健康老年人肠道中肠集聚性大肠埃希菌流行现状及防治策略  

Current epidemiology and prevention of enteroaggregative Escherichia coli in healthy elderly people

作　　者：许江燕[1] 王原[1] 骆丰[1] 曹俊敏[1] 吴健 

机构地区：[1]浙江中医药大学附属第一医院实验诊断中心,杭州310016 [2]江苏省盐城市第一人民医院检验科,224001

出　　处：《中华老年医学杂志》2016年第7期728-731,共4页Chinese Journal of Geriatrics

基　　金：浙江省自然科学基金项目（LY14H150004）;浙江省医药卫生科技计划项目（2015KYB262）

摘　　要：目的分析健康老年人肠道中肠集聚性大肠埃希菌（EAEC）的流行情况，并依此提出防治策略。方法收取175例健康老年人的粪便标本，分别接种于血平板、SS平板、麦康凯平板进行细菌培养，用全自动微生物鉴定仪和质谱仪鉴定细菌到种；对分离出大肠埃希菌采用双纸片协同法检测其超广谱β内酰胺酶（ESBL）的表型，用PCR法扩增其EAEC毒力基因astA和aggR；用PCR法检测ESBL表型阳性的EAEC菌株基因型。结果175例标本中，共检出160株大肠埃希菌，ESBL携带率为36．3％（58／160）；检出EAEC16株（10．0％），其中astA阳性14株（8．8％），aggR阳性2株（1．3％）；EAEC菌株的ESBL携带率为56．3％（9／16），其基因型均为CTX—M型，其中以CTX—M-14最多，占66．7％（6／9）。结论EAEC不仅是腹泻患者的病原菌，在健康老年人群中具有较高的携带率和耐药性，提醒我们应加强防范。Objective To analyze the current epidemiology of enteroaggregative Escheriehia coli （EAEC） in healthy elderly people, in order to help formulate prevention strategies. Methods Stool specimens from 175 healthy elderly people were cultured on blood plates, SS plates, and MAC plates. Bacterial strains were identified by the VITEK-2 compact automated identification system and mass spectrometry. The phenotype of extended-spectrum beta-lactamases （ESBL） was determined by the double-disk synergy method. The resistance genes and EAEC virulence genes astA and aggR were amplified by polymerase chain reaction （PCR）, which was also used to detected EAEC strains with positive ESBL phenotypes. Results Among the 175 samples, 160 strains were E. coli, with an ESBL-positive rate of 36.3% （58/160）; 16 stains （10.0%, 16/160） were EAEC, of which, 14 strains （8.75%） were astA-positive and 2 strains （1.3%） were aggR-positive, and the ESBL-positive rate of the EAEC strains was 56.25% （9/16）. All of the EAEC strains with positive ESBLs carried CTX-M types, and CTX-M-14 was the most dominant genotype, accounting for 66.7% （6/9）. Conclusions EAEC is a common bacterial pathogen of diarrhea and has a high carrier rate and drug resistance rate in healthy elderly people. Therefore, heightened prevention measures should be considered.

关 键 词：埃希菌属 大肠杆菌感染 

分 类 号：R446.5[医药卫生—诊断学]