北京市大兴区2018-2020年腹泻病人致泻大肠埃希氏菌检测结果分析

Analysis of detection results of diarrheagenic Escherichia coli in patients with diarrhea in Daxing district,Beijing,2018—2020

目的了解北京市大兴区肠道门诊病人中致泻大肠埃希氏菌的感染情况、流行病学和病原学特征及耐药状况。方法收集3年大兴区辖区定点医院肠道门诊腹泻病人的粪便标本进行致泻大肠埃希氏菌检验,依照GB 4789.6—2016《食品安全国家标准食品微生物学检验致泻大肠埃希氏菌检验》和WS271-2007《感染性腹泻诊断标准附录B.2肠致泻性大肠杆菌检验》进行检验,在传统生化分离培养基础上采用实时荧光PCR方法对菌株进行鉴定,并对分离出的菌株做出分析。结果三年共检测标本1049件,检出致泻大肠埃希氏菌75株(7.15%),5种基因型别均有检出,肠道集聚性大肠埃希氏菌(Enteroaggregative Esherichia coli,50.7%)构成比最高,其次为产肠毒素大肠埃希氏菌(Enterotgoxigenic Esherichiacoli,24.0%);1~10岁年龄组感染率最高(13.9%,χ2=15.057,P=0.035),男女感染率无差异(χ2=0.103,P=0.749);药敏试验结果显示检出菌株对所检测各抗生素耐药程度差异较大,耐药率最高的抗菌药物为红霉素(100%),其次为氨苄西林(82.7%)。结论致泻大肠埃希氏菌在肠道门诊腹泻病人中感染率较高,其不同型别感染率差异较大,人群年龄组阳性率差异显著,药物敏感性有差异,关注致泻大肠埃希氏菌感染情况对预防和治疗意义更大。

Objective To understand the infection status,epidemiological and etiological characteristics and drug resistance of diarrheagenic Escherichia coli in foodborne disease cases in Daxing district,Beijing.Methods The fecal specimens of patients with diarrhea were collected for diarrhoeal E.coli test for three years in the intestinal outpatient department of designated hospitals in Daxing district,According to GB 4789.6-2016 National food safety standard food-Microbiology test for diarrhoeal E.coli and WS 271-2007 Appendix B.2 test for diarrhoeal E.coli of diagnostic standard for infectious diarrhea.Results A total of 1049 specimens were tested in the past three years,and 75 strains(7.15%)of diarrhea-causing Escherichia coli were detected.Most genotypes were detected.Enteroaggregative Esherichia coli(50.7%)had the highest composition ratio,followed by Enterotgoxigenic Esherichia coli(24.0%).The highest infection rate(13.9%,χ2=15.057,P=0.035)was the age group of 1 to 10 years,there was no statistically significant difference(χ2=0.103,P=0.749)between male and female infections.The results of the drug susceptibility test showed a large difference in the degree of resistance.The antibiotic with the highest resistance rate was erythromycin(100%),followed by ampicillin(87.1%).Conclusion The infection rate of diarrhea-causing Escherichia coli is relatively high in diarrhea patients.The infection rate of different types is quite different,the positive rate of the population age group is significant different,and the drug sensitivity is different.Paying attention to the infection of diarrheal Escherichia coli is of great significance for prevention and treatment.