沈阳地区2012年-2014年致泻性大肠埃希菌耐药性监测分析

Surveillance and analysis of antimicrobial resistance of diagrrheagenic Escherichia coli in Shenyang during 2012- 2014

目的了解沈阳市腹泻人群中DEC的流行特征及耐药情况,为预防和治疗DEC感染性腹泻提供参考依据。方法采集2012年-2014年每年5月-9月医院肠道门诊就诊的406例腹泻患者的粪便标本,应用多重PCR方法检测DEC,并作耐药性分析。结果共检出DEC 27株,检出率为6.65%,EAEC 19株(70.37%),ETEC 4株(14.81%),EPEC 2株(7.41%),EHEC和EIEC各1株(3.70%),检出率以EAEC最高。不同年龄、不同年份DEC检出率差异无统计学意义(P>0.05)。DEC对氨苄西林耐药率最高(33.33%),其次是庆大霉素和复方新诺明(29.63%),对其他抗菌药物耐药率均低于20%。结论沈阳市DEC存在5种类型,以EAEC为主;沈阳市DEC对多种抗菌药耐药率较高,建议加强对DEC的监控。

Objective To investigate the epidemic and antimicrobial resistance of diagrrheagenic escherichia coli（ DEC） among population with diarrhea in Shenyang,so as to provide reference for preventing and treating DEC infectious diarrhea.Methods The stool samples from 406 patients with diarrhea were collected,who came to the intestine clinic from May to September during 2012- 2014,and DEC was detected by multiplex PCR,and antimicrobial resistance was tested. Results A total of 27 strains of DEC were detected with the detection rate of 6. 65%,including 19 strains of EAEC（ 70. 37%）,4 strains of ETEC（ 14. 81%）,2 strains of EPEC（ 7. 41%）,1 strain of EHEC and 1 strain of EIEC（ 3. 70%）. EAEC had the highest detection rate of DEC. There was no statistical significance on the differences among DEC detection rates in different ages and difference years（ P〈0. 05）. The resistant rate of DEC to ampicillin was the highest（ 33. 33%）,followed by gentamicin and compound sulfamethoxazole（ 29. 63%）,the others were all lower than 20%. Conclusion There were five types of DEC in Shenyang area,and EAEC is the dominant. The resistance rate of DEC to a variety of antimicrobial is higher,so the monitoring of DEC should be strengthened.