Institute of Microbiology, Guangdong Provincial Center for Disease Control and Prevention, 511430 Guangzhou, China.
BMC Infect Dis. 2014 Jun 17;14:338. doi: 10.1186/1471-2334-14-338.
Salmonella enterica includes the major serovars associated with human salmonellosis. In this study, 1764 clinical Salmonella enterica isolates from diarrhea outpatients were collected from fifteen cities in Guangdong province, China, between 2007 and 2012. These isolates represent all of the Salmonella isolates collected from the province during that period.
The isolates were characterized by serovar determination, antimicrobial susceptibility tests and PFGE fingerprint typing.
The serovar distribution results demonstrated that Salmonella Typhimurium (n=523, 29.65%) and Salmonella 4,5,12:i:- (n=244, 13.83%) are the most common serovars causing infant salmonellosis, whereas Salmonella Enteritidis (n=257, 14.57%) mainly causes human salmonellosis in adults. The serovar shift from Salmonella Enteritidis to Salmonella Typhimurium occurred in 2008. Antimicrobial susceptibility data showed a high burden of multidrug resistance (MDR) (n=1128, 56.58%), and a 20%-30% increase in the number of isolates resistant to ciprofloxacin (n=142, 8.05%) and third-generation cephalosporins (n=88, 4.99%) from 2007-2012. Only 9.97% of isolates (n=176) were fully susceptible to all agents tested. A high burden of MDR was observed in Salmonella Typhimurium and Salmonella 4,5,12:i:- for all age groups, and a reduced susceptibility to third-generation cephalosporins and quinolones occurred particularly in infants (≤ 6 years). The dominant PFGE patterns were JPXX01.GD0004, JEGX01.GD0006-7 and JNGX01.GD0006-7. ACSSuT was the predominant MDR profile in the Salmonella Typhimurium & 4,5,12:i:- complexes, while ASSuT-Nal and ASSu-Nal were the major MDR profiles in Salmonella Enteritidis. The predominant PFGE patterns of the Salmonella Typhimurium & 4,5,12:i:- complexes and Salmonella Stanley were most prevalent in infants (≤ 6 years). However, no obvious relationship was observed between these PFGE profiles and geographic location.
These data reveal the serovar distribution of isolates recovered from diarrhea patients, the characteristics of resistant strains and fingerprint typing in Guangdong from 2007 to 2012. These results highlight a serovar shift and a worrying percentage of MDR strains with increasing resistance to quinolones and third-generation cephalosporins. Thus, continued surveillance of Salmonella and their MDR profiles using combined molecular tools and efforts to control the rapid increase in antimicrobial resistance among Salmonella in Guangdong are needed.
肠炎沙门氏菌包括与人类沙门氏菌病相关的主要血清型。本研究收集了 2007 年至 2012 年间广东省 15 个城市腹泻门诊的 1764 株临床肠炎沙门氏菌分离株,这些分离株代表了该省同期所有的沙门氏菌分离株。
通过血清型鉴定、药敏试验和 PFGE 指纹图谱分型对分离株进行鉴定。
血清型分布结果表明,肠炎沙门氏菌(n=523,29.65%)和 4,5,12:i:-(n=244,13.83%)是引起婴幼儿沙门氏菌病的最常见血清型,而肠炎沙门氏菌(n=257,14.57%)主要引起成人沙门氏菌病。2008 年发生了从肠炎沙门氏菌到鼠伤寒沙门氏菌的血清型转变。药敏数据显示,耐多药(MDR)(n=1128,56.58%)负担沉重,2007-2012 年间,对环丙沙星(n=142,8.05%)和第三代头孢菌素(n=88,4.99%)的耐药性分离株数量增加了 20%-30%。只有 9.97%(n=176)的分离株对所有检测药物完全敏感。鼠伤寒沙门氏菌和 4,5,12:i:- 对所有年龄组均表现出高 MDR 负担,特别是婴儿(≤6 岁)对第三代头孢菌素和喹诺酮类药物的敏感性降低。主要的 PFGE 模式为 JPXX01.GD0004、JEGX01.GD0006-7 和 JNGX01.GD0006-7。鼠伤寒沙门氏菌和 4,5,12:i:- 复合物中主要的 MDR 模式为 ACSSuT,而肠炎沙门氏菌中主要的 MDR 模式为 ASSuT-Nal 和 ASSu-Nal。鼠伤寒沙门氏菌和 4,5,12:i:- 复合物和斯坦利沙门氏菌的主要 PFGE 模式在婴儿(≤6 岁)中最为常见。然而,这些 PFGE 图谱与地理位置之间没有明显的关系。
这些数据揭示了 2007 年至 2012 年广东省从腹泻患者中分离的菌株的血清型分布、耐药菌株的特征和指纹图谱分型。这些结果突出表明,血清型发生了转变,对喹诺酮类和第三代头孢菌素的耐药性不断增加,导致耐多药菌株的比例令人担忧。因此,需要继续使用联合分子工具监测沙门氏菌及其耐药谱,并努力控制沙门氏菌在广东省的抗菌药物耐药性迅速增加。