腹泻儿童感染致病性大肠埃希菌的血清型分布及耐药性  

Analysis on serotype and drug resistance of enteropathogenic Escherichia coli in children with diarrhea

作　　者：万富明[1] 欧丽琼 缪群英 

机构地区：[1]四川省自贡市妇幼保健院检验科,四川自贡643000

出　　处：《国际检验医学杂志》2013年第13期1700-1702,共3页International Journal of Laboratory Medicine

摘　　要：目的监测自贡地区婴幼儿腹泻粪便中致病性大肠埃希菌(EPEC)的血清型分布及耐药状况。方法采集2012年7月至2013年2月来院就诊的细菌性感染腹泻患儿新鲜粪便标本425例进行细菌分离培养和血清学鉴定及药敏试验。结果检出42株EPEC,检出率9.88%。男性28例,构成比66.67%(28/42),检出率11.11%(28/253);女性14例,构成比33.33%(14/42),检出率8.09%(14/173);男女检出比2∶1,性别间检出率差异无统计学意义(P>0.05,χ2=0.000)。2个月至1岁婴儿感染EPEC者31例(73.81%)。共检出9种血清型,以O127aK63(26.19%)、O128K67(21.43%)和O125K70(16.67%)多见。EPEC对亚胺培南、阿米卡星敏感率100%,哌拉西林/他唑巴坦敏感率92.9%。EPEC对青霉素类、头孢菌素类和磺胺类耐率较严重。EPEC产ESBLs发生率较高,达66.77%。3种及以上药物耐药的菌株占88.10%。结论 EPEC是引起儿童细菌性腹泻的一种重要致病菌。自贡地区腹泻婴幼儿感染的EPEC血清分型较分散,且多重耐药情况严重。临床治疗应以药物敏感性试验为依据选药,哌拉西林/他唑巴坦可作为EPEC感染患儿的经验用药。Objective To survey the serotype and drug resistance of enteropathogenic Escherichia coli（EPEC） in children with diarrhea in Zigong area.Methods 425 samples were cultured from July 2012 to February 2013.The isolated EPEC strains were identified by serotyping,and the antibiotic susceptibility was determined by MIC test.Results 42 strains of EPEC were isolated（9.88%）,including 28 male and 14 female,with the ratio of 2∶1.No significant difference was found in the infection rates of EPEC between male and female patients（P0.05,χ2=0.000）.31 cases of the 42 patients（73.81%） that between two months and 1 year old were infected.9 serotypes were detected,and the major serotypes were O127aK63（11 stains/26.19%）,O128K67（9 strains/21.43%） and O125K70（7 strains/16.67%）.The rates of drug resistance to imipenem,amikacin and piperacillin/tazobactam were 0.0%,0.0% and 92.9%,respectively.The strains were highly resistant to penicillins,cephems and sulfamethoxazole compound.The incidence of ESBLs was 67.77% in the isolated strains.Multidrug-resistant organism（MDRO） were 37 strains（88.10%） in the isolated strains.Conclusion EPEC is an important pathogen leading to infant diarrhea.The strains have various serotypes in the area of Zigong,and are highly resistant to many antibiotics.Clinicians should select correct antibiotics according to the results of susceptibility test.The best choice for empirical treatment of children with EPEC is piperacillin/tazobactam.

关 键 词：腹泻 大肠杆菌 抗药性 微生物 

分 类 号：R446.5[医药卫生—诊断学]