致泻性大肠埃希菌感染腹泻患者血清型分布与耐药性

Distribution of serotypes and drug resistance of diarrhea patients caused by Escherichia coli infection

目的探究导致患者腹泻的致泻性大肠埃希菌(DEC)分布及其耐药性,为临床治疗DEC感染导致的腹泻作为参考依据。方法选取2011年3月-2013年3月门诊腹泻患者的肛拭子标本1 876份作为总体样本,筛选出可疑菌落后通过生化及血清学试验确定致病菌的种类及血清型,并对检出病原菌进行K-B纸片琼脂扩散法进行药敏测定分析。结果 1 876份肛拭子标本共分离出肠道病原菌2 011株,DEC 102株占5.07%,其中致病性大肠埃希菌(EPEC)62株占60.79%,侵袭性大肠埃希菌(EIEC)28株占27.45%,产毒性大肠埃希菌(ETEC)9株占8.82%;EPEC对哌拉西林、氨苄西林、环丙沙星、诺氟沙星等均具有较高的耐药率,均>40.00%。结论 DEC在腹泻患者中检出率较高,且具有较高的耐药性,临床应明确病因针对性应用高效的抗菌药物,避免盲目应用抗菌药物造成的病原菌耐药。

OBJECTIVE To investigate the distribution and drug resistance of Escherichia coli causing diarrheal in patients so as to provide references for clinical treatments .METHODS From Mar .2011 to Mar .2013 ,a total of 1876 copies of outpatients rectal swab specimens in patients with diarrhea were chosen as the overall samples .The suspected bacteria colonies were screened out by biochemical and serological tests to determine the types of bacteria and serotypes ,and K‐B paper agar diffusion method was adopted to analyze the drug sensitivity of detected patho‐gens .RESULTS A total of 2011 strains of intestinal pathogens were isolated from the samples ,in which DEC had 102 strains ,accounting for 5 .07% and pathogenic EPEC got 62 strains ,holding 60 .79% .Totally 28 strains of EIEC were isolated ,accounting for 8 .82% .EPEC was highly resistant to piperacillin ,ampicillin ,ciprofloxacin , and norfloxacin .with resistance rates of more than 40% .CONCLUSION DEC are highly detected in patients with diarrhea and has a relatively high drug resistance .The clinical application of antibiotics should be clearly targeted and efficient to avoid blind application of antibiotics causing pathogens‐resistant drugs .