北京市大兴区2018—2020年腹泻病人致泻大肠埃希氏菌检测结果分析

目的 了解北京市大兴区食源性疾病病例中致泻大肠埃希氏菌的感染情况、流行病学和病原学特征及耐药状况,为疾病防控及临床治疗提供依 据。 方法 通过收集三年大兴区辖区定点医院肠道门诊腹泻病人的粪便标本,依照GB4789.6-2016《食品安全国家标准 食品微生物学检验 致泻大肠埃希氏菌检验》和WS271-2007《感染性腹泻诊断标准附录B.2 肠致泻性大肠杆菌检验》进行检验,在传统生化分离培养基础上采用实时荧光PCR方法对菌株进行鉴定,并对分离出的菌株做出分析。 结果 三年共检测标本1049件,检出致泻大肠埃希氏菌75株(7.15%),多数基因型别均有检出,肠道集聚性大肠埃希氏菌(EAEC,3.91%)检出率最高,其次为产肠毒素大肠埃希氏菌(ETEC,2.29%),有3株菌为双重菌合并感染,;1~10岁年龄组感染率最高(13.91%),年龄组别有统计学差异,男女感染无显著性差异;药敏试验结果耐药程度差异较大,耐药率最高的抗菌药物为红霉素(100%),其次为氨苄西林(87.1%)。结论 致泻大肠埃希氏菌在腹泻病人中感染率较高,其不同型别致病性、毒力、引起的症状均有不同,临床治疗也有差异,关注致泻大肠埃希氏菌感染情况更多要关注不同基因型别的感染状况,对预防和治疗意义更大。

Analysis of detection results of diarrhea-causing Escherichia coli in patients with diarrhea in Daxing District, Beijing from 2018 to 2020

: Objective To understand the infection status, epidemiological and etiological characteristics and drug resistance of diarrheal Escherichia coli in foodborne disease cases in Daxing District, Beijing, and provide evidence for disease prevention and control and clinical treatment. Methods The fecal specimens of patients with diarrhea in the intestinal outpatient department of designated hospitals in Daxing District were collected for three years, according to GB4789.6-2016 "National Food Safety Standard, Food Microbiological Test, Diarrhea Escherichia coli Test" and WS271-2007 "Infectiousness" Diarrhea diagnostic criteria Appendix B.2 Enterodiarrheal Escherichia coli test" for testing, on the basis of traditional biochemical separation and culture, real-time fluorescent PCR method is used to identify the strains, and the isolated strains are analyzed. Results A total of 1,049 specimens were tested in three years, and 75 strains (7.15%) of diarrhea-causing Escherichia coli were detected. Most genotypes were detected. Intestinal-aggregating Escherichia coli (EAEC, 3.91%) were detected. The highest rate of infection is followed by enterotoxigenic Escherichia coli (ETEC, 2.29%), with 3 strains of dual bacteria co-infected, and the highest infection rate (13.91%) in the age group of 1 to 10 years, with age groups having There was no statistically significant difference between male and female infections; the results of the drug susceptibility test showed a large difference in the degree of resistance. The antibiotic with the highest resistance rate was erythromycin (100%), followed by ampicillin (87.1%). Conclusion The infection rate of diarrhea-causing Escherichia coli is relatively high in patients with diarrhea. The pathogenicity, virulence, and symptoms caused by different types are different. There are also differences in clinical treatment. Pay attention to the infection of diarrhea-causing Escherichia coli More attention should be paid to the infection status of different genotypes, which is of greater significance for prevention and treatment.