204株致泻性大肠埃希菌及其产超广谱β-内酰胺酶菌株的分布特征  

Distribution characteristics of 204 strains of Escherichia coli and its extended-spectrum β-lactamase producing strains

作　　者：郭惠[1] 童晶[1] 吴畏畏 刘庭君 王路梅 郑东宇[2] GUO Hui;TONG Jing;WU Wei-wei;LIU Ting-jun;WANG Lu-mei;ZHENG Dong-yu(Health Inspection Center,Xuzhou Municipal Center for Disease Control and Prevention,Xitzhou,Jiangsu 221006,China;不详)

机构地区：[1]徐州市疾病预防控制中心卫生检验中心,江苏徐州221006 [2]江苏省疾病预防控制中心食品安全评价所,江苏南京210000

出　　处：《中国卫生检验杂志》2021年第3期262-266,共5页Chinese Journal of Health Laboratory Technology

基　　金：江苏省卫计委预防医学科研课题(Y2015012);国家科技重大专项(2018ZX10713-001);国家科技重大专项(2018ZX10713-002);徐州市科技局项目(KC16SW174)。

摘　　要：目的了解致泻性大肠埃希菌(DEC)及其产超广谱β-内酰胺酶(Extended-spectrumβ-lactamases,ESBLs)菌株在徐州地区急性腹泻人群中的流行病学和耐药特征。方法 2014年-2019年徐州市食源性疾病主动监测哨点医院收集2 962例腹泻病例标本,以标准化方法进行DEC分离鉴定、耐药检测、PFGE分子分型。结果 2 962份标本中检出204株DEC,其中58株(28.4%)产ESBLs,EPEC中产ESBLS表型的检出率最高(37.1%)。DEC在不同职业及不同年龄腹泻人群中的检出差异均有统计学意义(P <0.01),以托幼儿童、散居儿童人群为主,以0岁~3岁婴幼儿腹泻人群中阳检率最高;DEC对阿奇霉素、萘啶酮酸的耐药率较高,为59.3%。11株产ESBLs EAEC、ETEC菌株分别具有5簇100%相同的PFGE带型。结论 DEC导致腹泻的易感人群为免疫力较低的人群,产ESBLs的EAEC、ETEC克隆群在急性腹泻病例中持续存在。Objective To understand the epidemiological and drug resistance characteristics of diarrheal Escherichia coli( DEC) and its extended-spectrum β-lactamases( ESBLs) strains in patients with acute diarrhea in Xuzhou area.Methods A total of 2 962 patients with diarrhea were collected from the sentinel hospital for active surveillance of foodborne diseases in Xuzhou from 2014 to 2019,and DEC was isolated and identified,drug resistance was detected,and PFGE molecular typing was performed by standardized methods. Results A total of 204 DECs were detected in 2 962 specimens,of which 58 strains( 28. 4%) produced ESBLs,and the ESBLS phenotype in EPEC had the highest detection rate( 37. 1%). Occupational and age differences were detected in DEC among diarrhea populations,with the differences statistically significant( P < 0. 01),mainly in childcare and diaspora children,and the highest positive rate was found in diarrhea populations aged 0 to 3;the resistance rate to azithromycin and picolinic acid was 59. 3%. Eleven ESBLs-producing EAEC and ETEC strains have five clusters of 100% identical PFGE bands. Conclusion The susceptible population of DEC to diarrhea is the population with low immunity. The EAEC and ETEC clones producing ESBLs still exist in patients with acute diarrhea.

关 键 词：感染性腹泻 致泻性大肠埃希菌 超广谱Β-内酰胺酶 耐药性 流行病学特征 分子分型 

分 类 号：R378.27[医药卫生—病原生物学]