广州地区腹泻患儿肠致病性大肠杆菌的血清型及耐药性  

Serotype and antimicrobial resistance of enteropathogenic Escherichia coli isolated from pediatric patients with diarrhea in Guangzhou

作　　者：梁秉绍 黄艳梅[1] 麦嘉良 钟华敏[1] 谢永强[1] 邓秋连 黄莲芬[1] 周珍文[1] LIANG Bing-shao;HUANG Yan-mei;MAI Jia-liang;ZHONG Hua-min;XIE Yong-qiang;DENG Qiu-lian;HUANG Lian-fen;ZHOU Zhen-wen(Guangzhou Women and Children＇s Medical Center,Guangzhou Medical University,Guangzhou,Guangdong 510120,China)

机构地区：[1]广州医科大学附属广州市妇女儿童医疗中心,广东广州510120

出　　处：《热带医学杂志》2018年第7期919-922,共4页Journal of Tropical Medicine

基　　金：广东省科技计划项目(2014A020212013;2016A020215013);广州市科技创新委员会(201707010010);广州市卫生与计划委员会(20171A010267)

摘　　要：目的调查广州地区腹泻患儿肠致病性大肠杆菌(EPEC)感染的情况,分析EPEC菌株的血清型及耐药性,为更有效地防治EPEC感染提供重要基础数据。方法回顾性分析2014年7月-2016年12月广州市妇女儿童医疗中心3 013名提供大便培养的腹泻患儿的临床资料,统计EPEC感染的流行特征,并分析EPEC阳性菌株的血清型分布及耐药情况。结果在3 013份急性腹泻患儿提供的大便培养标本中分离到96株无重复的EPEC,分离率为3.19%。以1~2岁和大于5岁年龄组检出率相对较高,年龄组间检出率的差异有统计学意义(P<0.05)。以冬、夏季检出率较高,季节间检出率差异亦有统计学意义(P<0.05)。共分为12个血清型,其中血清型O86K61、O125K70、O44K74、O126K71为优势血清型。EPEC对抗生素耐药率最高为氨苄西林(86.46%),其次为复方新诺明(76.04%)和头孢噻肟(57.29%)。未发现对亚胺培南耐药菌株,其他抗生素均有一定程度的耐药。多重耐药率为61.46%。结论 EPEC是婴幼儿腹泻的重要病原菌,O86K61为最常见血清型,该菌多重耐药严重,应加强监测并根据药物敏感试验合理选择抗生素进行治疗。Objective Aimed to explore the prevalence,serotypes,and antibiotic susceptibility of enteropathogenic Escherichia coli（EPEC）isolated from pediatric patients in Guangzhou,providing more scientific information on control of EPEC infection.Methods This was a retrospective study of 3 013 stool culture collected at Guangzhou Women and Children＇s Medical Center from July 2014 to December 2016.The characteristics of EPEC infection,and the serotypes and antibiotic susceptibility were analyzed.Results A total of 96 EPEC isolates were identified,with an isolation rate of3.19%.The isolation rates among age groups were significantly different（P〈0.05）;the isolation rate of age groups 1~2 years and 5 years old relatively higher than those of the other age groups.The isolation rates among seasons were significantly different（P〈0.05）,which were relatively higher in winter and summer.Twelve serotypes were identified,and O86 K61,O125 K70,O44 K74 and O126 K71 were the prevalent serotypes.The resistant rate to ampicillin（86.46%）was the highest,followed by trimethoprim/sulfamethoxazole（76.04%）and cefotaxime（57.29%）.No isolates was resistant to imipenem（0.00%）,while showed a certain degree of resistance to antibiotics.The multidrug resistance rate of EPEC was61.46%.Conclusion EPEC is an important pathogen in pediatric patients with diarrhea.O86 K61 was the most common serotype.Rational use of antibiotics based on antibiotic susceptibility test is critical in control of EPEC and reduction of drug resistance.

关 键 词：腹泻 肠致病性大肠杆菌 血清型 耐药 

分 类 号：R378.21[医药卫生—病原生物学]