2018-2019年江苏省食源性疾病中致泻大肠埃希氏菌流行特征及耐药性分析

目的 了解江苏省食源性疾病患者中致泻大肠埃希氏菌的病原学特征、流行状况和耐药性特征，为其预防控制和指导临床合理用药提供科学依据。 方法 从江苏省各设区市哨点医院共收集24 292例食源性疾病患者的粪便或肛拭子标本进行致泻大肠埃希氏菌检测，采用实时荧光定量PCR进行毒力基因分型，采用微量肉汤稀释法进行药敏实验。 结果 致泻大肠埃希氏菌检出率为2.48%。EAEC(36.48%)、EPEC(31.85%)及ETEC(30.00%)为主要毒力基因型。致泻大肠埃希氏菌在不同年龄（x2=33.428， P <0.001）、不同季节（x2=131.452， P <0.001）间检出率差异有统计学意义，<1岁年龄段及夏季检出率最高。致泻大肠埃希氏菌对氨苄西林耐药率最高（71.85%）；多重耐药率为64.81%。 结论 EAEC在江苏省食源性致泻性大肠埃希菌中最常见。夏季感染ETEC可能性大。多重耐药率高于往年，应加强耐药性监测。

Epidemiological characteristics and drug resistance of diarrheal Escherichia coli in foodborne diseases in Jiangsu, 2018-2019

To know the pathogenic characteristics,the prevalence,and the antibiotic susceptibility of diarrheagenic Escherichia coli isolated from patients with foodborne diseases in Jiangsu Province,providing scientific basics for disease control and clinical rational drug use. Methods The 24292 specimens were collected from the stool or anal swab samples of outpatients in the sentinel hospitals located in various cities of Jiangsu. Virulence genotype was detected by real-time PCR,the antibiotic susceptibility was conducted by microdilution broth method. Results The detection rate of diarrheagenic E. coli was 2. 48%. EAEC( 36. 48%),EPEC( 31. 85%) and ETEC( 30. 00%) were the most common genotypes. The detection rate of different age groups( χ2= 33. 428,P < 0. 001) and different seasons( χ2= 131. 452,P < 0. 001) was statistically significant. The highest proportion was found in children aged < 1 and in summer. 71. 85% of diarrheagenic E. coli were resistant to ampicillin,and the multi-drug resistance rate was 64. 81%. Conclusion EAEC is the major genotype in Jiangsu. The possibility of ETEC infection is high in summer. It’s necessary to strengthen the surveillance for higher multi-drug resistance rate.