肠道感染致泻性大肠埃希菌的检测与流行分析

Detection of diarrheagenic Escherichia coli causing intestinal infections and analysis of epidemic

目的：为检测肠道感染致泻性大肠埃希菌（DEC ），并对疾病流行进行分析，为预防和诊治疾病提供依据。方法选取2009年5月－2014年5月医院消化门诊腹泻患者841例，所有患者均通过粪便标本以及PCR基因检测方法检测病原菌种类，统计致泻性大肠埃希菌，并结合患者的临床资料，分析其流行情况。结果841例标本中检出DEC 151例，阳性率为17．95％，其中肠致病性大肠埃细菌（EPEC）22株、肠出血性大肠埃希菌（EHEC）1株、肠产毒性大肠埃希菌（ETEC）64株、肠聚集性大肠埃希菌（EAEC）15株、弥散聚集性大肠埃希菌（DAEC）29株，分别占14．57％、0．66％、42．38％、9．39％和19．21％；仅e as tA基因阳性未能分类20株占13．25％；发病年龄与DEC检出率：0～12岁为6．62％、13～59岁为75．50％、≥60岁为17．88％；DEC好发于夏秋季（6～11月），共检出DEC106例占70．20％。结论 DEC是导致肠道感染腹泻的主要病原菌之一，DEC在不同季节和不同年龄的人群检出率有所差异，好发于夏秋季，且年龄在13～60岁检出率较高。

OBJECTIVE To detect the diarrheagenic Escherichia coli causing intestinal infections and analyze the ep‐idemic so as to provide guidance for clinical prevention and treatment .METHODS A total of 841 diarrhea patients who were treated in the gastroenterology outpatient department from May 2009 to May 2014 were enrolled in the study .The stool specimens were collected from all the patients ,the species of pathogens were detected by using PCR method ,the diarrheagenic E .coli strains were taken for statistics ,and the prevalence was observed by com‐bining the clinical data of the patients .RESULTS The diarrheagenic E .coli was detected positive in 841 of 151 specimens with the positive rate of 17 .95% ;there were 22 （14 .57% ） strains of enteropathogenic E . coli ,1 （0 .66% ） strain of enterohaemorrhagic E .coli ,64 （42 .38% ） strains of enterotoxigenic E .coli ,15 （9 .39% ） strains of enteroaggregative E .coli ,and 29 （19 .21% ） strains of dispersion aggregation of E .coli .Only 20 strains that were tested positive for eastA gene were unclassified ,accounting for 13 .25% .The detection rate of the diar‐rheagenic E .coli was 6 .62% in the patients aged between 0 and 12 years old ,75 .50% in the patients aged be‐tween 13 and 59 years old ,17 .88% in the patients aged no less than 60 years old .The diarrheagenic E .coli was the most prevalent in summer and autumn （from Jun to Nov ） .Totally 106 strains of diarrheagenic E .coli were i‐solated ,accounting for 70 .20% .CONCLUSION The diarrheagenic E .coli is one of the major species of pathogens causing the intestinal infections in the diarrhea patients ,the detection rate of the diarrheagenic E .coli varies in different seasons and different age groups of patients ,the strains are prevalent in summer and autumn ,and the de‐tection rate is relatively high in the patients aged between 13 and 60 years old .