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目的了解2010-2015年深圳市龙岗区致泻大肠埃希菌(DEC)的分子流行病学特征。方法收集来自腹泻病人和健康人群的1 714份粪便或肛拭子标本,对其进行DEC的分离培养,生化及PCR鉴定与分型,再利用脉冲场凝胶电泳技术(PFGE)对DEC分离株进行分子分型。结果共检出DEC阳性160人,检出率为9.3%,其中感染性腹泻病人中检出率为9.7%(117/1 204);健康人群中检出率为8.4%(43/510)。人群中DEC的检出类型以产毒性大肠埃希菌(ETEC)为主,占45.0%,其次为致病性大肠埃希菌(EPEC)和黏附性大肠埃希菌(EAEC),分别占32.5%、18.7%;腹泻人群和健康人群中检出类型差异有统计学意义(P<0.05),前者以ETEC为主(59.8%),后者以EPEC为主(60.5%)。135株DEC样本菌株共分为123种PFGE带型,其中70株ETEC共分为60种PFGE带型,37株EPEC分为36个带型,23株EAEC分为22个带型,病人和健康人群之间检出了带型一致的EAEC菌株。结论研究地区DEC的基因型多样,人群感染类型以ETEC为主。ETEC可能存在优势克隆菌株的感染流行,存在暴发感染的可能;腹泻人群和健康人群之间可能存在同源克隆菌株的感染。
Objective To understand the molecular epidemiological characteristics of diarrhea-causing Escherichia coli (DEC) from 2010 to 2015 in Longgang District, Shenzhen. Methods A total of 1 714 samples of feces or anus swab from diarrhea patients and healthy people were collected and subjected to isolation, culture, biochemical and PCR identification and typing of DEC. Pulsed-field gel electrophoresis (PFGE) Molecular typing. Results A total of 160 DEC positive were detected, with a detection rate of 9.3%. Among them, the detection rate was 9.7% (117/1 204) in infectious diarrhea patients and 8.4% (43/510) in healthy subjects. In the population, the detection type of DEC was predominantly toxin-producing Escherichia coli (ETEC), accounting for 45.0%, followed by pathogenic Escherichia coli (EPEC) and adhering Escherichia coli (EAEC), accounting for 32.5 %, 18.7% respectively. There were significant differences between the diarrhea population and the healthy population (P <0.05). The former was predominantly ETEC (59.8%) and the latter was predominantly EPEC (60.5%). The 135 strains of DEC samples were divided into 123 PFGE patterns, of which 70 were divided into 60 PFGE patterns, 37 were classified into 36 bands, 23 were divided into 22 bands, and their health and well-being Strains of identical EAEC strains were detected among the populations. Conclusion The genotypes of DEC are diverse in the study area, and the type of infection in the population is mainly ETEC. ETEC may have prevalence of infection of clonal strains, there is the possibility of outbreaks of infection; diarrhea and healthy populations may exist between homologous clonal strains of infection.