Epidemiological characterization and antimicrobial resistance of diarrhea Escherichia coli from acute diarrheal and healthy children in Guangzhou City, 2014-2015
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摘要: 目的 了解广州地区致泻性大肠埃希菌感染情况、流行病学特征及耐药情况。方法 2014年7月~2015年7月分别收集广州地区某综合医院腹泻患儿及健康儿童粪便标本143份、83份,进行细菌分离培养,采用聚合酶链反应检测肠致病性大肠埃希菌、聚集性大肠埃希菌、产毒性大肠埃希菌和肠侵袭性大肠埃希菌,Kirby Bauer法(K-B纸片扩散法)进行药敏试验。结果 四种致泻性大肠埃希菌在腹泻患儿与健康儿童中的检出率分别为1.4%、3.6%;2.8%、2.4%;1.4%、1.2%;0.7%、1.2%;腹泻患儿3~7岁年龄段检出率最高,占26.7%;然而,健康儿童中5~7岁年龄段检出率最高,占8.4%。药敏试验结果显示,大肠埃希菌对四环素、氨苄西林耐药率为52.6%~63.2%;头孢类耐药率为5.3%~21.1%;多重耐药率50.5%。结论 致泻性大肠埃希菌在腹泻患儿及健康儿童均有检出,并存在多重感染,提示致泻性大肠埃希菌是机会感染菌;除此之外,耐药及多重耐药高,应加强致泻性大肠埃希菌监测及管理抗生素使用。Abstract: Objective To investigate the epidemiological characteristics and antimicrobial resistance of diarrhea escherichia coli.Methods From June 2014 to June 2015, 143 and 83 stool samples were collected from children infected with acute diarrhea and healthy children respectively. Diarrhea escherichia coli was identified by biochemistry identification and PCR.Kirby Bauer methods(K-B disk diffusion methods) was adopted to evaluate antimicrobial resistance.Results The detection rates of enteropathogenic escherichia coli, enteroaggregative escherichia coli, enterotoxigenic escherichia coli and enteroinvasive escherichia coli in acute diarrhea children and health children specimens were 1.4% and 3.6%,2.8% and 2.4%,1.4% and 1.2%,0.7% and 1.2%,respectively. The age of 3-7 children with acute diarrhea had the highest detection rate of 26.7%, however,the age of 5-7 healthy children had the highest rate of 8.4%. The antimicrobial susceptibility tests showed that the resistance rates for tetracycline, ampicillin and cephalosporin were 52.6%-63.2%,and 5.3%-21.1%. In addition, the multi-drug resistance rate was 50.5%.Conclusions Diarrhea escherichia coli was detected in both acute diarrhea children and health children, and there were multiple infections,which hint diarrhea escherichia coli is an opportunistic infections bacteria. The result of antimicrobial resistance as well as multiple antimicrobial resistance are not optimistic. It is necessary to strengthen the surveillance of diarrheagenic escherichia coli and antimicrobial resistance, and providing a guide for clinical using antibiotic is also imperative.
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Key words:
- Diarrhea /
- Enteropathogenic escherichia coli /
- Epidemiologic methods
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Talachian E, Bidari A, Noorbakhsh S, et al. Serum levels of vitamins A and D, and zinc in children with acute diarrhea: A cross-sectional study [J]. Med J Islam Repub Iran, 2015,29(207):1-7. 龚磊,吴家兵,王爱红,等. 2007-2012年安徽省其他感染性腹泻流行特征分析 [J]. 中华疾病控制杂志, 2014,18(10):972-975. 陈惠芳,胡婷婷,姚月娴,等. 广州地区5岁以内儿童病毒性腹泻病原及流行病学特点 [J]. 中华疾病控制杂志, 2014,18(4):336-339. 曲梅,张新,钱海坤,等. 北京地区腹泻病患者致泻性大肠埃希菌感染类型及其流行特征 [J]. 中华流行病学杂志, 2014,35(10):1123-1126. 郭邦成,闫立群,郝琼,等. 宁夏致泻性犬肠杆菌的流行特征及耐药现状研究 [J]. 宁夏医学杂志, 2013,35(4):307-309. 秦小玄,朱朝敏. 致泻性大肠埃希氏菌的流行及耐药现状 [J]. 儿科药学杂志, 2008,13(2):61-64. 万根平,黄勇,邓秋连,等. 儿童肠道感染致病性大肠埃希菌血清型分布及耐药性研究 [J]. 实用医学杂志, 2010,(2):310-311. Parashar UD, Gibson CJ, Bresee JS, et al. Rotavirus and severe childhood diarrhea [J]. Emerg Infect Dis, 2006,12(2):304-306. 中华人民共和国国家卫生和计划生育委员会. GB 4789.31-2013食品安全国家标准食品微生物学检验沙门氏菌、志贺氏菌和致泻大肠埃希氏菌的肠杆菌科噬菌体诊断检验 [S]. 北京:中国标准出版社, 2014. 中华人民共和国国家卫生和中国国家标准化管理委员会. GB/T4789.6-2003食品卫生微生物学检验、致泻性大肠埃希菌检验 [S]. 北京:中国标准出版社, 2003. 王毓三,申子瑜,叶应抚. 全国临床检验操作规程 [M]. 第3版. 南京:东南大学出版社, 2006:1-1017. Toma C, Lu Y, Higa N, et al. Multiplex PCR assay for identification of human diarrheagenic Escherichia coli [J]. J Clin Microbiol, 2003,41(6):2669-2671. 贾宇静. 广州市某医院腹泻病人香港海鸥型菌和ETEC的检测及耐药性分析 [D]. 广州: 南方医科大学, 2010. Nada RA, Shaheen HI, Touni I, et al. Design and validation of a multiplex polymerase chain reaction for the identification of enterotoxigenic Escherichia coli and associated colonization factor antigens [J]. Diagn Microbiol Infect Dis, 2010,67(2):134-142. JB Patel. M100-S24 Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement[S]. USA:Clinical and Laboratory Standards Institute, 2014. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance [J]. Clin Microbiol Infect, 2012,18(3):268-281. 周芳美. 2011-2013年杭州地区致泻性大肠埃希菌的流行特征与耐药性分析 [D]. 浙江: 浙江大学, 2013. Onanuga A, Igbeneghu O, Lamikanra A. A study of the prevalence of diarrhoeagenic Escherichia coli in children from Gwagwalada, Federal Capital Territory, Nigeria [J]. Pan Afr Med J, 2014,17(146):1-8. Ben Salem-Ben Nejma I, Hassine Zaafrane M, Hassine F, et al. Etiology of acute diarrhea in tunisian children with emphasis on diarrheagenic Escherichia coli: prevalence and identification of E. coli virulence markers [J]. Iran J Public Health, 2014,43(7):947-960. 桓新,张效本,马颖,等. 开封市健康人群大肠埃希菌多重耐药性变迁及产超广谱β-内酰胺酶分析 [J]. 临床荟萃, 2013,28(7):806-808.
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