2017—2022年上海市虹口区腹泻病例中致泻性大肠埃希菌检测结果分析  

Analysis of detection results of diarrheogenic Escherichia coli in diarrhea cases in Hongkou District of Shanghai from 2017 to 2022

作　　者：倪春苗 金虹飞 沈静[1] 徐映如 刘莹 李思佳 NI Chunmiao;JIN Hongfei;SHEN Jing;XU Yingru;LIU Ying;LI Sijia(Hongkou Center for Disease Prevention and Control,Shanghai 200082,China)

机构地区：[1]上海市虹口区疾病预防控制中心,上海200082

出　　处：《寄生虫病与感染性疾病》2024年第3期159-164,共6页Parasitoses and Infectious Diseases

摘　　要：目的 了解上海市虹口区腹泻患者中致泻性大肠埃希菌(diarrheogenic E. coli,DEC)的感染状况、型别分布和耐药情况,为DEC的防控和临床合理用药提供依据。方法 对2017—2022年上海市虹口区哨点医院肠道门诊腹泻监测病例的粪便标本进行DEC的分离培养、型别检测、毒力基因检测和药物敏感性试验。使用SPSS 20.0软件进行数据分析,利用卡方检验对不同类别之间的率进行比较,以P<0.05为差异有统计学意义。结果 在997份送检样本中检测出136株DEC,阳性率为13.6%(136/977)。其中肠聚集性大肠埃希菌(enteroaggregative E. coli,EAEC)最多(57株),占比41.9%。136株DEC分别检出uidA、astA、aggR等多种毒力基因;同一型别的菌株有不同种毒力基因组合,以aggR—astA毒力基因组合为主的EAEC占比最高。DEC阳性检出率最高的年龄组是31~40岁,占18.7%。6至9月检出率较其他月份明显升高。结论 上海市虹口区DEC检出率较高,以EAEC、肠产毒性大肠埃希菌(enterotoxigenic E. coli,ETEC)、肠致病性大肠埃希菌(enteropathogenic E. coli,EPEC)为主,在不同季节和不同年龄段的人群中检出率有差异。DEC菌株携带的毒力相关基因呈现多样性,且耐药率总体呈上升趋势。Objective To understand the infection status,type distribution and drug resistance of diarrheogenic Escherichia coli(DEC)in patients with diarrhea in Hongkou District of Shanghai,and to provide basis for the prevention and control of DEC and clinical rational drug use.Methods Fecal specimens from diarrhea monitoring cases in the intestinal outpatient department of sentinel hospitals in Hongkou District of Shanghai from 2017 to 2022 were subjected to isolation,cultivation,type testing,virulence gene testing and drug sensitivity testing of DEC.SPSS 20.0 software was used for data analysis,and Chi-square test was used to compare the rates among different categories.P<0.05 was considered to be statistically significant.Results A total of 136 strains of DEC were detected in 997 samples,with a positive rate of 13.6%(136/977).Among them,enteroaggregative E.coli(EAEC)was the most common,with 57 strains(41.9%).A variety of virulence genes such as uidA,astA and aggR were detected in 136 strains of DEC.The same type of strain had different combinations of virulence genes,with the highest proportion of EAEC being dominated by the aggR-astA virulence gene combination.The age group with the highest DEC positive detection rate was 31-40 years old(18.7%).The detection rate increased significantly from June to September compared to other months.Conclusions The detection rate of DEC in Hongkou District of Shanghai was relatively high,and EAEC,enterotoxigenic E.coli(ETEC)and enteropathogenic E.coli(EPEC)were the main strains.The detection rates were different among different seasons and age groups.The virulence related genes carried by DEC strains exhibited diversity,and the overall resistance rate was on the rise.

关 键 词：致泻性大肠埃希菌 毒力基因 流行特征 耐药性 

分 类 号：R446.5[医药卫生—诊断学]