Zemličková Helena, Dědičová Daniela, Jakubů Vladislav, Mach Jakub, Kolínská Renata, Malíková Eliška, Urbášková Pavla, Adámková V, Bartoniková N, Bártová M, Bendová E, Bergerová T, Bohunová Z, Čápová E, Dovalová M, Glasnák M, Hanslianová M, Hásková H, Heinigeová B, Hermanová N, Horníková M, Horová B, Chmelařová E, Janečková J, Ježek P, Jindrák V, Kohnová I, Kolářová L, Krčková D, Kůrková V, Linhart P, Machučová M, Miklová J, Niemczyková J, Nyč O, Ochvatová B, Ouertani A, Paterová P, Pokorná Z, Pomykal J, Sekáčová A, Scharfen J, Skačáni H, Steinerová A, Šimečková E, Štolbová M, Tejkalová R, Trojan L, Uhlířová E, Vašková L, Vesela E, Zálabská E, Zamazalová D, Záruba R, Železná J
Statni zdravotni ustav, Praha.
Epidemiol Mikrobiol Imunol. 2013 Jul;62(2):43-9.
To determine antibiotic resistance and incidence of multidrug resistance among Nontyphoidal salmonellae serovars isolated from humans.
Consecutive Salmonella isolates from patients, recovered in 48 microbiology laboratories in May 2012, were analyzed in the respective reference laboratories at the National Institute of Public Health. Strains were re-identified and differentiated into serovars. Their minimum inhibitory concentrations (MICs) to 11 antibiotics were determined by the microdilution method.
Of 25 serovars identified among 637 strains of Salmonella enterica, the most frequent were Enteritidis (87.0 %), Typhimurium (4.9 %), and monophasic Typhimurium 4,[5],12:i:- (2.0 %) and Mbandaka (0.6 %); other serovars were rare. Altogether 558 strains (87.6 %) were susceptible to all antibiotics tested and the remaining 79 strains were resistant to one or more antibiotics. The prevalence rates of resistance to individual antibiotics among 637 study strains were as follows: ampicillin 8.5%, tetracycline 5.7%, sulfamethoxazole 5.2%, cipro-floxacin 3.8%, and chloramphenicol 2.5%. Resistance to gentamicin, trimethoprim, and third and fourth generation cephalosporins was rare ( 0.5%) and none of the study strains showed resistance to meropenem. Three producers of extended spectrum beta-lactamase were multidrug resistant and two of them recovered from twins exhibited a different pattern of resistance. Resistant strains were most often assigned to the following serovars: Enteritidis (49.4%), Typhimurium (26.6%), and monophasic Typhimurium (15.2%). While only 7% (39 of 554 strains) of Enteritidis strains were resistant, the serovars Typhimurium and its monophasic variant 4,[5],12:i:- showed high rates of resistance, i.e. 66.7 and 92.3%, respectively. Furthermore, resistance was revealed in all strains of the serovars Virchow (n = 3), Kentucky (n = 1), and Newport (n = 1), in two of three strains of the serovar Infantis, and in one of two strains of the serovar Stanley. All five blood isolates were assigned to the serovar Enteritidis and one of them showed resistance to ciprofloxacin. Of 79 resistant strains, 26.6% showed resistance to ampicillin only and 24.1% to ciprofloxacin only, with multidrug resistance, i.e. resistance to three or more antibiotics, confirmed in 43.0% of strains.
Despite a relatively low prevalence of resistance to the antibiotics tested among 637 study strains, the following alarming findings were made: Detection of Salmonella enterica strains resistant to ciprofloxacin as the drug of choice or to higher generation cephalosporins and multidrug resistance revealed in two thirds of the strains of the serovar Typhimurium and in all but one strains of its monophasic variant 4,[5],12:i:-.
确定从人类分离出的非伤寒沙门氏菌血清型的抗生素耐药性及多重耐药发生率。
2012年5月在48个微生物实验室从患者中连续分离出的沙门氏菌菌株，在国家公共卫生研究所的各个参考实验室进行分析。对菌株进行重新鉴定并区分血清型。采用微量稀释法测定它们对11种抗生素的最低抑菌浓度（MIC）。
在637株肠炎沙门氏菌中鉴定出25种血清型，最常见的是肠炎型（87.0%）、鼠伤寒型（4.9%）、单相鼠伤寒型4,[5],12:i:-（2.0%）和班达卡型（0.6%）；其他血清型较少见。总共558株（87.6%）对所有测试抗生素敏感，其余79株对一种或多种抗生素耐药。637株研究菌株中对个别抗生素的耐药率如下：氨苄西林8.5%、四环素5.7%、磺胺甲恶唑5.2%、环丙沙星3.8%、氯霉素2.5%。对庆大霉素、甲氧苄啶以及第三代和第四代头孢菌素的耐药性较少见（0.5%），且研究菌株中无一株对美罗培南耐药。3株产超广谱β-内酰胺酶的菌株为多重耐药，其中2株从双胞胎中分离出，表现出不同的耐药模式。耐药菌株最常属于以下血清型：肠炎型（49.4%）、鼠伤寒型（26.6%）和单相鼠伤寒型（15.2%）。虽然肠炎型菌株中只有7%（554株中的39株）耐药，但鼠伤寒型及其单相变体4,[5],12:i:-的耐药率较高，分别为66.7%和92.3%。此外，维尔乔型（n = 3）、肯塔基型（n = 1）和纽波特型（n = 1）的所有菌株、婴儿型3株中的2株以及斯坦利型2株中的1株均显示耐药。所有5株血液分离株均属于肠炎型，其中1株对环丙沙星耐药。在79株耐药菌株中，26.6%仅对氨苄西林耐药，24.1%仅对环丙沙星耐药，43.0%的菌株确认存在多重耐药，即对三种或更多种抗生素耐药。
尽管在637株研究菌株中对测试抗生素的耐药率相对较低，但仍有以下令人担忧的发现：检测到肠炎沙门氏菌菌株对首选药物环丙沙星或更高代头孢菌素耐药，并且在三分之二的鼠伤寒型菌株及其除一株外的所有单相变体4,[5],12:i:-菌株中发现多重耐药。
