Ward L R, Threlfall E J, Rowe B
Central Public Health Laboratory, Division of Enteric Pathogens, London.
J Clin Pathol. 1990 Jul;43(7):563-6. doi: 10.1136/jcp.43.7.563.
Each year from 1981 through to 1988 the most common serotypes isolated from man in England and Wales and identified at the Division of Enteric Pathogens were S typhimurium, S enteritidis, and S virchow. In 1981 these three serotypes accounted for 45%, 12%, and 7% of isolations. The remaining 35% comprised strains belonging to a further 188 different serotypes, none of which accounted for more than 1% of the total. In 1988 S typhimurium accounted for 24% of isolations, S enteritidis 57%, and S virchow 4%. The remaining 15% comprised strains of a further 184 serotypes. The resistances to the common antimicrobial drugs in non-typhoidal salmonellas isolated in England and Wales in 1981 and 1988 were reported with particular reference to resistance to four or more antimicrobial drugs (multiple resistance). For S typhimurium the overall percentage of resistant strains varied little, but multiple resistance more than doubled from 5% to 12%; in S enteritidis the incidence remained the same. In S virchow the percentages of strains resistant to all the antimicrobial drugs and in particular, to chloramphenicol, streptomycin, trimethoprim and furazolidone, rose from 0.2% to 10.4%. Salmonella enteritis in man is usually a self limiting disease and antimicrobial treatment is seldom required; but should spread beyond the intestine occur, effective antimicrobial treatment is essential. Under these circumstances a knowledge of the likelihood of resistances to commonly available drugs could be of considerable value to the clinician.
从1981年至1988年的每年中,在英格兰和威尔士从人类身上分离出并由肠道病原体部门鉴定的最常见血清型为鼠伤寒沙门氏菌、肠炎沙门氏菌和维尔肖沙门氏菌。1981年,这三种血清型分别占分离菌株的45%、12%和7%。其余35%包括属于另外188种不同血清型的菌株,其中任何一种血清型所占比例均不超过总数的1%。1988年,鼠伤寒沙门氏菌占分离菌株的24%,肠炎沙门氏菌占57%,维尔肖沙门氏菌占4%。其余15%包括另外184种血清型的菌株。报告了1981年和1988年在英格兰和威尔士分离出的非伤寒沙门氏菌对常用抗菌药物的耐药性,特别提及对四种或更多种抗菌药物的耐药性(多重耐药性)。对于鼠伤寒沙门氏菌,耐药菌株的总体百分比变化不大,但多重耐药性从5%增加了一倍多,达到12%;肠炎沙门氏菌的发生率保持不变。在维尔肖沙门氏菌中,对所有抗菌药物尤其是对氯霉素、链霉素、甲氧苄啶和呋喃唑酮耐药的菌株百分比从0.2%升至10.4%。人类的沙门氏菌肠炎通常是一种自限性疾病,很少需要抗菌治疗;但如果感染扩散到肠道以外,有效的抗菌治疗至关重要。在这种情况下,了解对常用药物耐药的可能性对临床医生可能具有相当大的价值。