2018－2020年供膳人員糞便中非傷寒性沙門氏菌分離株的藥敏型式

Antimicrobial Susceptibility Pattern of Non-typhoidal Salmonella Isolates from Catering Personnel in 2018-2020

陳昱馨(Yu-Hsin Chen) ； 趙育德(Yu-Te Chao) ； 陳詩涵(Se-Han Chen) ； 蔡文城(Wen-cherng Tsai)

《檢驗及品保雜誌》 10卷3期 (2021/07) Pp. 126-134

https://doi.org/10.6573/JTQA.202107_10(3).04

摘要

非傷寒性沙門氏菌（non-typhoidal Salmonella, NTS）是引起食物中毒的原因之一，雖然臨床分離NTS的藥敏型式已有許多文獻報告，然而從健康者（如供膳人員）所分離的NTS卻甚少有文獻記載，為了瞭解大台北地區供膳人員NTS之藥敏型式，本研究利用瓊脂紙錠擴散方法藥敏試驗檢測沙門氏菌各血清群（A、B、C1、C2、D1及E）對ampicillin（AMP，氨比西林）、ciprofloxacin（CIP，環丙沙星）、sulfamethoxazole-trimethoprim（SXT，甲氧芐啶－磺胺甲噁唑）、ceftriaxone（CRO，頭孢曲松）及chloramphenicol（C，氯黴素）的藥敏型式，結果指出從健康之供膳人員分離的沙門氏菌菌株對AMP、SXT及C的抗藥性高於3~5年前從臨床患者所分離的NTS抗藥性。沙門氏菌血清學分群試驗結果顯示以E血清群的數目最多，佔28.9%（59/204），其次為C2群與B群，分別佔25.5%（52/204）與24.5%（50/204）。E、C2及B血清群對三種抗微生物劑的抗藥性分別為：AMP（49.2%、86.5%與46%）、SXT（50.8%、86.5%與12%）及C（54.2%、71.2%與36%）；另外，操作C2血清群菌株對其他4種抗微生物劑：streptomycin（鏈黴素）、tetracycline（四環素）、colistin（桿菌素）及ertapeneam（厄他培南）的藥敏試驗，結果發現C2血清群中有一株對所有測試的7種抗微生物劑呈抗藥性，其為疑似Salmonella enterica serovar Goldcoast血清型。總之，本研究結果指出供膳人員糞便檢體分離之沙門氏菌菌株對第一線治療抗微生物劑中的AMP、SXT及C具有高度抗藥性，尤其多重抗藥性的NTS中含有潛在Salmonella enterica serovar Goldcoast，因此，衛生當局有必要加強管理臨床、獸醫與動物飼料方面的抗微生物劑使用。

關鍵字

非傷寒性沙門氏菌（non-typhoidal Salmonella, NTS） ； 瓊脂紙錠擴散方法 ； 沙門氏菌血清學分群 ； Salmonella enterica serovar Goldcoast

並列摘要

Non-typhoid Salmonella (NTS) is a cause of food poisoning. Although the drug susceptibility patterns of clinical NTS have been reported, those of NTS from healthy people (e.g. food workers) remain to be determined. Therefore, we assessed the antimicrobial susceptibility patterns of NTS isolated from food catering personnel in the Greater Taipei area. With the agar disk diffusion method, we determined the susceptibility patterns of Salmonella serogroups A, B, C1, C2, D1, and E against ampicillin (AMP), ciprofloxacin (CIP), sulfamethoxazole-trimethoprim (SXT), ceftriaxone (CRO), and chloramphenicol (C). Results showed that NTS isolates from healthy catering personnel were more resistant to these drugs than those from clinically ill patients. Among the various serogroups, isolates of serogroup E were most prevalent, accounting for 28.9% (59/204) of all isolates, followed by those of the C2 and B groups, accounting for 25.5% (52/204) and 24.5% (50/204), respectively. The resistance of serogroups E, C2 and B to the three antimicrobial agents are: ampicillin (49.2%, 86.5% and 46%), sulfamethoxazole-trimethoprim (50.8%, 86.5% and 12%) and chloramphenicol (54.2%, 71.2% and 36%). In addition to AMP, SXT, and C, isolates of serogroup C2 were also tested against streptomycin, tetracycline, colistin, and ertapenem. Results showed that one C2 isolate was resistant to all the seven antimicrobial agents tested, suggesting that it is Salmonella enterica serovar Goldcoast. In conclusion, results of this study indicate that Salmonella isolates from catering personnel are highly resistant to the first-line antimicrobial agents, including AMP, SXT, and C. The detection of multidrug resistant NTS, possibly Salmonella enterica serovar Goldcoast, is a concern. Therefore, it is necessary for health authorities to strengthen the management in the use of antimicrobial agents in clinical, veterinary, and animal feed areas.

並列關鍵字

Non-typhoidal Salmonella (NTS) ； agar disk diffusion method ； Salmonella serogroups ； Salmonella enterica serovar Goldcoast