泰州市腹泻病人中致泻大肠埃希氏菌感染状况及 病原学特征分析

摘要:目的　了解泰州市腹泻病人中致泻大肠埃希氏菌感染状况、毒力基因、分子分型以及耐药性情况，为致泻大肠埃希氏菌防治提供依据。方法　对2013年泰州市215份腹泻病人粪便标本进行多重PCR鉴定和分离培养，并对分离的致泻大肠埃希氏菌菌株进行生化鉴定、脉冲场凝胶电泳（Pulsed Field Gel Electrophoresis，PFGE）分子分型以及药敏试验。结果　215份腹泻病人粪便标本共检测出致泻大肠埃希氏菌30株，其中EPEC 20株（占9.30%），EAEC 5株（占2.33%），ETEC 5株（占2.33%）；PFGE结果表明，30株致泻大肠埃希氏菌PFGE带型种类多，各亲缘关系较近，但无100%的同源菌，同时PFGE分析结果表明在同一个粪便中有2种不同致泻大肠埃希氏菌感染情况存在；药敏试验表明，30株致泻大肠埃希氏菌对阿莫西林、四环素耐药性最高，3耐以及以上占63.33%。结论　泰州市腹泻病人中致泻大肠埃希氏菌感染普遍存在，并以EPEC、EAEC、ETEC感染为主，菌株的耐药性较强，耐药谱广；基因型呈多态分布，且具有流行相关性。

Infection status and etiology analysis of diarrheagenic Escherichia coli from Taizhou in 2013

Abstract: Objective This work was to investigate infection status, virulence genes, molecular types and antibiotic resistance of diarrheagenic Escherichia coli in Taizhou, so as to provide scientific basis for disease control and treatment. Methods Feces samples from 215 patients in 2013 were collected and tested by a multiplex PCR assay. The positive diarrheagenic E. coli isolates were identified by biochemical method, and tested by molecular typing method for genotype and also tested for antibiotic resistance. Results Totally there were 30 diarrheagenic E. coli including 20 strains of EPEC (9.30%), 5 strains of EAEC (2.33%), 5 strains of ETEC (2.33%). PFGE showed that the 30 diarrheagenic Escherichia coli had various genotypes, and these genotypes had close kinship but without 100% homologous strains among the 30 strains. Two different diarrheagenic E. coli strains were identified in the same specimen by PFGE analysis. The drug sensitivity test results indicated that 30 diarrheagenic E.coli had gained the highest resisitance to amoxicillin and tetracycline. The multidrug resistance rate (to three or more antibiotics) was 63.33%. Conclusion The infection of diarrheagenic E. coli was widespread in Taizhou, and the main genotype of the isolates were EPEC, EAEC, ETEC. These isolates had high antibiotic resistance and broad drug resistance spectrum. The genotypes exhibited polymorphism and epidemiology correlation.