8 5 Vol. 8 No. 5 2017 5 Journal of Food Safety and Quality May., 2017 叶丽艳, 马艳宁, 沈跃云, 马 * 薇, 张有江, 杨继勇, 罗燕萍 (, 100853) 摘要 : 目的 (enteropathogenic Escherichia. coli, EPEC), 方法 Vitek MS Vitek 2 compact GN,, (K-B ) Vitek 2 compact, CLSI2016-M100 结果 2008~2016 EPEC 82, 2.10%; EPEC (28.05%), EPEC O86:K61(B7)17 (20.73%), O11:K55(B4) O126:K71(B16) O119:K69(B14) O114:K90(B) EPEC -, 70.00% ; EPEC, / 97.56% 结论 EPEC,,,, / EPEC 关键词 : ; ; ; ; Prevalence and drug resistance of enteropathogenic Escherichia coli in People s Liberation Army General Hospital in Beijing YE Li-Yan, MA Yan-Ning, SHEN Yue-Yun, MA Wei, ZHANG You-Jiang, YANG Ji-Yong, LUO Yan-Ping * (People s Liberation Army General Hospital, Beijing 100853, China) ABSTRACT: Objective To investigate the distribution and drug resistance of enteropathogenic Escherichia coli (EPEC) isolated from diarrhea specimens in People s Liberation Army (PLA) General Hospital in Beijing, so as to provide an important basis for clinical treatment. Methods The bacteria was identified by Vitek mass spectrometer or Vitek 2 compact GN, and the serum type was detected by EPEC agglutination serum. The drug sensitivity test was carried out with the method of disc diffusion (K-B) or Vitek 2 compact. Susceptibility test and results were carried out and analyzed according to CLSI 2016-M100 standard. Results A total of 82 clinical isolates of EPEC were isolated in 2008~2016, and the detection rate was 2.10%. EPEC cases were mainly from emergency patients (28.05%). EPEC was detected in all age groups. The serotype of EPEC was mainly O86:K61 (B7) (17strain, 20.73%). These serotypes, 基金项目 : (AWS11C001) Fund: Supported by the Major Issues of The Army 12th Five-Year (AWS11C001) * 通讯作者 :,,, E-mail: ypluo301@aliyun.com *Corresponding author: LUO Yan-Ping, Master, Senior Technologist, PLA General Hospital, Department of Microbiology, No.28, Fuxing Road, Haidian District, Beijing 100853, China. E-mail: ypluo301@aliyun.com
5, : 1735 such as O11:K55 (B4), O126:K71 (B16), O119:K69 (B14) and O114:K90 (B) were not detected. The drug resistance of EPEC to piperacillin, ampicillin/sulbactam, and cefotaxime was serious, and the drug resistant rates were about 70%. The sensitivity of EPEC to carbapenems was 100%, which to piperacillin/tazobactam was almost 97.56%. Conclusion EPEC is an important pathogen causing diarrhea. The serotype of EPEC is dispersed and the drug resistance is serious. The choice of antibiotics should be based on drug sensitivity test. Piperacillin/tazobactam can be a good choice to be used as empirical treatment for EPEC. KEY WORDS: intestinal pathogenicity; Escherichia coli; diarrhea; drug resistance; prevalence 1 引言 (diarrheogenic E. coli, DEC),, [1-3] 6, (enteropathogenic E. coli, EPEC) (enterotoxigenic E. coli, ETEC) (entero invasive E. coli, EIEC) (enteroadhesive E. coli, EAEC) (enterohemorrhagic E. coli, EHEC) (diffusely adherent E. coli, DAEC) [4,5], 20 50,, (EPEC) EPEC 1955 [6] [7,8], EPEC, DEC [9,10] EPEC, 2008~2016 2 材料与方法 2.1 材料与试剂 2.1.1 标本来源及质控菌种 2008 1 2016 12 (EPEC) : ATCC8739 ATCC25922 ATCC27853( ); CICC 10664( ),, 37 18~24 h, 2.1.2 仪器和试剂 (Vitek MS, ); (Vitek 2 compact, ) ( ); ( OXOID ) 2.2 实验方法, Vitek MS Vitek 2 compact GN,, 2014 6 (K-B ), Vitek 2 Compact GN13 2.3 数据处理和统计方法 MiniTab 17.0,, P 0.05, Whonet 5.6, CLSI2016-M100 3 结果与分析 3.1 EPEC 的分离情况 2008 1 ~2016 12 3896, EPEC 82, 2.10% 2012 4.99%(20 ), 2015 3.63%(21 ), 2013 2.23%(15 ), 2008 2016 (P<0.05); EPEC (P>0.05), 1 3.2 科室分布 EPEC, 28.05%,, 14.63% 12.20%,, ;, 5.63%,, 4.22% 2 3.3 性别 年龄分布 EPEC, 57, 26 51~60, 15.85%, 0~94 ; 1 5,, 5.75%, 90 4.41%, 3
1736 8 表 1 2008~2016 年 EPEC 的检出率 Table 1 Detection rates of EPEC in 2008~2016 /% /% /% /% * /% 2008 0 0.00 1 2.13 1 1.72 0 0.00 2 1.14 2009 0 0.00 1 1.30 0 0.00 0 0.00 1 0.33 2010 0 0.00 0 0.00 0 0.00 0 0.00 0 0.00 2011 1 1.64 1 0.95 1 1.05 1 1.32 4 1.19 2012 5 5.88 6 5.31 8 7.02 1 1.12 20 4.99 2013 0 0.00 0 0.00 5 3.79 5 3.52 10 2.23 2014 1 0.65 5 2.81 0 0.00 3 1.91 9 1.37 2015 1 0.75 6 4.51 4 2.56 10 6.45 21 3.63 2016 4 2.02 1 0.46 5 2.38 5 1.95 15 1.70 P 0.00 12 1.41 21 2.03 24 2.08 25 2.31 82 2.10 : * P<0.05, 表 2 不同科室来源的 EPEC 的检出情况 Table 2 Detection of EPEC from different departments 表 3 不同年龄组腹泻病例 EPEC 检出情况 Table 3 Detection of EPEC in diarrhea cases of different age groups * /% /% /% /% 23 819 2.81 28.05 12 689 1.74 14.63 10 237 4.22 12.20 6 507 1.18 7.32 6 224 2.68 7.32 5 484 1.03 6.10 4 182 2.20 4.88 4 71 5.63 4.88 3 137 2.19 3.66 9 546 1.65 10.98 P 0.000 82 3896 2.10 100.00 <1 5 87 5.75 6.09 1~10 3 118 2.54 3.65 11~20 7 231 3.03 8.54 21~30 8 393 2.04 9.76 31~40 11 390 2.82 13.41 41~50 8 488 1.64 9.76 51~60 13 532 2.44 15.85 61~70 7 495 1.41 8.54 71~80 8 496 1.61 9.76 81~90 9 598 1.51 10.98 91~94 3 68 4.41 3.66 82 3896 2.10 100.00 : * P<0.05, 3.4 EPEC 的血清型分布及构成比 EPEC OK1 30, O86:K61(B7) 17, 20.73%, O127:K63(B8)8, 9.76%;, 2 O86:K61(B7) O127:K63(B8) 2 ; OK2 26, O125:K70(B15) 10, 12.20%, O128: K67(B12) O26:K60(B6) 8, 9.76%; OK3 26, O142:K86(B) 14, O44:K74(L) 12, (P<0.05) O11:K55(B4) O126:K71(B16) O119:K69(B14) O114:K90(B)
5, : 1737, 4 表 4 EPEC 血清型分布及构成比 Table 4 The serotype distribution and constituent ratios of EPEC * /% OK1 OK2 OK3 O86:K61(B7) 17 20.73 O127:K63(B8) 8 9.76 O55:K59(B5) 3 3.66 O86:K61(B7)& O127:K63(B8) 2 2.44 O125:K70(B15) 10 12.20 O128:K67(B12) 8 9.76 O26:K60(B6) 8 9.76 O142:K86(B) 14 17.07 O44:K74(L) 12 14.63 P 0.009 82 100.00 : * P<0.05 3.5 EPEC 的药物敏感性情况, EPEC /, 70.00% ; 56.10% 47.56%; /, 50.00%; ESBL 50.00%; EPEC, -, 97.56%, 5 表 5 EPEC 对常用抗菌药物的耐药情况 Table 5 Drug resistance of EPEC to common antibacterial drugs /% /% /% 68.29 9.76 21.95 / 2.44 0.00 97.56 / 73.17 2.44 24.39 48.78 2.44 48.78 73.17 0.00 26.83 20.73 0.00 79.27 25.61 8.54 65.85 0.00 0.00 100.00 0.00 0.00 100.00 28.05 2.44 69.51 45.12 0.00 54.88 4.88 0.00 95.12 56.10 0.00 43.90 47.56 8.54 43.90 48.78 0.00 51.22 ESBL 50.00 50.00 4 结论, [1,11] / /, EPEC, [12] 2008~2016 3896, EPEC 82, 2.10% [10] 4.3%,, PCR [13],,,,, EPEC EPEC, EPEC,, 15 72 h EPEC, EPEC EPEC (5.63%), (4.22%), 2 50,, 1 (5.75%), 90 (4.41%), EPEC, [11] EPEC 0~94, 51~60, 15.85%, 0~10 8, 1 7, 1 3, 8, 2 EPEC,, EPEC, 0~11 EPEC [14], [15,16] EPEC OK1 O86:K61(B7), [17,18] ; O11:K55(B4) O126:K71(B16) O119:K69(B14) O114:K90(B),, 2 O86:K61(B7) O127:K63(B8)2, ; EPEC β-,, 50.00%; EPEC,, /, EPEC, [19]
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