以中部某區域醫院收集的非傷寒性沙門氏菌進行藥物敏感性及流行病學探討

Exploring the Drug Sensitivity and Epidemiological Characteristics of Nontyphoidal Salmonella Collected from a Regional Hospital in Central Taiwan

目的：沙門氏菌是最常見的人畜共通傳染病原菌，廣泛存在環境中，且是全世界重要的公共衛生問題。因此，我们將收集到的非傷寒性沙門氏菌針對藥物敏感性及流行病學作近一步探討分析。所得之初步結果，可提供院內醫師診斷之參考。材料與方法：本研究以中部某區域醫院於2008年2月至2009年12月分離的228株非傷寒性沙門氏菌的之流行病學資料為基礎，再以agar disk diffusion method測試來判讀這228株菌株的抗生素藥物敏感性。此外，使用沙門氏菌分群抗血清的玻片凝集試驗來鑑定Salmonella血清群。並運用美國疾病預防控制中心推薦的脈衝場凝膠電泳方法確定沙門氏菌的DN A切圖譜，ioNumerics軟體分析電泳結果，確定沙門氏菌的血清型結果：228株非傷寒性沙門氏菌之病人資料分析：分析陽性病患年齡層以0到15歲最多，有140位（61.4％），其次是>60歲，有42位（18.4％）：性別方面男生有124人（佔54％），女性有104人（佔46％）：檢體來源主要是以st o o l有179（78.5％)，blood有38（16.7％）分離為主。感染病患所屬血清群當中，以血清群D的38.6％（88/228）和血清群B的32.0％（73/228）為主；若以血清型而言，228株非傷寒性沙門氏菌一共分出23個血清型，以S.enteritidis佔38.2％（87/228）、S.typhimurium佔17.1％（39/228）及S.newport的7.0％（16/228）為最盛行的型別。

Background: Salmonella is not only a very commonly observed zoonotic pathogen that exists extensively in the environment, but it is also a critical public health concern worldwide. The purpose of this study was to collect samples of nontyphoidal Salmonella in order to determine drug sensitivity and epidemiological features. Materials and methods: Epidemiologic data were obtained from 228 strains of nontyphoidal Salmonella collected between February 2008 and December 2009 in a regional hospital in central Taiwan. The agar disk diffusion method was used to determine drug sensitivity in these 228 strains of bacteria. In addition, Salmonella serogroups were identified using slide agglutination tests on the anti-serum of Salmonella groups. Salmonella DNA mapping was confirmed by pulsed field gel electrophoresis as recommended by the Center for Disease Control and Prevention. Results from the pulsed field gel electrophoresis were analyzed by BioNumerics software to verify the serotypes of Salmonella. Results: Analysis of the profiles of patients with the 228 strains of nontyphoidal Salmonella showed that most of the nontyphoidal Salmonella positive patients were between 0 and 15 years of age (N=140, 61.44%), and the second largest age group was that of patients older than 60 (N=42, 18.4%). In terms of gender, 124 of the patients were male (54%), the remaining 104 patients were female (46%). The two major sources of samples were stools (N=179, 78.5%) and blood (N=38, 16.7%). A total of 23 serotypes were found from the 228 strains of nontyphoidal Salmonella; the three most prevalent types were S. Enteritidis (38.2%, 87 out of 228), followed by S. Typhimurium (17.1%, 39 out of 228) and S. Newport (7.0%, 16 out of 228).