摘要
Abstract
Objective To analyze the subtype distribution characteristics of diarrheagenic Escherichia coli(DEC)in outpatients with acute foodborne diarrhea and analyze its drug resistance.Methods Fecal samples were collected from outpatients with acute foodborne diarrhea admitted to our hospital from January 2020 to December 2024.Pathogenic bacteria were isolated and cultured.For DEC,its subtypes were further identi-fied,and drug-sensitivity tests were performed to analyze its drug resistance.Results A total of 406 fecal specimens were collected from 406 patients with acute foodborne diarrhea,among which 52 cases(12.81%)were positive for DEC,and 53 strains were isolated.There were 51 cases of single-subtype DEC positivity,including 20 cases of enterotoxigenic Escherichia coli(ETEC),19 cases of enteroaggregative Escherichia coli(EAEC),10 cases of nteropathogenic Escherichia coli(EPEC),2 cases of enteroinvasive Escherichia coli(EIEC),and 1 case of EAEC/ETEC mixture.Epidemiological characteristics of 51 cases of single-subtype DEC infection:There was no significant gender difference in distribution;the detection rate was the highest in infants under 5 years old;clerks/cadres accounted for the highest proportion;the onset was more common from April to June and from July to September;abdominal pain,nausea,and vomiting were common clinical symp-toms;bloody stools were prominent in EIEC-infected patients,and red blood cells were common in fecal speci-mens;the suspected source of pathogenic bacteria was food,meat and its products accounted for the highest proportion.The drug-resistance analysis of 53 DEC strains showed that DEC strains were sensitive to merope-nem(MEM),amikacin(AMK),tigecycline(TIG),and polymyxin E(CST),and showed varying degrees of resistance to the other 13 types of antibiotics.Among them,the resistance rate to ampicillin(AMP)was the highest(75.47%),and the resistance rates to tetracycline(TET)and cefotaxime(CTX)were also>50%.There were certain differences in the drug resistance of different subtypes of EDC strains.ETEC had the high-est resistance rate to AMP(80.95%),followed by CTX,TET,and nalidixic acid(NAL),all with resistance rates>50%.EAEC had the highest resistance rate to AMP(80.00%),followed by CTX(50.0%).EPEC had the highest resistance to TET(70.00%),followed by AMP,streptomycin(STR),and trimethoprim-sulfamethoxazole(SXT),all with a resistance rate of 60.00%.EIEC was sensitive to other antibiotics except AMP.Among the 53 DEC strains,25(47.17%)were multi-drug resistant,and 1 strain was resistant to 9 antibiotics.Except for the multi-drug resistance rate of EIEC being 0,the multi-drug resistance rates of ETEC,EAEC,and EPEC were relatively high,being 55.00%,47.37%,and 50.00%respectively.Con-clusion DEC infections in outpatients with foodborne diarrhea are mainly of the ETEC and EAEC subtypes.The phenomenon of DEC resistance and multi-drug resistance is relatively serious,and it is generally resistant to AMP.关键词
急性食源性腹泻/致泻性大肠埃希菌/亚型/耐药性Key words
Acute foodborne diarrhea/Diarrheagenic Escherichia coli/Subtype/Drug resistance
