Branch for Enteric Disease Control and Prevention, Institute for Infectious Disease Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou, China.
J Clin Microbiol. 2011 Jan;49(1):232-42. doi: 10.1128/JCM.01508-10. Epub 2010 Nov 10.
In 2006, 3,531 fecal samples were collected from patients with diarrhea in Henan Province, China. A total of 467 (13.2%) Shigella strains were isolated and serotyped. Seventy-one Shigella flexneri strains were characterized by MIC determination, pulsed-field gel electrophoresis (PFGE), and detection of genes encoding cephalosporin resistance. Most infections were caused by S. flexneri variant X [IV:(7),8] (27.6%), S. sonnei (24.2%), and S. flexneri 2a (20.8%). However, large regional differences were observed. Significantly higher odds (2.0) of females compared to males were infected with S. flexneri 2a. Untypeable S. flexneri (-:6) isolates were absent among males, as were untypeable S. flexneri [I:(7),8] isolates among females. Patient ages ranged from 2 months to 82 years, with 231 subjects (49.7%) <5 years of age. Most of the patients were male (62.1% [n = 290]). Infections peaked in July; week 27 with 38 cases (8.1%). All of the 71 S. flexneri conferred resistance to nalidixic acid; in addition, 21% (n = 15) and 79% (n = 56) were high- and low-level resistant to ciprofloxacin, respectively. Six S. flexneri isolates {serotype 2b [II:7,(8)] and 2b [II:(3),4;7,(8)]} harbored the bla(CTX-M-14) or bla(CTX-M-15) gene. A total of 52 unique XbaI PFGE patterns were observed among the 71 S. flexneri isolates with 11 distinct PFGE clusters. This study revealed a high prevalence of shigellosis with geographical differences in the distribution of serotypes in the distribution of serotypes and also differences in comparisons by gender. A high frequency of resistance, including 100% resistance to ciprofloxacin and resistance to extended-spectrum cephalosporins, was observed. We detected several isolates exhibiting the same PFGE type and MIC profile, indicating multiple undetected outbreaks.
2006 年，从中国河南省腹泻患者中采集了 3531 份粪便样本。共分离鉴定出 467 株（13.2%）志贺菌，对 71 株福氏志贺菌进行 MIC 测定、脉冲场凝胶电泳（PFGE）和头孢菌素耐药基因检测。感染主要由福氏志贺菌变种 X [IV：（7），8]（27.6%）、宋内志贺菌（24.2%）和福氏志贺菌 2a（20.8%）引起。然而，存在显著的地区差异。与男性相比，女性感染福氏志贺菌 2a 的几率明显更高（2.0）。男性中未检出不可分型福氏志贺菌（-：6），女性中也未检出不可分型福氏志贺菌[I：（7），8]。患者年龄从 2 个月到 82 岁，231 名（49.7%）<5 岁。大多数患者为男性（62.1%[n=290]）。感染高峰期在 7 月，第 27 周有 38 例（8.1%）。71 株福氏志贺菌均对萘啶酸耐药；此外，21%（n=15）和 79%（n=56）对环丙沙星的耐药性分别为高水平和低水平。6 株福氏志贺菌（血清型 2b[II：7，（8）]和 2b[II：（3），4；7，（8）]）携带 bla（CTX-M-14）或 bla（CTX-M-15）基因。71 株福氏志贺菌共观察到 52 种独特的 XbaI PFGE 图谱，11 种不同的 PFGE 簇。本研究显示志贺菌病发病率较高，血清型分布存在地域差异，不同性别之间存在差异。耐药率较高，包括对环丙沙星 100%耐药和对头孢菌素的耐药性。我们检测到一些具有相同 PFGE 型和 MIC 谱的分离株，表明存在多个未被发现的暴发。
