臨床檢體中沙門氏菌血清群發生率及藥物感受性的回顧性研究

A Retrospective Study on the Incidence and Antimicrobial Susceptibility of Salmonella Serogroups in Clinical Specimens

沙門氏菌是引起食源性腸胃炎和菌血症的主要病原體，對全球公共健康構成重大威脅。沙門氏菌的抗生素抗藥性問題日益嚴重，不同沙門氏菌血清群對抗生素的感受性存在差異，這使得治療方案的仔細評估成為必要。基於上述問題，本回顧性研究旨在分析臨床檢體中沙門氏菌血清群的分布及其抗生素感受性概況。研究中選取了2023年6月1日至2023年9月30日期間通過MALDI-TOF MS技術鑑定為沙門氏菌的153株分離菌。每株沙門氏菌均使用Wellcolex Colour沙門氏菌檢測試劑進行血清群分型，同時根據CLSI的檢測方法和判讀標準，採用肉湯微量稀釋法或紙錠擴散法進行抗生素感受性測試。血清群分布如下：血清群A（1株）；血清群B（32株）；血清群C（36株）；血清群D（57株）；未明確血清群的沙門氏菌（27株）。血清群B和血清群C的分離菌，特別是在未分類的沙門氏菌中，常見對第一線抗生素（AMP、SXT、CIP）表現抗藥性，凸顯尋找替代療法的迫切需求。第三代頭孢菌素(Third-generation Cephalosporins: CRO, CTX, CAZ, FEP)對某些血清群仍具療效，但須持續監測。D群沙門氏菌則仍對抗生素較為敏感，因此較易處理。碳青霉烯類抗生素(Carbapenems: ETP, IPM, MEM)在治療重症或多重抗藥性病例方面仍非常有效，但應謹慎使用以避免產生抗藥性。這些研究結果有助於指引合理的抗生素使用與沙門氏菌感染的控制策略。

Salmonella is a major cause of foodborne gastroenteritis and bacteremia, leading to significant public health concerns worldwide. Antibiotic resistance in Salmonella is a growing concern and different Salmonella serogroups exhibit varying susceptibilities to antibiotics, necessitating careful evaluation of treatment options. Given these concerns, the aim of this retrospective study is to analyze the distribution of Salmonella serogroups and their antibiotic susceptibility profiles in clinical samples. One hundred and fifty-three isolates identify as Salmonella isolates by the MALDI-TOF MS technique were chosen between 1 June 2023 and 30 September 2023. Each Salmonella isolate was tested with the Wellcolex Colour Salmonella Test and antimicrobial susceptibility testing was carried out for all Salmonella isolates using either broth microdilution or the disk diffusion method following the CLSI testing methodology and interpretative criteria. The distribution of serogroups was as follows: serogroup A (1 isolate); serogroup B (32 isolates); serogroup C (36 isolates); serogroup D (57 isolates); and unspecified Salmonella species (27 isolates). Both group B and group C Salmonella isolates, particularly unclassified Salmonella species, exhibited frequent resistance to first-line antibiotics such as ampicillin, trimethoprim-sulfamethoxazole, and ciprofloxacin, underscoring the urgent need for alternative therapeutic strategies. Third-generation cephalosporins are still useful for some serogroups but require monitoring. Serogroup D remains the most antibiotic-sensitive, making it easier to manage. Carbapenems are still very effective, especially for severe or multidrug-resistant cases, but should be used cautiously to avoid resistance development. These findings help guide rational antibiotic use and control of salmonellosis.