摘要
【目的】了解江苏省苏州市2019—2023年分离鉴定的461株致泻性大肠埃希菌(DEC)的基因分型及耐药趋势。【方法】以苏州市近5年检出的DEC作为研究对象,通过实时荧光定量聚合酶链反应(PCR)检测毒力基因分型。应用微量肉汤稀释法进行药敏试验,根据其最低抑菌浓度(MIC)值的数据,以美国临床和实验室标准化委员会(CLSI)2017为标准,获得相应敏感(S)、中介(I)和耐药(R)的结果。采用χ^(2)检验或Fisher精确概率法比较不同毒力基因型的DEC耐药差异。【结果】2019—2023年苏州市检出DEC共461株,其中占比最高者为产肠毒素大肠埃希菌(ETEC)为45.77%(211/461),其次分别是肠致病性大肠埃希菌(EPEC),[占32.32%(149/461)]、肠聚集性大肠埃希菌(EAEC)[占20.39%(94/461)],肠出血性大肠埃希菌(EHEC)与肠侵袭性大肠埃希菌(EIEC)个别散发。耐药率最高的抗生素是氨苄西林(61.61%),其次分别为头孢唑啉(49.89%)、萘啶酸(44.47%)。DEC 3种主要毒力基因型(ETEC、EPEC及EAEC)对氨苄西林(AMP)、氨苄西林/舒巴坦(AMS)、阿莫西林/克拉维酸(AMC)、头孢西丁(CFX)、庆大霉素(GEN)、链霉素(STR)、四环素(TET)、萘啶酸(NAL)、氯霉素(CHL)、甲氧苄啶/磺胺甲噁唑(SXT)的耐药率差异有统计学意义。DEC的多重耐药(MDR)率为59.87%(276/461),各基因型的MDR率由高至低分别EIEC(75.00%)、EAEC(71.28%)、EHEC(66.66%)、EPEC(61.74%)及ETEC(52.86%)。【结论】苏州市近几年DEC流行的基因分型以ETEC、EPEC及EAEC为主,菌株耐药及MDR形势依然严峻,应引起公共卫生领域的广泛关注,进而采取针对性防控措施。
[Objective]To investigate the genotyping and drug resistance trends of 461 strains of diarrheagenic Escherichia coli(DEC)isolated and identified in Suzhou,Jiangsu Province from 2019 to 2023.[Methods]DEC detected in Suzhou in the past 5 years was used as the research subject,and the virulence genotyping was tested by real-time fluorescence quantitative polymerase chain reaction(PCR).The microbroth dilution method was used to perform drug susceptibility test,and the corresponding susceptibility(S),intermediate(I)and resistance(R)results were obtained based on the minimum inhibitory concentration(MIC)values,according to the criteria of United States Clinical and Laboratory Standardization Committee(CLSI)2017.Differences of DEC drug resistance among different virulence genotypes were compared by χ^(2) test or Fisher exact probability method.[Results]A total of 461 DEC strains were detected in Suzhou from 2019 to 2023,of which the highest proportion was enterotoxigenic Escherichia coli(ETEC)accounting for 45.77%(211/461),followed by enteropathogenic Escherichia coli(EPEC)accounting for 32.32%(149/461)and enteroaggregative Escherichia coli(EAEC)accounting for 20.39%(94/461),while enterohemor-rhagic Escherichia coli(EHEC)and enteroinvasive Escherichia coli(EIEC)were individually distributed.The antimicrobial drug with the highest resistance rate was ampicillin(61.61%),followed by cefazolin(49.89%)and nalidixic acid(44.47%).There were statistically significant differences in drug resistence rates of the three major virulence genotypes of DEC(ETEC,EPEC and EAEC)to ampicillin(AMP),ampicillin/sulbactam(AMS),amoxicillin/clavulanic acid(AMC),cefoxetine(CFX),gentamicin(GEN),streptomycin(STR),tetracycline(TET),nalidixic acid(NAL),and chloramphenicol(CHL),and methotrexate/sulfamethoxazole(SXT).The multi-drug resistance(MDR)rate of DEC was 59.87%(276/461),and the MDR rate of each genotype,from high to low,was EIEC(75.00%),EAEC(71.28%),EHEC(66.66%),EPEC(61.74%)and ETEC(52.86%).[Conclusion]ETEC,EPEC and EAEC are the main genotypes
作者
栾杭琪
张梦寒
朱莉勤
汤全英
杨旭晗
邹文燕
LUAN Hangqi;ZHANG Menghan;ZHU Liqin;TANG Quanying;YANG Xuhan;ZOU Wenyan(Department of Pathogenic Microbiology and Biological Laboratory,Suzhou Center for Disease Control and Prevention,Suzhou,Jiangsu 215137,China)
出处
《上海预防医学》
CAS
2024年第10期948-953,共6页
Shanghai Journal of Preventive Medicine
基金
江苏省苏州市医学重点学科基金项目(SZXK202117)
苏州市重大疾病项目(GWZX202202,GWZX202302)。
关键词
致泻性大肠埃希菌
毒力基因分型
耐药率
多重耐药
diarrheagenic Escherichia coli
virulence genotyping
drug resistance rate
multi-drug resistance
