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目的了解淮安市腹泻患者中致泻大肠埃希菌感染情况、毒力基因、耐药性以及分子分型,为致泻大肠埃希氏菌防治提供依据。方法对2014—2015年淮安市各哨点医院和社区医院腹泻门诊患者的粪便标本运用多重PCR筛查和生化试验检测致泻大肠埃希菌,检测出菌株的进一步做药敏试验和分子分型。结果在549份腹泻标本中共检出致泻大肠埃希菌39株,检出率为7.10%。其中肠聚集性大肠埃希菌(EAEC)18株(46.15%)检出最高,其余依次为肠产毒性大肠埃希菌(ETEC)8株(20.51%)、肠致病性大肠埃希菌(EPEC)7株(17.95%)、肠出血性大肠埃希菌(EHEC)5株(12.82%)和侵袭性大肠埃希菌(EIEC)1株(2.56%)。药敏结果显示,39株致泻大肠埃希菌中1种以上耐药菌27株,占41.25%;最高耐药达到9耐,其中四环素和萘啶酸耐药率,分别为53.84%、51.28%。脉冲场凝胶电泳(PFGE)结果显示,39株致病性大肠埃希菌有不同的带型,且带型有密切的亲缘关系。EAEC单独聚类,除zx14352和zx14395外,其他带型的相似度都超过50%。结论淮安市2014—2015年致泻大肠埃希菌感染主要以EAEC为主。菌株耐药性强,多重耐药谱广。菌株的基因型呈多态性分布,有流行相关性。
Objective To understand the infection, virulence genes, drug resistance and molecular typing of diarrhea-causing Escherichia coli in diarrhea patients in Huaian city and provide evidence for prevention and treatment of diarrhea-causing Escherichia coli. Methods Multiplex PCR screening and biochemical tests were performed on stool specimens of diarrhea outpatients in sentineted hospitals and community hospitals in Huaian from 2014 to 2015 to detect the diarrhea-causing Escherichia coli. The drug susceptibility tests and molecular typing of the strains were further tested . Results Among 549 diarrhea samples, 39 strains of diarrhea-causing Escherichia coli were detected, the detection rate was 7.10%. Among them, 18 strains (46.15%) of enterohepatic Escherichia coli (EAEC) were detected the highest, followed by 8 strains (20.51%) of enterotoxigenic Escherichia coli (ETEC), enteropathogenic Escherichia coli EPEC 7 (17.95%), E. coli (EHEC) 5 (12.82%) and invasive Escherichia coli (EIEC) 1 (2.56%). The results of drug sensitivity showed that there were 27 strains of more than one drug-resistant bacteria in 39 strains of diarrhea-causing Escherichia coli, accounting for 41.25% of the total, and the highest resistance rate was 9%. The resistance rates of tetracycline and nalidixic acid were 53.84% and 51.28% %. Pulsed-field gel electrophoresis (PFGE) results showed that 39 strains of pathogenic Escherichia coli have different bands, and the band has a close genetic relationship. EAEC clustering alone, with the exception of zx14352 and zx14395, the other bands are more than 50% similarity. Conclusions Escherichia coli in diarrhea caused by diarrhea in Huaian City in 2014-2015 is predominately EAEC. Strain resistant, multi-drug resistance spectrum wide. The genotypes of the isolates were polymorphic and epidemic.