摘要
目的了解安徽省马鞍山市腹泻患者中致泻性大肠埃希菌(DEC)的感染情况、毒力基因、耐药性以及分子分型,为DEC的防治提供依据。方法2014-2018年,对马鞍山市三家哨点医院门诊急性腹泻患者粪便标本进行DEC的分离、鉴定与毒力基因检测,并对阳性菌株进行药敏试验及脉冲场凝胶电泳(PFGE)分子分型。结果1711份腹泻粪便标本中有120份检出阳性,共分离得到123株DEC,标本检出阳性率为7.01%。DEC阳性病例年龄分布以0~5岁的婴幼儿及20~39岁青壮年为主;病例集中在夏季(6-8月)。DEC分型中以肠产毒性大肠埃希菌(ETEC)和肠致病性大肠埃希菌(EPEC)为主,分别占58.54%和31.71%。123株DEC菌株的药敏试验结果显示,超广谱β-内酰胺酶(ESBL)阳性菌株耐药严重,所有菌株耐≥6种药物。PFGE分子分型产生119种带型,带型相对分散,相似度为49.7%~97.7%。结论2014-2018年马鞍山市腹泻患者DEC的感染类型以ETEC和EPEC为主,存在年龄及季节分布特征,本地分离DEC菌株的耐药程度较为严重,PFGE带型分散,应控制抗生素的滥用,重点关注ETEC或EPEC的流行风险。
Objective To investigate infection status,virulence genes,antibiotic resistance and molecular types of diarrheogenic Escherichia coli(DEC)in diarrhea patients in Maanshan of Anhui province and provide scientific basis for the prevention and control of DEC infection.Methods The stool samples were collected from outpatients with acute diarrhea in three sentinel hospitals in Maanshan during 2014–2018 for DEC isolation,identification and virulence genes detection,and drug susceptibility test and pulsed-field gel electrophoresis(PFGE)were conducted for the positive strains.Results Among1711 stool samples of diarrhea cases,120 were DEC positive,and 123 DEC strains were isolated.The positive rate was 7.01%(120/1711).The DEC positive cases were mainly infants aged 0-5 years and young adults aged 20–39 years.The cases mainly occurred in summer(June-August).Enterotoxigenic E.coli(ETEC)and enteropathogenic E.coli(EPEC)were the main types of DEC,accounting for 58.54%and 31.71%,respectively.Drug susceptibility test of 123 DEC strains showed that extendedspectrum beta-lactamase strains were resistant to more than 6 antibiotics.PFGE results of 123 DEC strains showed 119 banding patterns,which were relatively dispersed,and the similarity of banding patterns was 49.7%–97.7%.Conclusion From2014 to 2018,DEC infections in diarrhea patients in Maanshan were mainly caused by ETEC and EPEC.The age and seasonal distributions of the infection cases was obvious.The antibiotic resistance of DEC strains was serious.The PFGE molecular bands of the strains were dispersed.The non-rational use of antibiotics should be controlled,and more attention should be paid to epidemic risk of ETEC or EPEC infections.
作者
王利
洪颖
陈谨
王蓉
罗颖
陈健
孙永
胡万富
苏斌
陈道利
WangLi;Hong Ying;Chen Jin;Wang Rong;Luo Ying;Chcn Jian;Sun Yong;Hu Wanju;Su Bin;Chen Daoli(Maanshan Center for Disease Control and Prevention,Maanshan 243000,Anhui,China;Anhui Provincial Center for Disease Control and Prevention,Hefei 230601,Anhui,China)
出处
《疾病监测》
CAS
2019年第11期1010-1016,共7页
Disease Surveillance
基金
国家科技重大专项(No.2018ZX10713003–002–005)~~
关键词
致泻性大肠埃希菌
毒力基因
脉冲场凝胶电泳
耐药性
Diarrheogenic Escherichia coli
Virulence genes
Pulsed-field gel electrophoresis
Drug sensitivity