产ESBLs大肠埃希菌和肺炎克雷伯菌呼吸道分离株的基因分型及耐药性分析

目的了解深圳市人民医院大肠埃希菌和肺炎克雷伯菌呼吸道分离株超广谱β-内酰胺酶(ESBLs)的基因型特点及耐药性。方法采用临床实验室标准化协会(CLSI)推荐的表型确证试验筛选出该院呼吸道分离株产ESBLs大肠埃希菌和肺炎克雷伯菌共78株。应用PCR及DNA测序法分析产酶株的TEM、SHV及CTX-M3种β-内酰胺酶基因,用琼脂稀释法测定细菌最低抑菌浓度(MIC)。结果 37株产ESBLs大肠埃希菌中,28株(75.7%)检出CTX-M-14基因,4株(10.8%)检出CTX-M-9基因,其他型较少见。41株肺炎克雷伯菌中,25株(61.0%)检出SHV-12基因,4株(9.8%)检出SHV-11基因,其他SHV型较少。20株(48.8%)检出CTX-M-14基因,5株(12.2%)检出CTX-M-3基因,其他型较少。产ESBL菌株均对亚胺培南敏感,对氨苄西林/舒巴坦的耐药率最高(90%),对其他抗生素有不同程度耐药。结论深圳市人民医院呼吸道分离的产ESBLs大肠埃希菌以CTX-M-14型为主,产酶肺炎克雷伯菌以SHV-12和CTX-M-14型为最常见。     

肠集聚性大肠埃希菌在健康老年人肠道中的分布及其耐药机制研究

目的分析健康老年人肠道中肠集聚性大肠埃希菌(EAEC)的检出率,并探讨其毒力基因及超广谱β-内酰胺酶(ESBL)的携带情况。方法取健康老年人的粪便标本分别接种于血平板、SS平板、麦康凯平板进行细菌培养,用全自动微生物鉴定仪和质谱仪鉴定细菌到种;对分离的大肠埃希菌采用双纸片协同法检测其ESBL的表型,用PCR法扩增其EAEC毒力基因astA和aggR;ESBL表型阳性的EAEC菌株用PCR法检测其ESBL基因型。结果在175例研究对象中,共检出160株大肠埃希菌,ESBL携带率为36.30%(58/160);EAEC检出16株(10.00%),其中astA阳性14株(8.75%),aggR阳性2株(1.25%);EAEC菌株的ESBL携带率为56.25%(9/16),其基因型均为CTX-M型,其中以CTX-M-14最多,占66.70%(6/9)。结论本研究获得了健康老年人肠道中EAEC的检出率及其毒力基因和ESBL的携带情况,提示我们EAEC不仅是腹泻患者的病原菌,还可以在健康老年人群中携带,且具有较高的携带率和耐药性,提醒我们加强防范。     

临床产ESBLs大肠埃希菌整合子检测及基因型分析

了解临床分离的产ESBLs大肠埃希菌(ESBLs-producing Escherichia coli,ESBL-EC)中Ⅰ、Ⅱ、Ⅲ类整合子及ESBL-EC基因型的分布。收集2014年1月至12月某三甲医院住院患者分离的大肠埃希菌,经全自动细菌分析系统鉴定并检测其对临床常用抗菌药物的耐药性,双纸片协同试验确定ESBL-EC,采用聚合酶链反应(PCR)对整合子基因和ESBLs基因进行检测。K-B法比较整合子阳性菌株与阴性菌株的耐药率。结果发现,98株临床非重复ESBL-EC对青霉素类、头孢菌素类、喹诺酮类、单环酰胺类和庆大霉素耐药率均大于50%,对妥布霉素耐药率为31.62%,对呋喃妥因、阿莫西林/克拉维酸和阿米卡星较敏感,分别为11.11%、13.4%和6.12%;对碳青霉烯类抗菌素、替加环素和哌拉西林/他唑巴坦敏感率为100%。98株菌中检出47株含Ⅰ类整合子(47.96%),3株含Ⅱ类整合子(3.06%),所有菌株中有1株同时含Ⅰ类和Ⅱ类整合子,未检出Ⅲ类整合子。整合子阳性菌株对四环素和复方新诺明的耐药率高于整合子阴性菌株(P0.05)。98株菌中β-内酰胺酶基因TEM、CTX-M-9、CTX-M-1、CTX-M-2和SHV阳性率分别为62.24%、53.06%、32.65%、4.08%和3.06%,ESBL-EC基因分型分布以TEM合并CTX-M-9型(共30株)最多见,占30.61%。结果表明,Ⅰ类整合子在产ESBLs大肠埃希菌中分布广泛,本研究尚不足以证明整合子的存在可影响ESBL-EC菌株抗生素耐药水平。同时携带TEM和CTX-M-9基因是安徽医科大学解放军174临床学院产ESBLs大肠埃希菌临床耐药菌株产生的主要原因。     

山东省某地区奶牛源大肠埃希菌的血清型、耐药特性及分子特性

【目的】旨在对从山东省某地区4个健康奶牛养殖场分离到的大肠埃希菌进行优势血清型、耐药特性、Ⅰ类整合子基因盒携带情况以及系统进化群分析。【方法】采集194份来自山东省某地区4个规模化奶牛场奶牛新鲜粪便样品,进行大肠埃希菌分离和鉴定,利用常用大肠埃希菌诊断血清进行血清型鉴定;利用10%的绵羊血平板检测溶血性;利用K-B法检测对14种常规抗菌药物的敏感性;利用聚合酶链式反应(PCR)检测革兰阴性菌常见的6大类24种耐药基因、Ⅰ类整合子基因盒结构并对目的条带测序分析;利用细菌多位点序列分型(Multilocus sequence typing,MLST)技术分析大肠埃希菌的ST型并使用eBURST v3软件分析菌株之间的克隆关系。【结果】从194份新鲜粪便样品中分离到171株大肠埃希菌,其中主要为致病性(19.9%)和侵袭性大肠埃希菌(17.0%),优势血清型分别为O128:K67(12/171)和O143:K7(12/171)。另外,具有溶血性的大肠埃希菌阳性率为9.4%(16/171);药敏试验结果显示多重耐药菌株的比率为22.2%,其中对氨苄西林耐药率最高为33.9%,四环素次之,为24.0%;PCR检测耐药基因和整合子结果显示,59.1%的菌株携带β-内酰胺类耐药基因blaTEM,59.1%的菌株携带氨基糖苷类耐药基因ant(2′),未检测到四环素耐药基因tetA和tetB;Ⅰ类整合子的阳性率为4.1%(7/171),dfrA12-aadA2-sul1为优势基因盒结构(4/171);MLST将大肠埃希菌分为8种ST型,其中,ST155(10/171)和ST58(45/171)形成一个克隆复合物且没有发现新的ST型。【结论】本研究证实,从该地区规模化健康奶牛场新鲜粪便中分离到的大肠埃希菌优势血清型为O128:K67和O143:K7;少部分大肠埃希菌具有溶血性;仅对氨苄西林、四环素等具有较高的耐药率;优势基因盒结构为dfrA12-aadA2-sul1;MLST分型显示不同奶牛场分离出亲缘关系较近的菌株,其分布具有多态性,血清型与ST型之间无相关性。本研究表明源自表观健康的奶牛的大肠埃希菌存在多重耐药现象,具有食品公共卫生安全隐患,该研究对于提升规模化奶牛场奶制品的安全生产与质量评估具有一定的理论指导意义。     

社区和医院获得性尿道致病性大肠埃希菌耐药性分析

目的了解浙江省社区和医院获得性尿道致病性大肠埃希菌的耐药现状及产超广谱β-内酰胺酶(ESBLs)菌株基因型,为临床合理用药提供科学依据。方法对2014年1月至2014年12月浙江省社区和医院获得性尿道致病性大肠埃希菌耐药情况进行分析,并随机各抽取20株菌株进行CTX-M基因型检测。结果社区和医院获得性大肠埃希菌共收集到93株和992株,产ESBLs菌株的阳性率分别为47.7%和68.5%,差异有统计学意义(P0.05);社区获得性菌株CTX-M基因检出率为30.0%(6/20),其中又以CTX-M-9为主(4/6)。医院获得性菌株CTX-M基因检出率50.0%(10/20),其中CTX-M-9占7/10。医院获得性菌株对头孢呋辛、头孢唑啉、头孢曲松、环丙沙星、左旋氧氟沙星、甲氧苄氨嘧啶/磺胺甲恶唑、呋喃妥因和阿米卡星的敏感率明显低于社区获得性菌株(P0.05)。结论浙江省医院获得性尿道致病性大肠埃希菌对部分抗菌药物的耐药率明显高于社区获得性菌株,ESBLs基因以CTX-M-9为主。     

碳青霉烯类耐药大肠埃希菌耐药机制研究

目的研究碳青霉烯类耐药大肠埃希菌的的耐药机制。方法收集本院2011年8月至2012年8月的碳青霉烯类耐药大肠埃希菌,采用琼脂稀释法进行药敏试验;改良Hodge试验筛查菌株是否产碳青霉烯酶;利用聚合酶链反应扩增KPC、IMP、VIM、NDM、SHV、TEM、CTX-M-1组、CTX-M-9组耐药基因,并对扩增产物进行测序。结果 21株实验菌均为多重耐药菌,对17种抗菌药物中耐药率60%的有11种,其中耐药率90%的有5种,分别为头孢他啶、头孢噻肟、头孢西丁、环丙沙星和氨曲南。耐药率最低的为多粘菌素B,均表现为敏感。9株改良Hodge试验阳性。6株携带碳青霉烯类耐药基因(3株NDM-1阳性、3株IMP阳性)。共有18株检出β-内酰胺类耐药基因。结论该院碳青霉烯类耐药大肠埃希菌携带的碳青霉烯酶基因以NDM-1和IMP基因较常见。     

产超广谱β-内酰胺酶细菌耐药性基因型分析

检测我院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的耐药性和基因型。表型确定临床分离产ESBLs的大肠埃希菌和肺炎克雷伯菌56株,应用PCR基因扩增技术及双脱氧DNA测序方法,分别对TEM、SHV、CTX-M-1、CTX-M-2和CTX-M-9编码基因进行分析。产酶菌株对亚胺培南、美洛培南、阿米卡星、头孢吡肟耐药性较低,对其他16种抗生素耐药性较高。在56株菌株中有50株为CTX-M型,占89%,34株为TEM型(60.7%),20株SHV型(35.7%);其中CTX-M-9型共计39株占78%,CTX-M-1型19株占38%,CTX-M-2型16株占32%。产ESBLs大肠埃希菌和肺炎克雷伯菌的耐药性值得关注,主要临床流行基因型是CTX-M型。     

泌尿系感染产ESBLs大肠埃希菌基因分型

目的 了解深圳市人民医院临床泌尿系感染标本中产ESBLs大肠埃希菌的基因型特点.方法 收集近几年深圳市人民医院临床尿液标本中非重复的产ESBLs大肠埃希菌43株,PCR分别扩增菌株的TEM、SHV、CTX-M基因,阳性株进行DNA测序分型.结果 43株产ESBLs大肠埃希菌中40株CTX-M基因阳性,分别为CTX-M-14型36株,CTX-M-9型2株,CTX-M-15型2株,其中17株CTX-M-14型菌株检出TEM-1基因;所有菌株均未检出SHV基因.结论 本地区致泌尿系感染产ESBLs大肠埃希菌中,CTX-M-14型为主.     

产ESBLs大肠埃希菌的AmpC基因型分析

目的 了解深圳市人民医院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌合并产AmpC酶的状况及基因型特点.方法 从近几年深圳市人民医院产ESBLs大肠埃希菌临床菌株中,筛选出对头孢西丁耐药菌株51株,PCR分别扩增菌株的TEM、SHV、CTX-M基因,同时应用多重PCR检测菌株的AmpC酶基因,序列测定PCR阳性产物以确定其基因亚型.结果 51株菌中有49株至少检出一种ESBLs或AmpC基因.单ESBLs基因阳性菌株37株(72.5％),单AmpC基因阳性4株(7.8％),合并ESBLs和AmpC基因阳性的8株(15.6％).共有41株(80.4％)含CTX-M-14基因,4株含CTX-M-15,其他基因型ESBLs较少.2株检出两种ESBLs基因;一株同时检三种ESBLs基因.检出AmpC基因的菌株12株,其中10株为DHA-1型,2株为CMY-2型;其中6株DHA-1型及2株CMY-2型菌同时检出CTX-M-14基因.结论 该院头孢西丁耐药产ESBLs大肠埃希菌中大多数为单产ESBLs菌,主要为CTX-M-14型;少数同时产生ESBLs和AmpC酶,AmpC酶以DHA-1型为最常见.     

重症监护病房产ESBLs菌的基因分型

目的了解深圳市人民医院重症监护病房分离菌超广谱β-内酰胺酶（ESBLs）的检出率及其基因型分布情况。方法收集来自重症监护病房大肠埃希菌和肺炎克雷伯菌分离株48株,采用CLSI推荐的表型确证方法筛选出ESBLs株,并利用PCR及DNA测序法分析产酶菌株的ESBL基因型。结果（1）48分离株菌中共检出产ESBLs菌24株,阳性率为50.0%。（2）产酶菌中93.8%（15/16）的大肠埃希菌和87.5%（7/8）的肺炎克雷伯菌分别检出CTX-M基因;其中72.7%（16/22）为CTX-M-14。6株肺炎克雷伯菌检出SHV基因,其中3株为SHV-11型,另3株为SHV-12型,6株含SHV基因的肺炎克雷伯菌中5株合并CTX-M基因。而所有大肠埃希菌株均未检出SHV基因。所有产酶菌中,分别有10株大肠埃希菌和2株肺炎克雷伯菌检出TEM-1基因,其中1株大肠埃希菌只检出TEM-1基因,未检出SHV型或CTX-M型基因。结论重症监护病房分离菌ESBLs检出率高,以CTX-M-14为主要基因型。     

The challenges of developing novel antiparasitic drugs

Only a few novel classes of antiparasitic drugs have emerged over the last few decades, reflecting the difficulties associated with bringing a safe, effective molecule to market. In recent years, the screening paradigm has shifted from empirical whole parasite screening towards mechanism-based high throughput screening. This approach requires investment in molecular parasitology and in understanding the basic biology of parasites, as well as requiring considerable investment in an infrastructure for screening. Add to this the fact that the drug discovery process is iterative with high attrition, the Animal Health industry by necessity must focus on discovering medicines for diseases, which will deliver a return on investment. In recent years the rapid progression of genomics has unlocked a plethora of tools for target identification, validation and screening, revolutionising mechanism-based screening for antiparasitic drug discovery. The challenge still remains; however, to identify novel chemical entities with the properties required to deliver a safe, effective antiparasitic drug.     

多粘菌素耐药性的研究进展

多粘菌素因在多重耐药革兰氏阴性菌上的治疗效果良好,再度被应用于临床,其耐药水平在多种抗菌药中曾一度较低,但目前有研究表明多粘菌素的耐药率有增加趋势。作为抗击多重耐药革兰氏阴性菌的最后一道防线,如何抑制其耐药的发生就显得尤为重要。本文就多粘菌素的耐药性现状、产生机制及防控措施三个方面进行了综述,为指导临床科学合理使用多粘菌素及革兰氏阴性菌耐药菌株传播和蔓延的防控措施提供理论依据。     

Small Molecule Screening in Human Induced Pluripotent Stem Cell-derived Terminal Cell Types

A need for better clinical outcomes has heightened interest in the use of physiologically relevant human cells in the drug discovery process. Patient-specific human induced pluripotent stem cells may offer a relevant, robust, scalable, and cost-effective model of human disease physiology. Small molecule high throughput screening in human induced pluripotent stem cell-derived cells with the intent of identifying novel therapeutic compounds is starting to influence the drug discovery process; however, the use of these cells presents many high throughput screening development challenges. This technology has the potential to transform the way drug discovery is performed.     

Identification and Functional Characterization of a Novel Bacterial Type Asparagine Synthetase A: A tRNA SYNTHETASE PARALOG FROM LEISHMANIA DONOVANI*

Asparagine is formed by two structurally distinct asparagine synthetases in prokaryotes. One is the ammonia-utilizing asparagine synthetase A (AsnA), and the other is asparagine synthetase B (AsnB) that uses glutamine or ammonia as a nitrogen source. In a previous investigation using sequence-based analysis, we had shown that Leishmania spp. possess asparagine-tRNA synthetase paralog asparagine synthetase A (LdASNA) that is ammonia-dependent. Here, we report the cloning, expression, and kinetic analysis of ASNA from Leishmania donovani. Interestingly, LdASNA was both ammonia- and glutamine-dependent. To study the physiological role of ASNA in Leishmania, gene deletion mutations were attempted via targeted gene replacement. Gene deletion of LdASNA showed a growth delay in mutants. However, chromosomal null mutants of LdASNA could not be obtained as the double transfectant mutants showed aneuploidy. These data suggest that LdASNA is essential for survival of the Leishmania parasite. LdASNA enzyme was recalcitrant toward crystallization so we instead crystallized and solved the atomic structure of its close homolog from Trypanosoma brucei (TbASNA) at 2.2 Å. A very significant conservation in active site residues is observed between TbASNA and Escherichia coli AsnA. It is evident that the absence of an LdASNA homolog from humans and its essentiality for the parasites make LdASNA a novel drug target.     

脑膜炎败血伊丽莎白菌耐药性的研究进展

脑膜炎败血伊丽莎白菌(Elizabethkingia meningoseptica, EM)可引起肺部感染、新生儿脑膜炎、菌血症等疾病,医院重症监护病房检出率较高,是院内感染的重要病原体之一。随着抗菌药物的广泛使用,EM对β-内酰胺类、氨基糖苷类、氟喹诺酮类等临床常用抗菌药物呈多重耐药,给临床治疗带来极大困难。目前EM的耐药机制研究主要集中于产生药物灭活酶、药物作用靶位改变、外排泵、形成生物膜等方面。EM可同时携带多个耐药基因,如GOB、BlaB、CME等,从而介导多重耐药。本文就国内外EM耐药现状、耐药机制进行综述,旨在为预防和控制EM的医院内感染提供参考。     

假病毒技术用于抗HIV-1药物筛选及抗药性分析

HIV抗药性的产生严重阻碍了HIV疾病的治疗进程,因此开发新的抗HIV药物以及对病毒进行抗药性分析对于提高HIV疾病的治疗效果非常重要。将利用HIV假病毒构建的抗HIV药物评价系统及病毒抗药性分析系统应用于药物筛选及耐药性分析具有常规方法无法替代的优点。介绍了目前常用的几种类型HIV假病毒的特点和构建方法,同时介绍了假病毒感染细胞的系统及其在细胞水平筛选抗HIV药物和对HIV临床分离株进行耐药性分析这两方面的应用,并通过与常规方法进行比较来分析利用假病毒技术进行研究的优势及局限性, 还通过总结大量学者的研究成果证明了利用假病毒技术进行药物筛选和抗药性分析具有准确、安全和高效的特点。     

Chemotoxicity and survival of tumor-bearing mice under exposure to randomized photoperiodic regimen

Although disruption of the circadian rhythm had been traditionally considered as a pathological sign, there is an increasing recognition that an existence of internal disorder (or chaos) in the organism's homeostasis is, to some degree, essential to the organism's well being. In this study we explored the effects of rhythm scrambling by exposure to random light/dark (RLD) alternation or by hydrocortisone administration. The variables measured were the toxicity of Adriamycin, Vincristin, Cisplatinum and Cyclophosphamide in C57Bl/6J mice and the survival of EL4 lymphoma-bearing mice, before and after chemotherapy. Rhythm alterations were determined by WBC counts and plasma Alkaline Phosphatase activity. Injections of Adriamycin, Cisplatinum and Vincristin in RLD conditions resulted in a better survival than in control groups of mice kept in LD illumination regimen, although the differences between the groups were significant only for injection of Adriamycin. RLD conditions imposed a "protective" effect on survival of tumor-bearing mice. On the 94th day, 20% of the injected mice in RLD conditions still survived while, there were no survivors beyond 38 days in control group. Chemotherapy had a more prominent beneficial effect on survival in RLD group, as compared to LD group. The injections of hydrocortisone had detrimental effect on survival in both illumination schedules. However, the survival in the RLD group was still better than in the LD group. These experiments indicate that temporal disorganization has beneficial effects on lymphoma-bearing mice and could be used for development of new therapeutic modalities.     

长沙地区临床分离金黄色葡萄球菌的耐药监测

目的了解长沙地区临床分离金黄色葡萄球菌（以下简称金葡菌）对常用抗菌药物的耐药现状,探讨金黄色葡萄球菌对甲氧西林的耐药水平。方法收集长沙地区11家医院2009年11月至2010年11月临床分离的非重复金葡菌279株,应用Vitek-2全自动微生物分析系统进行鉴定,K-B法检测金葡菌对24种药物的敏感性,产色头孢菌素试验检测β-内酰胺酶以及D试验检测诱导型克林霉素耐药。应用头孢西丁和苯唑西林纸片扩散法筛查耐甲氧西林的金葡菌（MRSA）,琼脂稀释法检测头孢西丁和苯唑西林的最低抑菌浓度（MIC）。结果在被检测的24种药物中,敏感率〉50%的药物为9种,未发现对万古霉素、替考拉宁和利奈唑胺耐药菌株;耐药率〉50%的抗菌药物有11种,其中以青霉素和氨苄西林的耐药率最高（均为97.1%）。MRSA的分离率达54.5%,且对常用的16种抗菌药物的耐药率均显著高于甲氧西林敏感金黄色葡萄球菌（MSSA）。279株金葡菌中,β-内酰胺酶阳性250株（89.6%）;红霉素耐药而克林霉素敏感或中介的30株中,D试验阳性22株（73.3%）。苯唑西林（OXA）和头孢西丁（FOX）MIC范围分别为0.125～〉256μg/mL和2～〉256μg/mL,苯唑西林的MIC50和MIC90分别为128μg/mL和256μg/mL,头孢西丁的MIC50和MIC90分别为64μg/mL和256μg/mL。结论长沙地区临床分离金葡菌对常用抗菌药物呈多重耐药;MRSA不仅分离率高,而且对甲氧西林呈高水平耐药。     

SynergyFinder Plus: Toward Better Interpretation and Annotation of Drug Combination Screening Datasets

Combinatorial therapies have been recently proposed to improve the efficacy of anticancer treatment. The SynergyFinder R package is a software used to analyze pre-clinical drug combination datasets. Here, we report the major updates to the SynergyFinder R package for improved interpretation and annotation of drug combination screening results. Unlike the existing implementations, the updated SynergyFinder R package includes five main innovations. 1) We extend the mathematical models to higher-order drug combination data analysis and implement dimension reduction techniques for visualizing the synergy landscape. 2) We provide a statistical analysis of drug combination synergy and sensitivity with confidence intervals and P values. 3) We incorporate a synergy barometer to harmonize multiple synergy scoring methods to provide a consensus metric for synergy. 4) We evaluate drug combination synergy and sensitivity to provide an unbiased interpretation of the clinical potential. 5) We enable fast annotation of drugs and cell lines, including their chemical and target information. These annotations will improve the interpretation of the mechanisms of action of drug combinations. To facilitate the use of the R package within the drug discovery community, we also provide a web server at www.synergyfinderplus.org as a user-friendly interface to enable a more flexible and versatile analysis of drug combination data.     

大连市伤寒沙门菌耐药性及耐药基因分析

目的检测多重耐药伤寒沙门菌对抗菌药物的敏感性及其耐药基因携带情况,为伤寒沙门菌引起的腹泻治疗提供科学依据。方法采用微量肉汤稀释的方法测定大连地区临床分离的78株伤寒沙门菌对12种抗生素的敏感性;用PCR方法检测TEM型β内酰胺酶基因、catA和catB氯霉素乙酰基转移酶基因以及cmlA氯霉素外排泵蛋白基因、aac(6′)Ⅰb和aac3Ⅱ型氨基糖苷类修饰酶基因、qacEΔ1sul1耐消毒剂和磺胺基因、多重耐药外排基因acrB等8种耐药基因。结果78株沙门菌对12种药物有不同程度耐药(1.28%~74.35%)。得到9株多重耐药菌株,其中5株检出TEM型β内酰胺酶基因;7株耐氯霉素的伤寒沙门菌菌株中,2株仅检出catA基因,1株仅检出catB基因,1株仅检出cmlA氯霉素外排泵蛋白基因,2株同时检出catA基因和cmlA氯霉素外排泵蛋白基因;2株检出aac(6′)Ⅰb基因,1株检出aac3Ⅱ型氨基糖苷类修饰酶基因;4株检出耐消毒剂和磺胺基因qacEΔ1sul1;6株检出多重耐药外排基因acrB。结论大连地区临床分离的伤寒沙门菌存在严峻的耐药现象,多种耐药基因存在于耐药伤寒沙门菌中,可能是导致菌株对多种抗菌药物耐药的原因。