| 摘要: |
| ［摘要］ 目的 分析桂林市某医院腹泻儿童致泻性大肠埃希菌（DEC）病原学与耐药特征。方法 收集2022年1月至2023年12月桂林市妇幼保健院儿童门诊收治的0～14岁腹泻儿童的新鲜粪便标本793例，进行大肠埃希菌分离培养。通过多重聚合酶链反应（PCR）检测菌株毒力基因，以判定不同的DEC致病型。采用微量肉汤稀释法测定菌株对10类19种抗生素的敏感性。结果 793例粪便标本检出DEC 49例（6.18%），其中肠聚集性大肠埃希菌（EAEC）占比最高（24例，48.94%），其次为肠致病性大肠埃希菌（EPEC）（23例，46.94%）。检出1例携带stx2f基因的肠出血性大肠埃希菌或产志贺毒素大肠埃希菌（EHEC/STEC）和1例同时携带stIa、stIb基因的肠产毒性大肠埃希菌（ETEC）。未检出肠侵袭性大肠埃希菌（EIEC）。49例DEC药物敏感试验结果显示，耐药率最高的是氨苄西林（59.18%），其次为头孢唑林（36.73%），所有菌株均对美罗培南、替加环素、阿米卡星及黏菌素敏感，40.82%的菌株对3类以上抗生素耐药。结论 DEC是桂林市儿童腹泻的主要病原菌之一，以EAEC和EPEC为主，菌株耐药率较高，应重视临床抗生素的合理使用。 |
| 关键词: 儿童腹泻 致泻性大肠埃希菌 毒力基因 耐药率 桂林市 |
| DOI：10.3969/j.issn.1674-3806.2025.05.18 |
| 分类号:R 725.1 |
| 基金项目:广西卫生健康委员会科研课题项目（编号：Z-C20231627） |
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| Analysis on etiology and antibiotic resistance of diarrheagenic Escherichia coli in children with diarrhea in a hospital in Guilin City |
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QIN Wenzhen1, LIU Zhibing2, YE Yanzhen1, LIANG Yong2, MA Li1, TANG Guorong2
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1.Department of Laboratory Medicine, Guilin Maternal and Child Health Hospital, Guilin 541000, China; 2.Guilin Center for Disease Control and Prevention, Guilin 541000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the etiology and antibiotic resistance profile of diarrheagenic Escherichia coli(DEC) in children with diarrhea in a hospital in Guilin City. Methods A total of 793 fresh fecal specimens from diarrhea children aged 0-14 years who were treated in the Children′s Outpatient Department of Guilin Maternal and Child Health Hospital from January 2022 to December 2023 were collected for isolation and culture of Escherichia coli. The virulence genes of the bacterial strains were detected by using polymerase chain reaction(PCR) to determine different pathogenic types of DEC. The sensitivity of the bacterial strains to 19 kinds of antibiotics in 10 categories was determined by using the broth microdilution method. Results DEC was detected in 49 fecal specimens of the 793 fecal specimens(6.18%). Among the different pathogenic types of DEC, enteroaggregative Escherichia coli(EAEC) had the highest proportion(24 cases, 48.98%), followed by enteropathogenic Escherichia coli(EPEC)(23 cases, 46.94%). One case of enterohemorrhagic Escherichia coli or Shiga toxin-producing Escherichia coli(EHEC/STEC) carrying stx2f gene and one case of enterotoxigenic Escherichia coli(ETEC) carrying both stIa and stIb genes were detected. No enteroinvasive Escherichia coli(EIEC) was detected. The results of drug sensitivity test of 49 cases of DEC showed that the drug with the highest resistance rate was ampicillin(59.18%), followed by cefazolin(36.73%). All the strains were sensitive to meropenem, tigecycline, amikacin and colistin and 40.82% of the strains were resistant to more than three categories of the antibiotics. Conclusion DEC is one of the main pathogenic bacteria causing diarrhea in children in Guilin City, and among the different pathogenic types of DEC, EAEC and EPEC are predominant. The drug resistance rates of the strains are relatively high, and the rational use of antibiotics should be emphasized in clinical practice. |
| Key words: Pediatric diarrhea Diarrheagenic Escherichia coli(DEC) Virulence gene Antibiotic resistance rate Guilin City |
