2018—2020年江阴市致泻性大肠埃希菌流行情况及药物敏感性分析  

Prevalence of diarrhoeagenicEscherichia coli and antimicrobial susceptibility tests in Jiangyin City from 2019 to 2022

作　　者：谢雯 高海英[1] 刘晓骏[1] 蒋云菲 王博 沙丹[3] XIE Wen;GAO Hai-ying;LIU Xiao-jun;JIANG Yun-fei;WANG Bo;SHA Dan(Jiangyin Municipal Center for Disease Control and Prevention,Wuxi Jiangsu 214431,China;不详)

机构地区：[1]江阴市疾病预防控制中心,江苏无锡214431 [2]南京大学金陵学院 [3]无锡市疾病预防控制中心

出　　处：《江苏预防医学》2024年第1期80-83,123,共5页Jiangsu Journal of Preventive Medicine

基　　金：江南大学公共卫生研究中心项目(JUPH201817);江阴市卫健委科研项目(G201907,G202010)。

摘　　要：目的了解江阴市腹泻患者中的致泻性大肠埃希菌(diarrheagenic escherichia coil,DEC)感染状况、毒力基因、分子分型及耐药情况。方法按照2018年无锡市食源性疾病监测工作手册,采集腹泻患者肛拭样本,分离出DEC后进行实时荧光PCR确认,并进行脉冲场凝胶电泳(PFGE)和药物敏感性实验。结果2018—2020年在2家哨点医院共采集腹泻患者440份肛拭样本,检出DEC阳性菌株132株,检出率为30.00%,其中肠道致病性大肠埃希菌(intestinal pathogenic escherichia coli,EPEC)检出率6.59%,肠道集聚性大肠埃希菌(enteric escherichia coli,EAEC)检出率18.87%,产肠毒素大肠埃希菌(enterotoxigenic escherichia coli,ETEC)检出率3.18%,肠道侵袭性大肠埃希菌(enteric invasive escherichia coli,EIEC)检出率1.36%。药物敏感性实验结果表明,DEC对氨苄西林和萘啶酸的耐药程度最高(53.85%),其次为四环素(41.54%)和阿奇霉素(35.38%);多重耐药率较高,为50.77%。PFGE结果表明,65株DEC可分为63种PFGE带型,带型较为分散,呈多态性分布。结论江阴地区DEC的流行情况相对严峻,基因型高度多态,尚不存在优势流行株。建议治疗上多用头孢菌素类抗菌药物。Objective To investigate the prevalence of diarrhoeagenic Escherichia coli(DEC)infections,virulence gene,molecular typing and drug resistance among diarrheal patients in Jiangyin City.Methods Anal swab samples were collected from diarrheal patients according to the 2018 Handbook for Surveillance on Food-borne Diseases in Wuxi City.DEC was isolated and confirmed with real-time fluorescence PCR assay.In addition,pulsed field gel electrophoresis(PFGE)and antimicrobial susceptibility tests were performed.Results A total of 440 anal swab samples were collected from diarrheal patients in two sentinel hospitals from 2018 to 2020,and a total of 132 DEC-positive isolates were detected,with a detection rate of 30.00%.The prevalence rates of enteropathogenic E.coli(EPEC),enteroaggregative E.coli(EAEC),enterotoxigenic E.coli(ETEC),and enteroinvasive E.coli(EIEC)were 6.59%,18.87%,3.18%and 1.36%,respectively.Antimicrobial susceptibility tests showed that DEC had the highest level of resistance to ampicillin and nalidixic acid(53.85%),followed by tetracycline(41.54%)and azithromycin(35.38%),and a high prevalence rate of multidrug resistance was detected(50.77%).PFGE revealed that 65 DEC isolates produced 63 PFGE band patterns,appearing scattered band patterns and polymorphic distributions.Conclusions The prevalence of DEC is high in Jiangyin City,and highly polymorphic genotypes are identified;however,there are no dominant epidemic isolates.Cephalosporin antibiotics are recommended for clinical treatment of DEC infections.

关 键 词：致泻性大肠埃希菌 感染状况 耐药情况 脉冲场凝胶电泳 

分 类 号：R378.2[医药卫生—病原生物学]