2016年江苏省食源性疾病患儿中致泻大肠埃希氏菌毒力基因分布与耐药性特征

目的 了解江苏省食源性疾病患儿中致泻大肠埃希氏菌的流行状况、不同毒力基因型的分布和对抗生素的敏感性特征。方法 从江苏省各设区市的三甲医院共收集3566例食源性疾病患儿的粪便或肛拭子标本进行致泻大肠埃希氏菌检测, 用实时荧光定量PCR进行毒力分型, 用微量肉汤稀释法进行药敏实验。结果 江苏省食源性疾病患儿中, 共检出致泻大肠埃希氏菌104株, 总检出率为2.9%(104/3566)。在5种毒力基因型致泻大肠埃希氏菌中, 肠聚集性大肠埃希氏菌、肠致病性大肠埃希氏菌是主要的毒力基因型, 分别占61.5%(64/104)、26.9%(28/104)。致泻大肠埃希氏菌对氨苄西林耐药率最高, 达71.2%, 其次为四环素和萘啶酸, 分别为59.6%和54.8%。未发现亚胺培南耐药菌株。多重耐药率为75.0%。结论 肠聚集性大肠埃希氏菌是导致江苏省儿童食源性疾病最主要的致泻大肠埃希氏菌。约95%以上的致泻大肠埃希氏菌对头孢他啶、头孢西丁敏感, 100%对亚胺培南敏感。耐药率及多重耐药率高, 应加强致泻大肠埃希氏菌耐药性监测及临床抗生素合理使用。

Virulence genotype distribution and drug resistance characterization of diarrheagenic Escherichia coli from children with foodborne diseases in Jiangsu province in 2016

Objective To investigate the prevalence, the distribution of different virulence genotypes, and the antibiotic susceptibility of diarrheagenic Escherichia coli isolated from children with foodborne diseases in Jiangsu province. Methods A total of 3566 fecal or anal swab samples of children with foodborne diseases were collected from grade a hospitals in districts and cities of Jiangsu province for the detection of diarrheal Escherichia coli, toxicity typing was conducted by real-time fluorescence quantitative PCR, and the antibiotic susceptibility was conducted by microdilution broth method. Results Among the children with foodborne diseases in Jiangsu province, 104 strains of diarrheal Escherichia coli were detected, with a total detection rate of 2.9% (104/3566). Among five virulence genotypes of diarrheagenic Escherichia coli, enteroaggregative Escherichia coli was the predominant strains, which took account for 61.5% (64/105), followed by enteropathogenic Escherichia coli, which reached to 26.9% (28/105). And 71.2% of diarrheagenic Escherichia coli were resistance to ampicillin, followed by tetracycline and nalidixic acid, which took account for 59.6% and 54.8%, respectively. No imipenem resistance strains were found. The multi-drug resistance rate was 75.0%. Conclusion Intestinal aggregated Escherichia coli is the main diarrhea-causing Escherichia coli that causes foodborne illness in children in Jiangsu province. About 95% of the diarrhea-causing Escherichia coli are sensitive to ceftazidime and cefoxitin, and 100% are sensitive to imipenem. The drug resistance rate and multi-drug resistance rate are high. The surveillance of resistance to Escherichia coli and the rational use of clinical antibiotics should be strengthened.