Sirichote Pantip, Bangtrakulnonth Aroon, Tianmanee Kanokwan, Unahalekhaka Aekkawat, Oulai Amonrat, Chittaphithakchai Patcharee, Kheowrod Wachirapa, Hendriksen Rene S
Regional Medical Sciences Center, Samut Songkhram, Department of Medical Sciences, Ministry of Pubic Health, Nonthaburi, Thailand.
Southeast Asian J Trop Med Public Health. 2010 Nov;41(6):1405-15.
This study was carried out to elucidate the epidemiological trends and antimicrobial susceptibilities against Salmonella serovars among Thai patients and asymptomatic carriers during 2001-2006 in central Thailand. A total of 1,401 human and 260 non-human isolates from various sources were included. The isolates were characterized using serotyping and antimicrobial susceptibility testing. The most common serovars in patients submitting stool samples were S. Weltevreden, S. Stanley, S. Anatum, and S. Rissen. Significantly higher odds ratios were observed in blood samples versus stool sample for S. Choleraesuis, S. Enteritidis, S. Typhimurium, and S. Typhi. Children under five years old suffered the most frequently from gastroenteritis. The patients most commonly infected with an invasive serovar were children and people from 26 to 55 years of age. Antimicrobial susceptibility data revealed that S. Schwarzengrund, S. Choleraesuis, S. Anatum, S. Stanley, S. Rissen, and S. Typhimurium were the most resistant serovars observed. The invasive serovar, S. Choleraesuis was resistant to cefotaxime and norfloxacin. Antimicrobial resistance to cefotaxime, was observed in S. Agona, S. Rissen, S. Typhimurium, S. Anatum, and S. Weltevreden. An alarmingly high frequency of resistance to third generation cephalosporins was observed. We recommend Thai authorities take action in order to prevent spread of resistant S. Choleraesuis and other serovars among animals and humans by enforcing a more strict policy on the use of antimicrobials in food animals.
本研究旨在阐明2001 - 2006年泰国中部地区患者及无症状携带者中沙门氏菌血清型的流行病学趋势及抗菌药敏情况。共纳入了来自不同来源的1401株人类分离株和260株非人类分离株。通过血清分型和抗菌药敏试验对分离株进行鉴定。提交粪便样本的患者中最常见的血清型为韦太夫雷登沙门氏菌、斯坦利沙门氏菌、阿纳托姆沙门氏菌和里森沙门氏菌。对于猪霍乱沙门氏菌、肠炎沙门氏菌、鼠伤寒沙门氏菌和伤寒沙门氏菌,血液样本中的优势比显著高于粪便样本。五岁以下儿童患肠胃炎最为频繁。最常感染侵袭性血清型的患者为儿童及26至55岁的人群。抗菌药敏数据显示,施瓦岑格伦德沙门氏菌、猪霍乱沙门氏菌、阿纳托姆沙门氏菌、斯坦利沙门氏菌、里森沙门氏菌和鼠伤寒沙门氏菌是观察到的耐药性最强的血清型。侵袭性血清型猪霍乱沙门氏菌对头孢噻肟和诺氟沙星耐药。阿贡纳沙门氏菌、里森沙门氏菌、鼠伤寒沙门氏菌、阿纳托姆沙门氏菌和韦太夫雷登沙门氏菌对头孢噻肟耐药。观察到对第三代头孢菌素的耐药频率高得惊人。我们建议泰国当局采取行动,通过对食用动物使用抗菌药物实施更严格的政策,防止耐药性猪霍乱沙门氏菌和其他血清型在动物和人类之间传播。