2017年江苏省食源性疾病中致泻大肠埃希氏菌的感染状况及耐药性分析
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江苏省科技强卫重点学科项目(ZDXKA2016008)


Infection status and drug resistance of diarrheogenic Escherichia coli in foodborne diseases in Jiangsu Province,2017
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    摘要:

    目的:了解江苏省食源性疾病病例中致泻大肠埃希氏菌的感染、耐药及病原学特征,为疾病防控及临床治疗提供依据。方法:收集2017年江苏省48家食源性疾病哨点医院腹泻患者粪便或肛拭子标本,采用传统分离培养结合荧光定量PCR方法,检测5种致泻大肠埃希氏菌并进行分型鉴定,对其感染状况进行流行病学分析;采用微量肉汤稀释法测定266株致泻大肠埃希氏菌对8类14种抗菌药物的耐药性。结果:在9 884份粪便或肛拭子样本中,检出289份致泻大肠埃希氏菌(2.92%),5种病原型别中检出率最高为肠黏附性大肠埃希氏菌(EAEC,1.53%),其次为肠产肠毒素大肠埃希氏菌(ETEC,0.81%)和肠致病性大肠埃希氏菌(EPEC,0.54%),有2株菌为双重菌合并感染;致泻大肠埃希氏菌夏秋季节检出较高,其中8月份检出率最高;男性、女性检出率分别为2.78%和3.08%,差异无统计学意义(χ2=0.801,P>0.05);在年龄分布上,<1岁组检出最高(4.55%),1~5岁组其次(4.06%),不同年龄组检出率有统计学意义(χ2=45.780,P<0.01);致泻大肠埃希氏菌呈现较高的耐药率(91.35%),耐药率最高的抗菌药物是氨苄西林(64.3%),其次是萘啶酸(60.9%)和四环素(51.9%);多重耐药率达到60.9%,其中1株菌耐受14种抗菌药物。结论:江苏省食源性致泻性大肠埃希菌中EAEC感染率最高,多重耐药情况较为严重,<5岁的婴幼儿需要重点关注。

    Abstract:

    Objective:To analyze pathogenic characteristics of diarrheogenic Escherichia coli(DEC)in the patients with food borne diseases in Jiangsu Province;to understand drug resistance status and provide effective basis for better prevention,control and clinical treatment in the future. Methods:The fecal specimens of diarrhea patients in 48 food borne disease sentinel hospitals in Jiangsu Province were collected in 2017,5 kinds of DEC were detected by traditional separation culture method combined with fluorescence quantitative PCR. The infection characteristics were analyzed by epidemiological description. At the same time,266 DEC strains were subjected to drug resistance test against 14 antibiotics of 8 categories by micro broth dilution method. Results:Among 9 884 samples of fecal or anal swabs,a total of 289 DEC were detected(accounted for 2.92%),the highest detection rate in 5 types was EAEC(accounted for 1.53%),followed by ETEC(accounted for 0.81%)and EPEC(accounted for 0.54%),2 samples were double bacteria combined infection. The positive DEC detection rate was relatively higher in summer,the highest rate was observed in August. The proportions of male and female infection(2.78% and 3.08%,respectively)were approximately equal and no statistical difference was found between different genders(χ2=0.801,P>0.05). For age distribution,the highest rate was detected among the 1 year old group(accounted for 4.55%),followed by 1-5-year-old group(accounted for 4.06%),the detection rate of different age groups was statistically significant(χ2=45.780,P < 0.01). The DEC demonstrated high drug resistance rate(accounted for 91.35%),among which ampicillin had the highest drug resistance rate(64.3%),followed by nalidixic acid(60.9%)and tetracycline(51.9%);multi-drug resistance rate was 60.9%,1 strains was resistant to all 14 kinds of antibiotics. Conclusion:The infection rate of EAEC in DEC is the highest among food borne DEC in Jiangsu province. Infants younger than 5 years old require emphasized focus. The multi-drug resistance of DEC is relatively serious,which needs to more attention.

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唐 震,沈 赟,秦 思,郑东宇,马 恺,乔 昕,周永林.2017年江苏省食源性疾病中致泻大肠埃希氏菌的感染状况及耐药性分析[J].南京医科大学学报(自然科学版),2018,(10):1371-1375

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  • 收稿日期:2018-06-26
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  • 在线发布日期: 2018-11-08
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