| Objective: To investigate the serotype distribution and drug sensitivity of diarrheal Escherichia coli from patients with diarrhea in Cangzhou of Hebei province,which provides clinical basis for preparation of local vaccine,epidemiological study and rational use of antibiotics.Methods: A total of 247 strains of diarrheal Escherichia coli isolated from fecal specimens of patients with acute diarrhea were cultured and identified,all of the patients were in the intestinal clinic or emergency department of Cangzhou people's Hospital between February 2015 and February 2018.Then specific virulence genes of 5 kinds of diarrheogenic Escherichia coli were detected by polymerase chain reaction(PCR).O and H serotype of all the strains of diarrhea Escherichia coli were typed by slide agglutination,and the drug sensitivity test in vitro was carried out by disk Agar diffusion method.In the last,the infection status was analyzed for patients infection with diarrheic Escherichia coli,and serotype distribution and drug sensitivity of different types were compared.Results:1.The peak periods of acute diarrhea were summer and autumn.The incidences of acute diarrhea were concentrated between the age of 19 and 40.The ratio of male to female was 1:1.05.313 cases(27.46%)were collected in period from February to December 2015,394 cases(34.56%)were in 2016,421 cases(36.93%)were in 2017 and 12 cases(1.05%)were from January to February 2018.2.The study included 1140 patients with acute diarrhea.247 strains of diarrheal Escherichia coli were detected in these cases,the positive rate was 21.67%.In the overall detection rate,it was 12.19% of enteroaggregative Escherichia coli,it was 7.54% of enterotoxigenic Escherichia coli,it was 1.93% of enteropathogenic Escherichia coli,no enteroinvasive Escherichia coli and enterohemorrhagic Escherichia coli were detected.The positive rate of enteroaggregative Escherichia coli was significantly higher than that of other types of Escherichia coli,the difference was statistically significant(P < 0.05).3.154 strains of 247 strains of diarrhea Escherichia coli had serum agglutination,the rate was 62.35%,6 strains of these had O self-coagulation and 3 strains of these had H self-coagulation.The incidence of serum coagulation in enteroaggregative Escherichia coli was 51.80%,20 of them were O serotypes and 16 of them were H serotypes.Serotype of the highest agglutination rate was O6: H10,the highest O serotype was O6 and O148,the highest H serotype was H10,O self-coagulation occurred in 3 strains,and H self-coagulation did not occur in strains.The incidence of serum coagulation in enterotoxigenic Escherichia coli was 70.93%,11 of them were O serotypes and 7 of them were H serotypes.Serotype of the highest agglutination rate was O159:H34,the highest O serotype was O159,the highest H serotype was H34,O self-coagulation occurred in 2 strains,and H self-coagulation occurred in 3 strains.The incidence of serum coagulation in Enteropathogenic Escherichia coli was 59.10%,5 of them were O serogroups and 6 of them were H serums,O self-coagulation occurred in 1 strain,but no H self-coagulation occurred.4.The sensitivity rate of intestinal aggregation Escherichia coli to norfloxacin was the highest,reaching 100%,which to imipenem was 99.28%,which to cefoxitin,piperacillin/tazobactam were 98.56% and 98.56%,respectively;the resistance rate of the strains to compound trimethoprim was the highest,reaching 65.47%,that was 64.75% to ampicillin and was 50.36% to Nalidixic acid.In the drug susceptibility test of enterotoxic Escherichia coli,the susceptibility rates to multiple drugs were 100% those including chloramphenicol,ciprofloxacin,norfloxacin,levofloxacin,cefoxitin,furantoin,amikacin and piperacillin/tazobactam;the order of first three drug resistance from high to low followed by Nalidixic acid(45.35%),ampicillin(33.72%)and compound trimethoprim(26.74%).In the drug susceptibility test of enteropathogenic Escherichia coli,the sensitivity rates were all 100% that to amikacin,imipenem,piperacillin/tazobactam;the order of first three drug resistance from high to low followed by cefazolin(59.10),tetracycline(59.09%)and ampicillin(54.55%).Conclusion:1.Enteroaggregative Escherichia coli,enterotoxic Escherichia coli and enteropathogenic Escherichia coli account for the main strains from patients with diarrhea in Cangzhou City.2.Enteroaggregative Escherichia coli is more sensitive to norfloxacin and imipenem;Enterotoxic Escherichia coli has the highest sensitivity to chloramphenicol,ciprofloxacin,norfloxacin,levofloxacin,cefoxitin,nitrofurantoin,amikacin,piperacillin/ tazobactam;Enteropathogenic Escherichia coli has the highest sensitivity to amikacin,imipenem,piperacillin/tazobactam. |
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