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目的了解不同检测方法对儿童腹泻病原菌的检出情况及易感致泻性大肠杆菌的基因型特征。方法收集2013年5~10月在感染消化科就诊的腹泻患儿粪便标本,选择性培养基分离培养大肠杆菌、志贺菌和沙门菌,同时直接进行3种病原菌检测;采用8对特异性引物对大肠杆菌进行基因型分析。结果 122例腹泻标本中细菌培养法检出率为大肠杆菌80.3%,志贺菌25.4%,沙门菌24.6%;标本DNA直接PCR法为大肠杆菌84.4%,志贺菌41.0%,沙门菌49.1%。大肠杆菌基因型检测为EHEC(47.5%)、EPEC(17.2%)、EAEC(4.9%)、ETEC(3.3%)、EIEC(0.8%)。结论与培养法相比,标本DNA直接PCR法可以提高检出率,建议细菌培养法和PCR法联合应用以互补优势。2013年夏季北京地区儿童腹泻的主要病原菌为大肠杆菌,基因型以EHEC和EPEC为主。
Objective To investigate the detection of pathogenic bacteria in children with diarrhea by different detection methods and the genotypic characteristics of susceptible diarrhea-causing Escherichia coli. Methods Stool specimens of children with diarrhea who were admitted to Department of Gastroenterology from May to October 2013 were collected. Escherichia coli, Shigella and Salmonella were isolated and cultured in selective medium. Three kinds of pathogenic bacteria were detected directly. Eight pairs of specific primers Genotype analysis of E. coli. Results 122 cases of diarrhea specimens by bacterial culture method detection rate of E. coli 80.3%, Shigella 25.4%, Salmonella 24.6%; specimens direct DNA PCR method for E. coli 84.4%, Shigella 41.0%, Salmonella 49.1% . EHEC (47.5%), EPEC (17.2%), EAEC (4.9%), ETEC (3.3%) and EIEC (0.8%) were detected in E. coli. Conclusion Compared with the culture method, the direct DNA PCR method can improve the detection rate. It is suggested that bacterial culture method and PCR method should be used in combination to complement each other. The main pathogen of childhood diarrhea in Beijing in summer 2013 was Escherichia coli, and the genotypes were EHEC and EPEC.