摘要
目的分析郴州市食源性疾病中致泻大肠埃希菌(DEC)的流行规律与耐药现状,为精准防控与临床合理用药提供科学依据。方法应用描述流行病学研究方法,对2015—2024年郴州市食源性疾病监测哨点医院上报的腹泻病例信息以及已完成的DEC菌株鉴定、血清分型与药敏试验结果资料进行整理与分析。结果共采集腹泻病例标本3877份,DEC总检出率为3.28%。肠集聚性大肠埃希菌(EAEC)为最主要致病型别,检出率达1.26%;其次为产肠毒素大肠埃希菌(ETEC)与肠致病性大肠埃希菌(EPEC),两者检出率均为0.77%。夏季(6—8月)DEC检出率高于其他季节(χ^(2)=22.374,P<0.001)。对不同性别和年龄组人群的DEC检出率进行分析,其差异均无统计学意义(性别:2χ=0.441,P=0.507;年龄:χ^(2)=4.722,P=0.580)。水果及其制品、乳与乳制品、粮食类及其制品为可疑暴露的主要食品类别。DEC对氨苄西林(AMP)耐药率最高(77.89%),其次是萘啶酸(NAL)和四环素(TET)(均为54.74%),亚胺培南(IPM)未检测到耐药菌株;DEC多重耐药率为70.53%,其中EAEC多重耐药率高于EPEC和ETEC,差异有统计学意义(χ^(2)=12.591,P=0.002)。结论郴州市食源性疾病病例DEC感染类型以EAEC为主,DEC感染呈全年散发态势,存在夏季流行高峰,DEC菌株耐药及多重耐药现象比较严重,需重点加强夏季食源性DEC感染的防控,广泛开展家庭食品加工处理规范操作指导,并依据药敏结果合理选用抗菌药物。
Objective To analyze the epidemic regularity and drug resistance status of diarrheagenic Escherichia coli(DEC)in foodborne diseases in Chenzhou City,so as to provide scientific basis for precise prevention and control and clinical rational drug use.Methods Descriptive epidemiological research methods were applied to collate and analyze information on diarrhea cases reported by sentinel hospitals for foodborne disease surveillance in Chenzhou from 2015 to 2024,along with completed data on DEC strain identification,serotyping,and antimicrobial susceptibility testing results.Results A total of 3877 diarrhea case specimens were collected,with an overall DEC detection rate of 3.28%.Enteroaggregative E.coli(EAEC)was the predominant pathogenic type,with a detection rate of 1.26%;followed by enterotoxigenic E.coli(ETEC)and Enteropathogenic E.coli(EPEC),both with detection rates of 0.77%.The DEC detection rate in summer(June-August)was higher than in other seasons,(χ^(2)=22.374,P<0.001)).Analysis of DEC detection rates among different genders and age groups showed no statistically significant differences(Gender:χ^(2)=0.441,P=0.507;Age:χ^(2)=4.722,P=0.580).Fruits and their products,milk and dairy products,and grains and their products were the main suspected exposure food categories.DEC exhibited the highest resistance rate to Ampicillin(AMP)(77.89%),followed by Nalidixic Acid(NAL)and Tetracycline(TET)(both 54.74%).No resistant strains were detected against Imipenem(IPM).The multidrug resistance rate of DEC was 70.53%,and the multidrug resistance rate of EAEC was higher than that of EPEC and ETEC,with a statistically significant difference(χ^(2)=12.591,P=0.002).Conclusions EAEC is the main type of DEC infection in foodborne disease cases in Chenzhou City.DEC infections occur sporadically throughout the year with a peak in summer.DEC strains show severe resistance and multidrug resistance.It is necessary to strengthen the prevention and control of foodborne DEC infection in summer,widely promote standardized operation guidance for household food processing and handling,and rationally select antimicrobial agents based on drug susceptibility test results.
作者
刘勋
邓飞英
易细平
黄启麟
廖斌
欧社祥
郑文
谭文艳
Liu Xun;Deng Feiying;Yi Xiping(Chenzhou Center for Disease Control and Prevention,Chenzhou,Hunan 423000,China)
出处
《湘南学院学报(医学版)》
2025年第4期7-11,38,共6页
Journal of Xiangnan University(Medical Sciences)
基金
郴州市科技局项目(ZDYF2020200)
湖南省大学生创新训练项目(湘教通〔2025〕141号,3072)。
关键词
食源性疾病
致泻大肠埃希菌
流行病学特征
耐药性
Foodborne disease
Diarrheagenic Escherichia coli
Epidemiological characteristics
Drug resistance
