2014-2015年广州地区腹泻患儿和健康儿童致泻性大肠埃希菌流行特征及耐药分析

Epidemiological characterization and antimicrobial resistance of diarrhea Escherichia coli from acute diarrheal and healthy children in Guangzhou City,2014-2015

目的 了解广州地区致泻性大肠埃希菌感染情况、流行病学特征及耐药情况。方法 2014年7月～2015年7月分别收集广州地区某综合医院腹泻患儿及健康儿童粪便标本143份、83份,进行细菌分离培养,采用聚合酶链反应检测肠致病性大肠埃希菌、聚集性大肠埃希菌、产毒性大肠埃希菌和肠侵袭性大肠埃希菌,Kirby Bauer法（K-B纸片扩散法）进行药敏试验。结果 四种致泻性大肠埃希菌在腹泻患儿与健康儿童中的检出率分别为1.4%、3.6%;2.8%、2.4%;1.4%、1.2%;0.7%、1.2%;腹泻患儿3～7岁年龄段检出率最高,占26.7%;然而,健康儿童中5～7岁年龄段检出率最高,占8.4%。药敏试验结果显示,大肠埃希菌对四环素、氨苄西林耐药率为52.6%～63.2%;头孢类耐药率为5.3%～21.1%;多重耐药率50.5%。结论 致泻性大肠埃希菌在腹泻患儿及健康儿童均有检出,并存在多重感染,提示致泻性大肠埃希菌是机会感染菌;除此之外,耐药及多重耐药高,应加强致泻性大肠埃希菌监测及管理抗生素使用。

Objective To investigate the epidemiological characteristics and antimicrobial resistance of diarrhea escherichia coli. Methods From June 2014 to June 2015, 143 and 83 stool samples were collected from children infected with acute diarrhea and healthy children respectively. Diarrhea escherichia coli was identified by biochemistry identification and PCR. Kirby Bauer methods （ K-B disk diffusion methods） was adopted to evaluate antimicrobial resistance. Results The detection rates of enteropathogenic escherichia coli, enteroaggregative escherichia coli, enterotoxigenic escherichia coli and enteroinvasive escheriehia coli in acute diarrhea children and health children specimens were 1.4% and 3.6% ,2. 8% and 2.4% ,1.4% and 1.2% ,0. 7% and 1.2% ,respectively. The age of 3-7 children with acute diarrhea had the highest detection rate of 26. 7%, however,the age of 5-7 healthy children had the highest rate of 8.4%. The antimicrobial suscep- tibility tests showed that the resistance rates for tetracycline, ampicillin and cephalosporin were 52.6%-63.2%, and 5.3%- 21.1%. In addition, the multi-drug resistance rate was 50. 5%. Conclusions Diarrhea escheriehia coli was detected in both acute diarrhea children and health children, and there were multiple infections,which hint diarrhea escherichia coli is an opportunistic infections bacteria. The resuh of antimierobial resistance as well as multiple antimicrobial resistance are not optimistic. It is necessary to strengthen the surveillance of diarrheagenic escherichia coli and antimicrobial resistance, and providing a guide for clinical using antibiotic is also imperative.