Wasfy M O, Oyofo B A, David J C, Ismail T F, el-Gendy A M, Mohran Z S, Sultan Y, Peruski L F
U.S. Naval Medical Research Unit No. 3, Cairo, Egypt.
J Health Popul Nutr. 2000 Jun;18(1):33-8.
While Campylobacter, Salmonella, and Shigella remain major contributors to acute enteric infections, few studies on these pathogens have been conducted in Egypt. From January 1986 to December 1993, 869 Salmonella, Shigella and Campylobacter strains were isolated from stool specimens from 6,278 patients, presenting to the Abbassia Fever Hospital, Cairo, Egypt, with acute enteric infections. Salmonella predominated, totalling 465 isolates, followed by Shigella with 258 isolates, and Campylobacter with 146 isolates. Of the Shigella isolates, 124 were Shigella flexneri, 49 were S. sonnei, 47 were S. dysenteriae (mainly serotype 1, 2, and 3), and 38 were S. boydii. Campylobacter spp. comprised 92 Campylobacter jejuni and 54 C. coli isolates. Isolation of Salmonella was highest during the months of February-March, June-July, and October-November, while that of Shigella was maximal from July to October. Isolation of Campylobacter increased during May-June and again during August-October. Although Salmonella was sensitive to amikacin, aztreonam, ceftriaxone, and nalidixic acid, it was, however, resistant to erythromycin, streptomycin, ampicillin, chloramphenicol, and tetracycline. Shigella (> 80%) was sensitive to amikacin, ceftriaxone, cephalothin, sulphamethoxazole-trimethoprim (except S. sonnei), aztreonam, and nalidixic acid. Resistance (> 50%) was noted only for ampicillin, chloramphenicol, and tetracycline. C. jejuni and C. coli were resistant to cephalothin, aztreonam, and streptomycin. Some of the above antibiotics were employed to characterize the Egyptian isolates, but did not have any clinical utility in the treatment of diarrhoea. Significant differences (p < 0.05) were observed in the resistance profiles of Shigella and Salmonella between late 1980s and early 1990s. The results suggest the use of fluoroquinolones or a third-generation cephalosporin as an empirical treatment of enteric diseases. However, alternative control strategies, including the aggressive development of broadly protective vaccines, may be more effective approaches to curbing morbidity and mortality due to acute enteric infections.
虽然弯曲杆菌、沙门氏菌和志贺氏菌仍是急性肠道感染的主要病原体，但在埃及针对这些病原体开展的研究较少。1986年1月至1993年12月期间，从埃及开罗阿巴斯亚发热医院6278例患有急性肠道感染的患者粪便标本中分离出869株沙门氏菌、志贺氏菌和弯曲杆菌菌株。沙门氏菌占主导，共465株分离株，其次是志贺氏菌，有258株分离株，弯曲杆菌有146株分离株。在志贺氏菌分离株中，124株为福氏志贺氏菌，49株为宋内志贺氏菌，47株为痢疾志贺氏菌（主要是血清型1、2和3），38株为鲍氏志贺氏菌。弯曲杆菌属包括92株空肠弯曲杆菌和54株大肠弯曲杆菌分离株。沙门氏菌的分离率在2月至3月、6月至7月以及10月至11月期间最高，而志贺氏菌的分离率在7月至10月最高。弯曲杆菌的分离率在5月至6月期间增加，在8月至10月再次增加。虽然沙门氏菌对阿米卡星、氨曲南、头孢曲松和萘啶酸敏感，但对红霉素、链霉素、氨苄西林、氯霉素和四环素耐药。志贺氏菌（>80%）对阿米卡星、头孢曲松、头孢噻吩、复方新诺明（宋内志贺氏菌除外）、氨曲南和萘啶酸敏感。仅对氨苄西林、氯霉素和四环素存在耐药性（>50%）。空肠弯曲杆菌和大肠弯曲杆菌对头孢噻吩、氨曲南和链霉素耐药。上述一些抗生素用于鉴定埃及分离株，但在治疗腹泻方面没有任何临床效用。在20世纪80年代末和90年代初，志贺氏菌和沙门氏菌的耐药谱存在显著差异（p<0.05）。结果表明，可使用氟喹诺酮类药物或第三代头孢菌素作为肠道疾病的经验性治疗药物。然而，包括大力研发广泛保护性疫苗在内的替代控制策略，可能是遏制急性肠道感染所致发病率和死亡率的更有效方法。
