摘要
目的了解安徽省致泻性大肠埃希菌(DEC)的菌群流行特点及耐药趋势,为安徽省DEC腹泻病的诊断和治疗提供科学依据。方法采集安徽省2015―2019年腹泻患者粪便样本,采用多重实时荧光定量PCR对细菌进行鉴定与分型,采用微量肉汤稀释法对细菌进行药敏试验。结果从6120份粪便中分离出DEC 557株,主要病原型为:非典型肠聚集性大肠埃希菌(aEAEC)191(34.29%)株,产肠毒素性大肠埃希菌(ETEC)153(27.47%)株,非典型肠致病性大肠埃希菌(aEPEC)108(19.39%)株,典型肠聚集性大肠埃希菌(tEAEC)77(13.82%)株,肠侵袭性大肠埃希菌(EIEC)11(1.97%)株,典型肠致病性大肠埃希菌(tEPEC)3(0.54%)株。药敏检测多重耐药255(45.78%)株;同种病理类型不同年份耐药性存在差异:aEAEC:氨苄西林/舒巴坦(AMS),萘啶酸(NAL),头孢西林(CFZ);tEAEC:AMS,CFZ,阿奇霉素(AZM);EPEC(aEPEC,tEPEC):氨苄西林(AMP),AMS,CFZ;ETEC:NAL,AZM,环丙沙星(CIP)。不同病理类型耐药性存在差异的抗生素有:AMP,AMS,四环素(TET),NAL,红霉素(ERY),氯霉素(CHL),头孢噻肟(CTX),CFZ,庆大霉素(GEN),甲氧苄啶/磺胺甲恶唑(SXT),AZM和CIP。2015―2019年,tEAEC对CFZ,EPEC对AMP,AMS和CFZ,ETEC对NAL和CIP,耐药性呈增强趋势。结论本地区DEC流行的主要型别是:aEAEC、ETEC、aEPEC和tEAEC。DEC的耐药情况较严重,常用抗生素AMP、AMS、NAL、CFZ和CIP在不同年份和不同病理类型间,耐药性差异明显,耐药性分析结果为临床合理使用抗生素,遏制抗菌药物耐药性增加提供参考。
Objective To understand the epidemic characteristics and drug resistance trend of diarrheogenic Escherichia coli(DEC)in Anhui area,so as to provide an important basis for prevention and treatment of DEC diarrhea in Anhui Province.Methods Fecal samples of diarrhea patients were collected and inoculated with McConkey culture medium in Anhui from 2015 to 2019.Suspicious colonies were identified and typed by multiple fluorescence quantitative PCR,and drug sensitivity test was carried out by microbroth dilution method.Results 557 strains were isolated from 6120 stool samples.The main pathotypes were 191(34.29%)a typical enteroaggregative Escherichia coli(aEAEC),153(27.47%)enterotoxigenic Escherichia coli(ETEC),108(19.39%)a typical enteropathogenic Escherichia coli(aEPEC),77(13.82%)typical enteroaggregative Escherichia coli(tEAEC),11(1.97%)enteroinvasive Escherichia coli(EIEC)and 3(0.54%)typical enteropathogenic Escherichia coli(tEPEC).Multidrug resistant bacteria accounted for 45.78%.The statistically significant resistance difference of the same pathotype in different years were as follows:a typical EAEC:ampicillin/sulbactam(AMS),nalidixic acid(NAL),cefoxicillin(CFZ);typical EAEC:AMS,CFZ,azithromycin(AZM);EPEC:ampicillin(AMP),AMS,CFZ;ETEC:NAL,AZM,ciprofloxacin(CIP).The antibiotics with statistically significant differences in drug resistance among different pathotypes were AMP,AMS,tetracycline(TET),NAL,erythromycin(ERY),chloramphenicol(CHL),cefotaxime(CTX),CFZ,gentamicin(GEN),trimethoprim/sulfamethoxazole(SXT),AZM and CIP.The resistance of tEAEC to CFZ,EPEC to AMP,AMS and CFZ,ETEC to NAL and CIP showed an increasing trend from 2015 to 2019.Conclusions The mainly epidemic pathotypes in Anhui area were aEAEC,ETEC,aEPEC and tEAEC.The resistances of antibiotics(AMP,AMS,NAL,CFZ and CIP)were significantly different among different years and pathotypes.The results of resistance analysis can provide reference for rational use of antibiotics and prevention of the increase of antimicrobial resistance.
作者
李春
陈国平
孟昭倩
王利
陈晴晴
孙永
张竹慧
LI Chun;CHEN Guo-ping;MENG Zhao-qian;WANG Li;CHEN Qing-qing;SUN Yong;ZHANG Zhu-hui(Microbiological laboratory of Anhui Provincial Center for Disease Control and Prevention,Hefei 230601,China;Department of Food Nutrition and School Health,Anhui Provincial Center for Disease Control and Prevention,Hefei 230601,China;Department of Laboratory of Fuyang Provincial Center for Disease Control and Prevention,Fuyang 236000,China;Department of Laboratory of Maanshan Provincial Center for Disease Control and Prevention,Maanshan 243000,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2020年第10期1154-1159,共6页
Chinese Journal of Disease Control & Prevention
基金
国家科技重大专项(2018ZX10713003-002-005)。
关键词
致泻性大肠埃希菌
分型
耐药性
Diarrheogenic Escherichia coli
Pathotypes
Resistance
