类 | TCC | 4 | blatem | 产生灭活酶 | 5 | 80 |
| 喹诺酮类 | CIP+LVX | 3 | gyrA | 抗生素作用的靶位改变 | 5 | 60 |
| 磺胺类 | SXT | 0 | sul2 | 抗生素作用的靶位改变 | 6 | 0 |
| 四环素类 | DOX、MMO | 3 | tetA | 外排泵 | 3 | 100 |
| 抗菌药物类别 | 耐药表型 | 耐药或中介菌株数/株 | 耐药基因型 | 耐药机制 | 携带耐药基因 菌株数/株 | 符合率/% |
|---|---|---|---|---|---|---|
| β-内酰胺酶类 | TCC | 4 | blatem | 产生灭活酶 | 5 | 80 |
| 喹诺酮类 | CIP+LVX | 3 | gyrA | 抗生素作用的靶位改变 | 5 | 60 |
| 磺胺类 | SXT | 0 | sul2 | 抗生素作用的靶位改变 | 6 | 0 |
| 四环素类 | DOX、MMO | 3 | tetA | 外排泵 | 3 | 100 |
| 项目 | 沙门菌株 | 功能 |
|---|---|---|
| 分泌系统 | ||
| SPI-1 | ||
| sipA | 1号,2号,3号,4号,5号,6号,7号 | 诱导宿主细胞的肌动蛋白重排,促进肠道上皮细胞内化细菌[ |
| sipC | 1号,2号,3号,4号,5号,6号,7号 | 调节肌动蛋白动力学;与多种成分相互作用,介导沙门菌侵袭[ |
| sopE | 1号,2号,3号,4号,5号,6号,7号 | 触发肌动蛋白细胞骨架重排,导致膜皱褶,促进细菌内化[ |
| invH | 1号,2号,3号,4号,5号,6号,7号 | 介导沙门菌的效应蛋白分泌至宿主细胞[ |
| SPI-2 | ||
| sseL | 1号,2号,3号,4号,5号,6号,7号 | 控制沙门菌在吞噬细胞内和上皮细胞中复制,躲避巨噬细胞辅酶Ⅱ依赖的杀伤作用[ |
| ssaB | 5号 | 分泌sseB和sseC所需[ |
| SPI-3 | ||
| misL | 1号,2号,3号,4号,5号,6号,7号 | 促进生物膜的形成,增强黏附和侵袭能力[ |
| mgtC | 1号,2号,3号,4号,5号,6号,7号 | 与菌体在宿主细胞内存活和在宿主肠道定殖有关[ |
| 毒力质粒 | ||
| spvB | 1号,2号,3号,4号,6号,7号 | 分解肌动蛋白,抑制NF-κB信号,破坏肠上皮的屏障,促进细菌的播散[ |
| spvD | 1号,2号,3号,4号,6号,7号 | 抑制NF-κB信号[ |
| 菌毛 | ||
| fimA | 1号,2号,3号,4号,5号,6号,7号 | 促进细菌对靶位点的黏附和定植[ |
| 项目 | 沙门菌株 | 功能 |
|---|---|---|
| 分泌系统 | ||
| SPI-1 | ||
| sipA | 1号,2号,3号,4号,5号,6号,7号 | 诱导宿主细胞的肌动蛋白重排,促进肠道上皮细胞内化细菌[ |
| sipC | 1号,2号,3号,4号,5号,6号,7号 | 调节肌动蛋白动力学;与多种成分相互作用,介导沙门菌侵袭[ |
| sopE | 1号,2号,3号,4号,5号,6号,7号 | 触发肌动蛋白细胞骨架重排,导致膜皱褶,促进细菌内化[ |
| invH | 1号,2号,3号,4号,5号,6号,7号 | 介导沙门菌的效应蛋白分泌至宿主细胞[ |
| SPI-2 | ||
| sseL | 1号,2号,3号,4号,5号,6号,7号 | 控制沙门菌在吞噬细胞内和上皮细胞中复制,躲避巨噬细胞辅酶Ⅱ依赖的杀伤作用[ |
| ssaB | 5号 | 分泌sseB和sseC所需[ |
| SPI-3 | ||
| misL | 1号,2号,3号,4号,5号,6号,7号 | 促进生物膜的形成,增强黏附和侵袭能力[ |
| mgtC | 1号,2号,3号,4号,5号,6号,7号 | 与菌体在宿主细胞内存活和在宿主肠道定殖有关[ |
| 毒力质粒 | ||
| spvB | 1号,2号,3号,4号,6号,7号 | 分解肌动蛋白,抑制NF-κB信号,破坏肠上皮的屏障,促进细菌的播散[ |
| spvD | 1号,2号,3号,4号,6号,7号 | 抑制NF-κB信号[ |
| 菌毛 | ||
| fimA | 1号,2号,3号,4号,5号,6号,7号 | 促进细菌对靶位点的黏附和定植[ |
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