致泻大肠埃希菌在水源水中的分布与腹泻病关系的研究

Distribution of the lapactic E.coli in water source and its relationship with diarrhea

目的探讨致泻大肠埃希菌在水源水中的分布与腹泻病之间的相互关系。方法腹泻病人粪便标本来自本市医院肠道门诊,水源水为本市的主要饮用水源。标本经增菌,分离培养、纯培养、生化反应、噬菌体裂解、血清学试验等微生物学鉴定确定致泻大肠埃希菌的分布。结果定点、定时采集1080份水源水,检出致泻大肠埃希菌149株,分属23个血清型,EPEC中以O86∶K61K62最为多见,O128∶K67次之;EIEC中以O29∶K分离菌株数最多,O28∶K73次之;ETEC中以O8∶K40K47最为常见,O6∶K15次之;同一时期自1142份腹泻病人粪便标本中分离到致泻大肠埃希菌143株,分属23个血清型,EPEC中以O86∶K61K62检出率最高,O142∶K86次之,EIEC中以O29∶k最为多见,O28∶K73次之,ETEC中以O8∶K40K47分离菌株数最多,O6∶K15次之;先后自腹泻病人粪便和水源水中分离到7株产H2S致泻大肠埃希菌。结论比较同一时期自腹泻病人和水源水标本中检出的致泻大肠埃希菌,发现两者除极个别外,血清型分布几乎完全相同,两者分离的致泻大肠埃希菌EPEC、EIEC、ETEC中均是分别以O86∶K61K62、O29∶K O8∶K40K47血清型最为常见,表明腹泻病人感染致泻大肠埃希菌与水源水污染有密切关系,为制定相应的腹泻病防治对策提供了依据;产H2S致泻大肠埃希菌的发现,填补了致泻大肠埃希菌家族的一项空白,提示临床医生在腹泻病防治工作中,同时也要关注生化学变异的腹泻病原菌的检测。

In order to clarify the interrelation of distribution of the lapactic E. coli in water source and diarrhea, feces specimere of patients with diarrhea and water samples from main drinking water sources in Liu an district of Anhui province were collected for study, and they were treated through various microbiological methods, such as enrichment, isolation eultue, pure culture, biochemical reactions, bacteriophage lytic test, serological testing and bacteriological identification etc, to comfirm the distribution of the lapaetic E. coll. In this survey, 149 strains of the lapactic E. coli were isolated from 1080 shares of water sources collected at fixed places and times. They belonged to 23 serotypes, in which the most common one in EPEC was O86 ： K61K62; and the second one was O128：K67; in EIEC, the most common one was O29：K , and O28：K73 ranked secondly; in ETEC, O8：K10K17 ranked first, and O6： K15, secondly. Interestingly, 7 strains of lapactic E. coli producing H2S had been isolated from feces specimens of patients with diarrhea and water samples of drinking water sources. To compare the lapaetic E. coli isolated from feces specimens of patients with diarrhea and those isolated from water sources at the same time, it was found the distributions of serotypes were almost just the same with very rare exception. In this condition, the most common serotypes in EREC, EIEC and ETEC were O86 ： K61K62, O29： K？ and O8： K10K17 respectively. This indicates that patients with diarrhea infected with lapactic E. coli have maintain dose ties with water sources contaminated.