首页|北京某医院感染性腹泻患者致泻性大肠埃希菌毒力和耐药特征分析

北京某医院感染性腹泻患者致泻性大肠埃希菌毒力和耐药特征分析

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目的 明确本院感染性腹泻患者致泻性大肠埃希菌毒力和耐药特征.方法 采用VITEK MS 微生物质谱检测系统初步鉴定,多重实时荧光PCR检测毒力基因,对本院感染性腹泻患者临床分离的致泻性大肠埃希菌(Diarrheagenic Escherichia coli,DEC)进行5 种型别鉴定.微量肉汤稀释法和E-test法药敏试验检测DEC菌株的耐药表型特征.二代测序及生物信息学分析其耐药分子特征.采用Fisher确切概率法进行统计学分析.结果 本院DEC检出率为 11.9%,其中EAEC占比 37.5%,非典型EPEC占比 34.38%,ETEC占比 25.0%,EIEC占比 3.12%,未检出EHEC菌株.32 株DEC对氨苄西林、四环素、甲氨苄啶/磺胺异恶唑耐药率最高,分别为 53.12%、43.75%和 37.5%.ESBLs(+)株占比 18.75%,其多重耐药菌株检出率为 83.83%,显著高于ESBLs(-)菌株,差异有统计学意义(P=0.042).32 株DEC共有 25 个ST型,优势基因型为ST10 共 4 株(12.5%),ST28、ST31 和ST3153 各2 株(各占比6.25%),其他21 个型别各1 株菌(各占比3.13%).EAEC中检出1 株携带blaNDM-1的耐碳青霉烯类菌株.结论 我院感染性腹泻患者的DEC以aggR、pic、astA、eae 4 种毒力基因较为常见,以EAEC、EPEC为主要型别,基因型别呈高度多态性,检出多重耐药菌株.
Analysis of virulence and drug resistance characteristics of diarrheagenic Escherichia coli isolated from patients with infectious diarrhea in a hospital in Beijing
Objective To investigate the virulence and drug resistance characteristics of diarrheagenic Escherichia coli isolated from patients with infectious diarrhea in our hospital.Methods The preliminary identification of microbes was carried out by the VITEK-MS microbial mass spectrometry detection system and virulence genes were detected by the multiplex real-time PCR.Five types of diarrhea-genic Escherichia coli(DEC)clinically isolated from patients with infectious diarrhea in our hospital were identified.The drug resist-ance characteristics of DEC strains were detected by the microbroth dilution and E-test.The drug-resistant molecular characteristics were analyzed by the next-generation sequencing and bioinformatics.The Fisher exact probability method was used for statistical analy-sis.Results The detection rate of DEC in our hospital was 11.9%,with enteroaggregative E.coli(EAEC)accounting for 37.5%,a-typical enteropathogenic Escherichia coli(EPEC)accounting for 34.38%,enterotoxigenic E.coli(ETEC)accounting for 25.0%,and enteroinvasive E.coli(EIEC)accounting for 3.12%.None of enterohemorrhagic E.coli(EHEC)strain was detected.The resistance rates of 32 DEC strains to ampicillin,tetracycline,and trimethoprim/sulfamethoxazole were 53.12%,43.75%,and 37.5%,respec-tively.ESBLs(+)strains accounted for 18.75%,and the detection rate of multidrug-resistant strains was 83.83%,significantly higher than that of ESBLs(-)strains(P=0.042).A total of 25 ST genotypes were obtained from 32 DEC strains.The dominant genotypes were ST10(4 strains,12.5%),followed by ST28(2 strains,6.25%),ST31(2 strains,6.25%),ST3153(2 strains,6.25%),and the other 21 genotypes(1 strain,3.13%).One carbapenem resistant strain carrying the blaNDM-1 gene was detected in EAEC.Conclu-sion Four virulence genes such as aggR,pic,astA,and eae,are more common in the DEC of patients with infectious diarrhea in our hospital,with EAEC and EPEC as the main subtypes.The genotypes are highly polymorphic,and multidrug-resistant strains have been detected.

diarrheagenic Escherichia colivirulence genedrug resistance gene

马思宇、马立艳、罗虎、周妍妍、王雅轩、苏建荣

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首都医科大学附属北京友谊医院临床检验中心,北京 100050

北京医院国家老年医学中心,北京 100730

国家卫生健康委临床检验中心,北京 100730

中国医学科学院老年医学研究院,北京 100730

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致泻性大肠埃希菌 毒力基因 耐药基因

国家重点研发计划

2021YFC2301004

2024

临床检验杂志
江苏省医学会

临床检验杂志

CSTPCD
影响因子:0.746
ISSN:1001-764X
年,卷(期):2024.42(1)
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