志贺菌流行株药物敏感性及质粒图谱分析

目的：分析志贺菌流行株的质粒图谱及其与细菌药物敏感性的相关性。方法：从菌痢患者粪便标本中分离6株 福氏志力和4株宋内志贺菌,分别对其质粒图谱与药物敏感性进行检测和对其相关性进行分析。结果：不同菌株的质粒图谱具有明显的差异,各菌株的质粒图谱与其对头孢三嗪、头孢唑林、环丙沙星、诺氟沙星、氯霉素的耐药特性无明显相关性。结论：获自患者的福氏志贺菌和宋内志贺菌具有不同的质粒图谱以及抗菌药物敏感性,提示在我市引起菌痢的志贺菌具有不同的来源。     

分离自腹泻成人志贺菌的血清分群及耐药性分析

目的 调查志贺菌在成人腹泻患者中的主要血清群和耐药性,为临床治疗和预防提供依据.方法 对2008年1月至2012年10月浙江萧山医院临床分离自腹泻成人志贺菌菌株,进行生化鉴定、血清学分群和抗生素敏感性试验,所有数据用WHONET 5.6软件进行回顾性分析.结果 共检出125株志贺菌,其中66(52.8％)株为宋内志贺菌,58(46.4％)株为福氏志贺菌;氨苄西林耐药率最高达95.9％,复方新诺明耐药率达79.8％,头孢噻肟为48.6％,未检出头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南和美罗培南耐药株,福氏志贺菌对环丙沙星和左旋氧氟沙星耐药率为87.0％和57.1％,而宋内志贺菌未检出氟喹诺酮类耐药株;福氏志贺菌和宋内志贺菌耐药率在哌拉西林、头孢他啶、头孢噻肟、头孢吡肟、复方新诺明和氟喹诺酮间差异有统计学意义(P＜0.01).结论 萧山地区成人志贺菌感染以宋内和福氏两种血清群为主,青霉素类和复方新诺明耐药率太高已不适合临床使用,含酶抑制剂抗生素是治疗志贺菌感染的首选药物.     

不同地区宋内志贺菌耐药性及脉冲场凝胶电泳分型分析

摘要:【目的】通过对不同地区的宋内志贺菌株进行药物敏感性检测、耐药基因的扩增以及基因分型,了解不同地区宋内志贺菌的耐药情况与流行趋势。【方法】使用微量肉汤稀释法测定了54 株宋内志贺菌对21种药物的敏感性,用PCR方法扩增相关耐药基因,利用脉冲场凝胶电泳(Pulsed Field Gel Electrophoresis,PFGE)技术进行宋内志贺菌的基因分型,最后采用BioNumerics分析软件对所有菌株进行聚类,分析其相似度。【结果】实验菌株对于甲氧苄氨嘧啶/磺胺甲噁唑、四环素、替卡西林/棒酸、氨苄西林、庆大霉素5种抗生素普遍耐药,对亚胺培南、头孢吡肟、左氟沙星、诺氟沙星、阿米卡星5种抗生素全部表现为敏感。共检测出包括blaTEM,blaCTX以及整合子在内的7 种不同的耐药基因。全部实验菌株可分为26个不同的PFGE带型,分型后表现出较高的基因同源性。宋内志贺菌的耐药性、携带基因与带型具有一定地域相关性。【结 论】目前各地区流行的宋内志贺菌株对甲氧苄氨嘧啶/磺胺甲噁唑与四环素已经普遍耐药,不同地区出现相同聚类分型的菌株表明存在跨区域流行的宋内志贺菌群。因此,加强对不同地区宋内志贺菌的监控对减少多重耐药菌株的产生具有重要意义。     

汉中市中心医院细菌性痢疾志贺菌16S rRNA序列分析、毒力基因与耐药检测

目的对汉中市中心医院细菌性痢疾患者分离的70株志贺菌进行16S rRNA序列分析、毒力基因与耐药检测。方法对2018年6月至2018年12月我院收治的细菌性痢疾患者进行病原菌分离鉴定,并进行16S rRNA遗传进化分析;PCR法检测其6种毒力基因;K-B法检测其对8种抗生素的敏感性。结果 16S rRNA测序结果显示,福氏志贺菌感染率为57.14%(40/70),宋内志贺菌感染率为42.86%(30/70)。16S rRNA系统进化分析结果显示,40株福氏志贺菌与参考菌株(NR_026331.1)同源性为95.2%～99.0%,30株宋内志贺菌与参考菌株(NR_104826.1)同源性为96.3%～99.9%。毒力基因检测结果表明,70株志贺菌均可以检测出6个相关毒力基因set1A、set1B、sen、Ial、ipaH、virA,毒力基因检出率最高的为ipaH,达到100.00%,其次为Ial、virA,均达到90.00%;其中福氏志贺菌set1A、set1B、Ial基因的检出率高于宋内志贺菌,sen和virA基因的检出率低于宋内志贺菌,二者ipaH基因的检出率都为100.00%。药敏试验结果表明,70株志贺菌耐药率最高的抗生素为氨苄西林,耐药率达到80.00%,其次为强力霉素,耐药率达到75.71%,耐药率最低的为头孢吡肟,耐药率为20.00%;其中40株福氏志贺菌耐药率最高的抗生素为强力霉素,其次为氨苄西林,最低的为头孢吡肟;30株宋内志贺菌耐药率最高的抗生素为氨苄西林,其次为哌拉西林,最低的为氧氟沙星。结论 2018年下半年汉中市中心医院从细菌性痢疾患者身上分离得到的志贺菌主要为福氏志贺菌与宋内志贺菌,毒力基因检测和耐药性试验结果显示分离菌株有较强致病性,提示对细菌性痢疾的监测、防控与治疗应进一步加强。     

210株肠道致病菌的分类及耐药性分析

目的：探讨本地区肠道致病菌的分类及主要致病菌的耐药性,给临床治疗腹泻疾病提供指导。方法：药敏试验采用K-B法,用WHONET4软件进行数据分析。结果：210株肠道致病菌中,志贺菌属占70％,沙门菌属占3％,致病性大肠埃希菌占4．8％,副溶血弧菌占3．8％,阴沟肠杆菌占3．3％,鼠伤寒沙门菌占2．4％,霍乱弧菌占1．9％,其他占10．8％等;在志贺菌属中,福氏占87％,宋内占13％。福氏和宋内志贺菌对三代头孢和IMP较敏感,对复方新诺明耐药率较高。结论：福氏志贺菌是肠道的主要致病菌;临床怀疑菌痢时,应首选三代头孢、IMP。     

沈阳地区铜绿假单胞菌药物敏感性测定及质粒图谱分析

目的 测定铜绿假单胞菌对22种药物的敏感性,帮助临床选择用药。并对分离株进行质粒图谱分析以了解耐药菌株的流行情况。方法 药物敏感性实验采用纸片琼脂扩散法,质粒指纹图谱分析采用碱变性法提取质粒DNA,限制性内切酶切割后进行凝胶电泳分析。结果 铜绿假单胞菌对头胞哌酮、氧派酸、丁胺卡那霉素、壮观霉素、多粘菌毒和头孢三嗪的敏感率在84％－100％之间。所有菌株对其他16种抗性素均有不同程度的耐药。质粒DNA图谱分析显示,12株被检测菌株中有11株含有质粒DNA,其中8株含有23kb质粒DNA。结论 铜绿假单胞菌对头胞哌铜、氟派酸、丁胺卡那霉素、壮观霉素、多粘菌素敏感;多数耐药菌株含23kb质粒DNA。     

183株志贺菌的菌群分布及药敏分析

目的了解本地区细菌性痢疾菌群分布及药敏情况。方法对183株志贺菌进行菌群分型及药敏分析。结果183株志贺菌有福氏志贺菌168株（91．8％）;宋内志贺菌9株（4．9％）;痢疾志贺菌4株（2．2％）;鲍氏志贺菌2株（1．1％）。药敏试验显示志贺菌对四环素、氨苄西林、复方新诺明耐药严重;对头孢他啶、阿米卡星、诺氟沙星比较敏感。结论本地区志贺菌主要是福氏志贺菌Ⅱa,应根据药敏试验结果选择合适抗菌药物。     

枯草芽孢杆菌活菌体外拮抗6种肠道致病菌的研究

对枯草芽孢杆菌BS 3株在体外对 6种常见肠道致病菌 (肠产毒性大肠杆菌、肠侵袭性大肠杆菌、肠致病性大肠杆菌、鼠伤寒沙门菌、福氏志贺菌和宋内志贺菌 )的拮抗作用进行了研究。结果表明 ,枯草芽孢杆菌BS 3株对宋内志贺菌、肠致病性大肠杆菌及肠产毒性大肠杆菌拮抗作用较为明显。     

圈养猕猴志贺氏菌的分离鉴定及药敏分析

目的确定猕猴感染志贺氏菌的状况,寻找有效治疗措施。方法采用不同选择培养基对13份病猴粪便样品进行分离培养、细菌革兰氏染色、镜检,并对分离的疑似菌株进行细菌生化鉴定和分子鉴定,经小白鼠致病性实验后,再用纸片扩散法测定分离菌株对23种抗生素的敏感性。结果从13份猕猴粪便样品中共检出12株志贺氏菌,检出率为92.31%,其中痢疾志贺菌(A群)1株、福氏志贺菌(B群)10株、宋内氏志贺菌(D群)1株;致病性试验结果表明,12株菌均能在72h内致死小白鼠,并能回收到注射的菌株;药敏试验结果表明,本实验中分离到的志贺氏菌对头孢噻肟(86.49%)最敏感,对头孢三嗪(75.00%)、头孢他啶(66.67%)次之,对多粘菌素B、羧苄西林、苄唑西林素等抗生素耐药性强。结论初步确定猕猴感染志贺氏菌普遍存在,进而引起腹泻、痢疾的可能性较大,头孢噻肟等为最敏感药物。     

苏州地区儿童感染志贺菌的耐药监测

目的调查苏州地区2000年至2006年儿童感染志贺菌的耐药情况,了解其耐药趋势,以指导临床合理用药。方法对2000年至2006年苏州大学附属儿童医院临床标本中分离的589株志贺菌（福氏志贺菌470株,宋内志贺菌119株）采用K-B法对氨苄西林、哌拉西林、头孢哌酮、头孢曲松、环丙沙星、SMZ＋TMP、亚胺培南进行药敏试验。结果于7年中470株福氏志贺菌的耐药率：氨苄西林：始终在90．0％以上;哌拉西林：从22．6％逐渐上升到63．2％;头孢哌酮：1．1％～56．1％;头孢曲松：2．2％～43．9％;环丙沙星：一直在10．0％左右;SMZ＋TMP：在70．0％～96．0％波动;对亚胺培南均敏感。119株宋内志贺菌的耐药率：氨苄西林：从7．1％逐渐上升到82．8％;哌拉西林：0～79．3％;头孢哌酮：0～55．2％;头孢曲松：0～51．7％;SMZ＋TMP：在62．5％～100．0％波动;对环丙沙星和亚胺培南均敏感。结论本地区儿童感染福氏志贺菌对氨苄西林严重耐药,同时伴有对SMZ＋TMP的高耐药率,对哌拉西林和3代头孢菌素的耐药率呈逐年上升趋势。宋内志贺菌的耐药率在2004年之前（除对复方新诺明外）,远低于福氏志贺菌,但在2005年其对氨苄西林和3代头孢菌素的耐药率突然上升,大有赶超福氏志贺菌之势。因此苏州地区儿童感染志贺菌的耐药情况不容乐观,对儿童细菌性痢疾的治疗将会面临困境。     

Differentiation of Shigella strains by plasmid profile analysis, serotyping and phage typing

Ninety-one Shigella flexneri and 29 Shigella sonnei strains isolated during 1994 from sporadic cases of shigellosis and healthy carriers were analyzed for plasmid profile in order to compare the discriminating ability of this method with that of serotyping and phage typing. Our study revealed 10 plasmid profiles (PP) among S. sonnei strains. A total of 26 out of 29 (89%) S. sonnei isolates could be placed into two phage types (type 1 and 20) comprising four PP for phage type 1 and seven PP for type 20, respectively. Twenty-three different PP were identified among S. flexneri strains. Each serotype was associated with a specific predominant plasmid profile, except serotype 2a. This serotype, the most frequently isolated in Romania, was still rather homogeneous: 33 out of 39 isolates belonged to phage type 125, 27 of which could be placed into two related PP (F10 and F17). Comparison of plasmid patterns of epidemiologically independent S. flexneri serotype 2a isolates with those exhibited by 45 serotype 2a isolates associated to six independent outbreaks revealed the same homogeneity. Thirty-eight strains, representing 4 of 6 outbreaks, had F10 and F17 plasmid patterns. The discrimination indices (D) for plasmid profile analysis alone (D = 0.890) and for the combination of serotyping and phage typing (D = 0.841) indicate that both typing systems have a nearly similar ability of discriminating among S. flexneri strains. By combining the results of the three typing methods, a total of 42 types are distinguished and the D value is 0.942. Our data suggest that plasmid profile analysis can complement phenotyping methods resulting in a degree of discrimination that cannot be achieved by either system alone.     

Significance of determination of Shigella antibiotic resistance in bacteriological diagnosis of dysentery]

The results of the Shigella antibiotic susceptibility assay within 1995-2002 are presented. 1472 cultures from 1158 patients with intestinal infections and bacteria carriers were isolated. The isolates were tested for their susceptibility to tetracycline, chloramphenicol, gentamicin, kanamycin, ampicillin and ofloxacin. It was shown that S. flexneri and S. sonnei were resistant to tetracycline. The S. flexneri isolates were highly resistant to chloramphenicol (73.3 to 96.0%) while resistance to it in the isolates of S. sonnei varied from 7.7 to 88.5%. In this connection the Levin medium with tetracycline was used to increase the Shigella isolation. In the study of the culture media efficiency with respect to isolation of Shigella it was observed that the Levin medium with tetracycline provided higher rates of S. flexneri and S. sonnei isolation (2.3- and 1.7-fold increase respectively) vs. the Shigella isolation on the Ploskirev medium without the antibiotic.     

食蟹猴肠道志贺氏菌感染情况的调查

本文对 337只食蟹猴肠道志贺氏菌进行调查 ,其感染率为 1 1 %。对所分离到的 2 7株志贺氏菌进行生化、血清学鉴定 ,分属三个群 ,八种血清型 ,痢疾志贺氏菌、福氏志贺氏菌、宋内氏志贺氏菌所占比例分别为 1 0 8%、86 5%、2 7% ,以福氏志贺氏 2a型居多 ,占 59 5%。对八种志贺氏菌血清型菌株进行药敏试验 ,结果表明 ,不同血清型菌株对同一种抗菌药物的敏感性、耐药性均有差异。提示不同血清型的菌株均可自然感染食蟹猴 ,在治疗时 ,对感染不同血清型志贺氏菌的食蟹猴区别用药 ,以提高治愈率 ,避免因用药不当所造成的经济损失。     

Characterization of plasmids from antibiotic-resistant Shigella isolates by agarose gell electrophoresis.

Gel electrophoresis of DNA from 95 clinical isolates of Shigella sonnei and Shigella flexneri resistant to antibiotics revealed a heterogeneous plasmid population. Most of the plasmids were smaller than 6 megadaltons (Mdal). Six S. sonnei isolates with the most common antibiotic resistance pattern were characterized. They had two plasmids in common: one was a self-transmissible Fi+ plasmid of 46 Mdal encoding resistance to streptomycin and sulphafurazole. In addition, several cryptic plasmids ranging in size from 1.0 to 24.5 Mdal were present. Mobilization of the 5.5 Mdal SuSm plasmid and a 1.0 Mdal cryptic plasmid was demonstrated with all six S. sonnei isolates during conjugation. This mobilization was mediated by the 46 Mdal self-transmissible Fi+ R plasmid and also by a 24.5 Mdal Fi- plasmid carrying no known drug resistance determinants.     

驱除痢疾杆菌侵袭大质粒的新方法

用质粒不相容性原理驱除痢疾杆菌福氏 2a 2 4 5 7T和宋内S7的侵袭大质粒 ,先从福氏2a侵袭大质粒分别扩增ori和inc基因 ,将它们克隆至 pMD18 T载体 ,得重组质粒pMDori和 pMDinc ,然后转化 2 4 5 7T和S7,不管是pMDori还是 pMDinc都能竞争驱除痢疾杆菌福氏 2a 2 4 5 7T和宋内S7的侵袭大质粒。     

Differences among Shigella spp. in susceptibility to the bactericidal activity of human serum

Clinical isolates of Shigella spp. were examined for their susceptibility to human serum. The susceptibility of the strains to immune and nonimmune human serum was dependent upon the size of the bacterial inoculum and the concentration of serum. There were differences among Shigella spp. in susceptibility to human serum: S. sonnei strains were the least susceptible, strains of S. boydii and S. flexneri serotype 6 were intermediate, and those of S. flexneri other than serotype 6 and S. dysenteriae were the most susceptible. Experiments in which heat-treated (56 degrees C for 30 min, or 50 degrees C for 20 min) serum was used, and analysis of activation of complement by lipopolysaccharides (LPS) from each Shigella sp., suggested that LPS composition, especially the O antigen polysaccharide chains, contributes to the differences among Shigella spp. in susceptibility to human serum.     

Frequency of IS1-mediated molecular events in different members of the family Enterobacteriaceae.

The numbers of chromosomal copies of the insertion sequence IS1 in strains of Salmonella typhimurium (0 to 8 copies), Shigella sonnei (56 copies), and Shigella flexneri (41 copies) isolated in Mexico City, Mexico, were similar to those reported for these genera isolated in other countries. Of the 11 Shigella strains studied, all carried several small plasmids; however, in only one of these strains did a small plasmid contain IS1, IS1 recombination, cointegrate formation mediated by IS1 or by the IS1-flanked transposon Tn9, and transposition of Tn9 occurred at a higher frequency in S. typhimurium than in either Escherichia coli or S. sonnei strains. The frequencies of IS1 recombination in S. typhimurium strains containing either zero or eight copies of IS1 were similar.     

Frequency of serovars and antimicrobial resistance in Shigella spp. from Brazil

A total of 296 Shigella spp. were received from State Public Health Laboratories, during the period from 1999 to 2004, by National Reference Laboratory for Cholera and Enteric Diseases (NRLCED)--IOC/Fiocruz, Rio de Janeiro, Brazil. The frequency of Shigella spp. was: S. flexneri (52.7%), S. sonnei (44.2%), S. boydii (2.3%), and S. dysenteriae (0.6%). The most frequent S. flexneri serovars were 2a and 1b. The highest incidence rates of Shigella isolation were observed in the Southeast (39%) and Northeast (34%) regions and the lowest rate in the South (3%) of Brazil. Strains were further analyzed for antimicrobial susceptibility by disk diffusion method as part of a surveillance program on antimicrobial resistance. The highest rates of antimicrobial resistance were to trimethoprim-sulfamethozaxole (90%), tetracycline (88%), ampicillin (56%), and chloramphenicol (35%). The patterns of antimicrobial resistance among Shigella isolates pose a major difficulty in the determination of an appropriate drug for shigellosis treatment. Continuous monitoring of antimicrobial susceptibilities of Shigella spp. through a surveillance system is thus essential for effective therapy and control measures against shigellosis.