2013年河南省致泻性大肠杆菌病原学与分子分型研究  

The etiological and molecular typing research of diarrheagenic Escherichia coli in Henan province in 2013

作　　者：赵嘉咏[1] 张白帆[1] 苏佳[1] 谢志强[1] 穆玉姣[1] 黄学勇[1] 夏胜利[1] 

机构地区：[1]河南省疾病预防控制中心传染病所,郑州450016

出　　处：《中华预防医学杂志》2016年第6期525-529,共5页Chinese Journal of Preventive Medicine

摘　　要：目的：分析河南省2013年5种致泻性大肠杆菌（DEC）在腹泻人群中分布情况及PFGE图谱特征。方法收集河南省2013年腹泻病多病原监测系统中分离自1037例患者的大肠杆菌菌株，共计1037株，涵盖4个监测哨点医院。采用克氏双糖铁/动力吲哚尿素培养基（KIA/MIU）对大肠杆菌做初步鉴定，热裂解法制备DNA模板，多重PCR鉴定5种DEC。根据国际PulseNet细菌性传染病分子分型监测网络公布的非O157大肠杆菌PFGE分型技术方案，对检出的DEC进行分型。结果1037株菌株中，共检测出125株DEC，总检出率12.05%。其中，肠聚集性大肠杆菌（EAEC）检出率为8.68%（90株）；肠致病性大肠杆菌（EPEC）检出率为2.31%（24株）；肠产毒性大肠杆菌（ETEC）检出率为0.39%（4株）；肠侵袭性大肠杆菌（EIEC）检出率为0.68%（7株）；未检出肠出血性大肠杆菌（EHEC）。1037例腹泻患者中男性639例，检出DEC 94株（14.71%）；女性398例，检出DEC 31株（7.79%）。农村患者782例，检出DEC 97株（12.40%）；城市患者255例，检出28株（10.98%）。125例DEC阳性患者中，≤5岁儿童有83例（66.4%）。PFGE分析显示，53株EAEC获得52种带型，每种带型包含菌株数1～2株不等，相似度为66.3%～100.0%；18株EPEC获得18种带型，每种带型均只包含1株菌，相似度为72.6%～94.8%；5株EIEC获得5种带型，每种带型均只包含1株菌，相似度71.9%～98.5%；2株ETEC获得2种带型，相似度小于70.0%。结论4种DEC作为致病病原构成了2013年河南省细菌性腹泻病原谱的重要组成部分；4种DEC携带不同的毒力基因种类，且细菌染色体指纹图谱呈现高度多态性。Objective To analyze the distribution and pulsed field gel electrophoresis （PFGE） patterns of five kinds of diarrheagenic Escherichia coli （DEC） in infected diarrhea population of Henan province in 2013. Methods Gathering 1 037 strains of E. coli of 1 037 diarrhea patients from four sentinel hospitals of multi-pathogen monitoring system in Henan province in 2013. Stool samples were cultured with Mac agar plates and using KIA/MIU biochemical action as the preliminary method to identify E. coli strains;preparation of DNA template with thermal cracking method and using multiplex PCR to detect five kinds of DEC. According to molecular typing method published by the international PulseNet bacterial infectious disease monitoring network, the PFGE molecular characteristics of DEC strains were analyzed. Results 125 DEC positive strains were detected in 1 037 strains of E. coli, the total detection rate was 12.05%. 90 strains were enteroaggregative E.coli （EAEC）, detection rate was 8.68% （n=90）; 24 strains were enteropathogenic E.coli （EPEC）, detection rate was 2.31%; 7 strains were enteroinvasive E.coli （EIEC）, detection rate was 0.68%; 4 strains were enterotoxigenic E.coli （ETEC）, detection rate was 0.39%;enterohemorrhagic E.coli （EHEC） was not detected. 639 cases of diarrhea samples were collected from male patients, 398 cases were from female patients, 94 positive cases were from male patients, the detection rate was 14.71%.The positive number of female cases were 31 cases, the detection rate was 7.79%. 97 positivenbsp;cases were detected from 782 countryside cases and 28 positive cases were detected from 255 urban area cases, with detection rate 12. 40%and 10.98%respectively. In 125 cases of DEC positive samples, children below 5 years old were 83 cases, accounting for 66.4%;53 strains of EAEC were divided into 52 molecular patterns by digestion with XbaⅠ and pulsed field gel electrophoresis, each pattern contained 1-2 strains with similarity ranged from 66.3%-100%;18 strains of EPEC

关 键 词：大肠杆菌 腹泻 细菌分型技术 毒力因子类 电泳 

分 类 号：R512.5[医药卫生—内科学]