2018-2020年甘肃省食源性疾病中致泻大肠埃希菌的耐药性分析

摘要：目的 本文对甘肃省2018-2020年食源性疾病监测中分离的致泻大肠埃希菌从年度、季度、性别、年龄分布进行分析，并对分离株耐药状况进行研究，为由致泻大肠埃希菌引起的食源性疾病的防控及抗生素的使用提供政策和依据。方法 按照《食源性疾病监测工作手册》从食源性疾病病例监测样本中分离得到大肠埃希菌株，PCR方法进行分型，采用微量肉汤稀释法进行药敏试验。结果 2018-2020年甘肃省由致泻大肠埃希菌引起的食源性疾病呈下降趋势，患病率男性大于女性，19~45岁组大于其他年龄组。致泻大肠埃希菌对氨苄西林的耐药率最高(78.8%)，对复方磺胺甲恶唑、头孢唑林、四环素3种抗生素的耐药率超过40%，对亚胺培南、头孢西丁、头孢他啶3种抗生素的耐药率低于10%。致泻大肠埃希菌的多重耐药率为69.8%。5种型别的致泻大肠埃希菌中EAEC占比为62.2%，各型别对氨苄西林、头孢唑林和头孢噻肟的抗生素敏感性存在显著性差异(P<0.05)。结论 甘肃省食源性疾病中致泻大肠埃希菌耐药形势严峻，各个市州应当完善食源性疾病中致泻大肠埃希菌的监测工作，并对抗生素的使用进行控制。

Drug resistance of diagrrheagenic Escherichia coli in foodborne diseases in Gansu province from 2018 to 2020

Abstract Objective To analyze the annual, quarterly, gender and age distribution of diagrrheagenic Escherichia coli isolated from food-borne disease surveillance in Gansu province from 2018 to 2020, and to study the drug resistance of the diagrrheagenic E. coli, so as to provide policy and basis for the use of antibiotics. Methods The E. coli strains were isolated from foodborne disease surveillance samples in accordance with the manual for the monitoring of foodborne diseases. Genotyping was performed by PCR. Drug susceptibility was tested using the microbroth dilution method. Results From 2018 to 2020 in Gansu Province, the food-borne diseases caused by diagrrheagenic E. coli showed a decreasing trend. The prevalence rate was higher in males than that in females, and higher in patients aged 19 to 45 than those in other age groups. The resistance rate of diagrrheagenic E. coli to ampicillin was the highest (78.8%), the resistance rates to trimethoprim/sulfamethoxazole, cefazolin, and tetracycline were over 40%, and the resistance rates to imipenem, cefoxitin, and ceftazidime were less than 10%. The multiple drug resistance rate was 69.8%. The EAEC accounted for 62.2 % of the five genotypes of diagrrheagenic E. coli. There were significant differences in the antibiotic sensitivity of each genotype to ampicillin, cefazolin, and cefotaxime (P<0.05). Conclusion The situation of drug resistance of diagrrheagenic E. coli in food-borne diseasesin Gansu province is grim. All regions should improve the monitoring of diagrrheagenic E. coli in food-borne diseases and control the use of