广州市腹泻病人香港海鸥形菌和产肠毒素性大肠杆菌感染情况调查及耐药性检测  

Prevalence and antimicrobial susceptibility of Laribacter hongkongensis and enterotoxigenic Escherichia coli isolated from patients with diarrhea in Guangzhou

作　　者：贾宇静 贺小峰[1] 张欧[1] 朱江峰[1] 胡静[1] 俞守义[1] 

机构地区：[1]南方医科大学公共卫生与热带医学学院流行病学系,广东广州510515

出　　处：《南方医科大学学报》2010年第3期455-457,462,共4页Journal of Southern Medical University

基　　金：国家自然科学基金(30700686);病原微生物生物安全国家重点实验室开放课题(SKLPBS0905);南方医科大学公共卫生与热带医学学院院长基金(GW200801-039)

摘　　要：目的初步了解广州市腹泻病人中香港海鸥型菌(LH)和产肠毒素性大肠杆菌(ETEC)感染情况和分离株的耐药情况。方法2008年9月～2009年10月于广州某医院采集了646例门急诊腹泻患者的新鲜粪便标本,用EC肉汤进行增菌,并分别采用麦康凯平板及头孢哌酮麦康凯平板进行ETEC和LH的分离培养;用生物梅里埃API20NE和API20E进行生化鉴定;用PCR方法进行基因鉴定;K-B纸片扩散法作耐药性检测。结果646例标本中未检出LH,检出38例ETEC,检出率6%。药敏结果显示ETEC对头孢类抗生素的敏感性较高,而对青霉素类,四环素类及磺胺类抗生素耐药率较高。结论广州市LH的人群感染率可能较低;ETEC引起的腹泻较10年前有降低倾向,仍需进一步做多中心调查。食用水产品可能是ETEC感染的主要危险因素之一;治疗ETEC类腹泻建议首选头孢类抗生素。Objective To survey the prevalence of enterotoxigenic Escherichia coli （ETEC） and Laribacter hongkongensis （LH） and their drug resistance in diarrhea patients in Guangzhou. Methods We detected 646 fecal cases collected between Sep 2008 and Oct 2009 from the out-patient and emergency departments in a hospital. EC enriched culture medium was used for enrichment. MAC- and CMAC-specific culture media were used to isolate ETEC and LH from the specimens. The biochemical agents API20NE and API20E were employed for biochemical identification, and PCR was used for genetic identification. K-B disk diffusion method was used for antimicrobial susceptibility testing. Results No LH was detected in the total 646 patients, and 38 patients were positive for ETEC, with a detection rate of 6%. Antibiotics resistance test showed that 38 strains of ETEC had a high resistance rate to penicillin, tetracycline and sulfa, but remained sensitive to cephalosporins. Conclusions LH may have a low prevalence in Guangzhou. The incidence of diarrhea caused by ETEC tends to decrease as compared with that a decade ago, and further multi-center survey is needed for confirmation. Consumption of aquatic products maybe one ofthe major risk factorsfor ETEC infection. Cephalosporinscan be used for ETEC-induced diarrhea.

关 键 词：腹泻 香港海鸥型菌 产肠毒素大肠杆菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]