临沂市肉鸡致病性大肠埃希菌的分离鉴定及耐药性研究

目的查清临沂市肉鸡大肠埃希菌的优势血清型及耐药情况,为研制疫苗和科学防治本病提供依据。方法对病料进行细菌分离培养,应用形态学检查、生化试验、致病性试验和血清学试验对大肠埃希菌及其血清型进行鉴定,通过药敏试验研究其耐药性。结果从365份病料中,分离出大肠埃希菌311株,分离率为85.2%。优势血清型为O78、O1、O11、O18、O15和O2;对链霉素、氨苄西林、利福平、庆大霉素、恩诺沙星、环丙沙星和左氧氟沙星等药物表现出很高的耐药性,耐药率分别为98.0%、87.3%、86.0%、77.3%、73.4%、70.0%和64.6%,而对大观霉素、头孢噻呋、多黏菌素、氟苯尼考和痢菌净高敏。结论临沂市肉鸡大肠埃希菌的优势血清型有O78、O1、O11、O18、O15和O2,分离菌株对大部分抗菌药物产生耐药性。因此,治疗鸡大肠埃希菌病应通过药敏试验,合理地选择药物。     

泌尿道感染大肠埃希菌耐药性分析

目的了解医院泌尿道感染大肠埃希菌产ESBLs的发生率和耐药情况。方法据NCCLS文件,产ESBLs细菌的检测用双纸片确认法。抗生素敏感测定采用K—B琼脂扩散法。结果在检出的176株大肠埃希菌中．ESBLs阳性的菌株有53例,ESBLs检出率为30．1％。检出的产ESBLs细菌对所有青霉素类抗生素产生耐药,产ESBLs对3代头孢类抗生紊头孢曲松、头孢噻肟的耐药率〉81％,对磺胺类、喹诺酮类也在71％以上。对亚胺培南全部敏感。结论医院泌尿道大肠埃希菌产ESBLs发生率较高,且对多种抗生素呈交叉耐药和多重耐药．应做好常规检测和监测．指导临床合理使用抗生素。     

新生儿大肠埃希菌败血症耐药性分析

目的 探讨新生儿败血症的大肠埃希菌耐药情况,为早期诊断和合理治疗提供依据.方法 对2002年8月至2011年8月确诊的64例大肠埃希菌败血症新生儿的药敏结果进行回顾性分析,并对早、晚发型新生儿败血症的大肠埃希菌分离株耐药率进行比较.结果 64株大肠埃希菌分离株中,产ESBLs 29株,检出率为45.31％.其中晚发型败血症ESBLs检出率明显高于早发型(56.41％ vs 28.00％,P＜0.05).早、晚发型新生儿败血症的大肠埃希菌分离株均对亚胺培南、美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦耐药率较低,均小于26.00％;早、晚发型新生儿败血症的大肠埃希菌分离株对多种抗生素的耐药率不同,差异具有统计学意义(均P＜0.05).结论 新生儿早发型与晚发型败血症的大肠埃希菌分离株对药物的耐药率有差异,建议临床在抗感染治疗时,应根据药敏结果,合理使用抗菌药物.     

产超广谱β-内酰胺酶大肠埃希菌的耐药性分析

目的:了解产超广谱β-内酰胺酶大肠埃希菌在泌尿系统感染中的流行情况及对12种常用抗菌药物的耐药性,为临床合理使用抗生素提供必要依据.方法:采用K-B纸片扩散法,测定128株大肠埃希菌对12种抗菌药物的耐药性,同时使用E-test方法筛选超广谱β-内酰胺酶阳性菌株.结果:从128株大肠埃希菌中共检出ESBL 26株,产ESBL细菌阳性率为20.3%.在12种抗菌药物中,亚胺培南的体外抗菌活性最好,敏感率为100%,其次为阿米卡星(90.5%).结论:产ESBL细菌多重耐药现象严重,只有正确使用抗生素才能降低ESBL的发生,而对于产ESBL菌株感染的治疗,亚胺培南应作为首选药物.     

大肠埃希菌耐药性及其基因同源性分析

目的 研究临床分离的大肠埃希菌对常用抗生索的耐药性及其基因分型,了解其耐药性趋势与传播流行情况,为临床合理治疗大肠埃希菌引起的感染提供参考依据。方法 采用常规鉴定技术鉴定细菌;采用K—B纸片扩散法测定77株大肠埃希菌对19种药物的耐药性;K—B法鉴定产超广谱β-内酰胺酶（ESBLs）;通过脉冲场凝胶电泳（PFGE）法对其进行基因分型以确定菌株之间的亲缘关系;FINGERPRINT Ⅱ软件进行细菌基因指纹图谱分析。结果 大肠埃希菌对青霉素类、喹诺酮类药物和氨曲南的耐药性明显增高,亚胺培南和美罗培南是大肠埃希菌感染患者的首选药物;经ESBLs确证试验,ESBLs阳性率为28．60％（22／77）;产ESBLs大肠埃希菌经PFGE指纹图谱分析,除第62株和第70株相似性系数为78．27％外,其余相似度均低于70．0％;ESBLs大肠埃希菌阴性株中除少数几对菌株相似性系数较高外,其余呈散在分布,且电泳带存有6条以上的不同条带,为流行病学无关的不同克隆。结论 大肠埃希菌对常用抗生索耐药性明显增高,且呈多重耐药趋势;该研究尚不能证明存在大肠埃希菌爆发性流行感染,提示可能存在院内感染大肠埃希菌的优势克隆;PFGE基因分型方法是耐药性与流行状况分析的有效手段。     

儿童泌尿系感染大肠埃希菌的耐药性分析

目的 了解大肠埃希菌在儿童中的感染情况及其耐药性.方法 对中段尿标本进行分离培养及鉴定,药敏试验用K-B法,检测ESBLs用表型确证试验,药敏结果分析用WHONET 5.5软件,统计分析采用x2检验.结果 2009年1月至2011年12月从儿科门诊和病房送检的1755份中段尿标本中共检出85株大肠埃希菌,检出率为4.8％,男女比为6:11; ＜3岁的婴幼儿组57例,占67.1％;3～6岁育龄前儿童17例,占20.0％;＞6岁儿童11例,占12.9％;产ESBLs的大肠埃希菌占60.0％;85株大肠埃希菌对亚胺培南和美罗培南全部敏感,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和阿米卡星的敏感率均为90％以上,产ESBLs的大肠埃希菌对氨苄西林、头孢唑啉、头孢他啶、头孢曲松、头孢吡肟、头孢西丁、头孢呋新酯、左旋氧氟沙星和罗红霉素的耐药率较非产ESBLs菌株的耐药率高,P值均＜0.05,差异有统计学意义.结论 儿童泌尿系感染大肠埃希菌,可以选用的抗菌素已极为有限,临床要谨慎用药,并及时根据药敏结果修正药物种类.     

新生儿病区产ESBLs大肠埃希菌整合子及其耐药性分析

目的 了解新生儿病区产ESBLs大肠埃希菌整合子的携带情况及其耐药性.方法 采用K-B琼脂扩散法对56株产ESBLs大肠埃希菌进行药敏试验;应用PCR法检测Ⅰ类、Ⅱ类和Ⅲ类整合子;以肠杆菌科重复序列-聚合酶链式反应(ERIC-PCR)进行基因分型.结果 56株产ESBLs大肠埃希菌的Ⅰ类整合子检出率为60.7％,未检出Ⅱ类和Ⅲ类整合子;菌株对庆大霉素、环丙沙星、左氧氟沙星、复方新诺明、头孢唑林、氨曲南、头孢他啶的耐药率差异有统计学意义(P＜0.05),阳性菌株的耐药率高于阴性菌株;56株大肠埃希菌分为45种基因型.结论 Ⅰ类整合子广泛存在于新生儿病区产ESBLs大肠埃希菌并与其耐药性相关.     

156例尿路感染大肠埃希菌耐药性分析

目的探讨大肠埃希菌尿路感染的临床发病特点及对抗生素的耐药情况。方法对2001年1月至2005年12月尿路感染患者尿培养分离出的156株大肠埃希菌进行耐药性分析,用纸片扩散法表型确证试验检测ESBLs。结果大肠埃希菌耐药率最低的抗菌药物是亚胺培南、美罗培南、头孢哌酮/舒巴坦、氧哌嗪青霉素/他唑巴坦,分别为1.28%、1.92%、3.21%、5.13%;对氨苄西林、氟喹诺酮类、庆大霉素、复方新诺明耐药率均>70%。产ESBLs的大肠埃希菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、氧哌嗪青霉素/他唑巴坦的耐药性均<10%,对氨苄西林、头孢菌素类、氟喹诺酮类均表现出很强的耐药性。结论治疗大肠埃希菌感染时,需根据药敏结果选用碳青霉烯类、β-内酰胺类/β-内酰胺酶抑制剂等。     

Detection and genetical characterization of Shiga toxin-producing Escherichia coli from wild deer

Shiga toxin (Stx)-producing Escherichia coli (STEC) strains isolated from wild deer in Japan were examined. A total of 43 fecal samples were collected 4 times from 4 different sites around Obihiro City, Hokkaido, Japan, in June and July 1997. Seven STEC strains were isolated by PCR screening, all of them were confirmed by ELISA and Vero cell cytotoxicity assay to be producing only active Stx type 2 (Stx2). Moreover, they seemed to carry the hemolysin and eaeA genes of STEC O157:H7, and some isolates harbored large plasmids which were similar to the 90-kilobase virulence plasmid of STEC O157:H7. Based on their plasmid profiles, antibiotic resistance patterns, PCR-based DNA fingerprinting data obtained by using random amplified polymorphic DNA (RAPD) and the stx2 gene sequences, all isolates were divergent from each other except for 3 isolates from the first and second samplings. A DNA sequence analysis of representative isolates revealed that deer originating STEC strains were closely related to each other, but not to the Stx2-producing STEC strains isolated from a mass outbreak in Obihiro at the same time. A phylogenic analysis of the deduced Stx2 amino acid sequences demonstrated that three distinct clusters existed in the deer originating STEC strains and that the Stx of deer originating STEC was closely associated with that originating from humans, but not those of STEC originating from other animals. These results suggest that STEC contamination of deer carcasses should be considered as a potential source of human infection and adequate sanitary inspection of meat for human consumption is also essential for wild animals.     

Detection and Long-Term Existence of Shiga Toxin (Stx)-Producing Escherichia coli in Sheep

The isolation and characterization of Shiga-like toxin (Stx)-producing Escherichia coli (STEC) from sheep are described. The distribution of stx genes in E. coli isolates was detected by PCR. When brain heart infusion (BHI) broth and novobiocin supplemented m-EC broth (N-mEC) were used as enrichment culture for the isolation of STEC, N-mEC, compared to BHI, showed clearly lower efficiency. Finally, 5 STEC isolates from 4 sheep were isolated and characterized by biochemical and genetical analysis. All of them were confirmed by ELISA and Vero cell cytotoxicity assay for the production of Stx. Moreover, some strains carried hemolysin and eaeA genes and harbored large plasmids. Based on their plasmid profiles, antibiotic patterns and PCR-based DNA fingerprinting analysis using random amplified polymorphic DNA (RAPD), all isolates were different from each other. Three of the isolates were identified to belong to serogroups O2, O153 and O165, respectively, and the STEC strains belonging to these serogroups had been isolated from STEC outbreaks in humans. Four months after the first isolation in July 1997, STEC from sheep #1 was isolated again. A new isolate, HI-11, was identified as STEC O2: Hnt. Simultaneously, 2 STEC, which were genetically and phenotypically different from each other, were isolated from the same sheep at intervals of 4 months. These results demonstrate that sheep may be an important animal for studying human STEC infections, and that further epidemiological surveys on STEC are necessary.     

Seasonal variation of Shiga toxin-encoding genes (stx) and detection of E. coli O157 in dairy cattle from Argentina

Aims:  To study the seasonal variation of Shiga toxin-encoding genes ( stx ) and to investigate the presence of Shiga toxin-producing Escherichia coli (STEC) O157 in cattle belonging to five dairy farms from Argentina.
Methods and Results:  Rectal swab samples were collected from 360 dairy cows in each season and 115 and 137 calves in autumn and in spring, respectively. The stx were investigated by multiplex PCR and it was used as the indicator for STEC. Samples positives for stx were tested by PCR for eae-γ1 of E. coli O157 and then subjected to IMS (immunomagnetic separation). In positive animals significant differences in the prevalence of stx between warm and cold seasons were detected. In warm seasons, stx1  +  stx2 increased and stx1 decreased, independently of the animal category. The prevalence of STEC O157 in cows and calves were 0·2% and 0·8%, respectively.
Conclusions:  This work provides new data about the occurrence of stx and STEC O157 in dairy herds from Argentina and suggests a relationship between the type of stx and season of year.
Significance and Impact of Study:  The detection of STEC O157 and the seasonality of stx and its types provide an opportunity to improve control strategies designed to prevent contamination of food products and transmission animal-person.     

Inhibition of growth of Shiga toxin-producing Escherichia coli by nonpathogenic Escherichia coli

During routine quality control testing of diagnostic methods for Shiga toxin-producing Escherichia coli (STEC) using stool samples spiked with STEC, it was observed that the Shiga toxin could not be detected in 32 out of 82 samples tested. Strains of E. coli isolated from such stool samples were shown to be responsible for this inhibition. One particular isolate, named E. coli 1307, was intensively studied because of its highly effective inhibitory effect; this strain significantly reduced growth and Shiga toxin levels in coculture of several STEC strains regardless of serovar or Shiga toxin type. The probiotic E. coli Nissle 1917 inhibited growth and reduced Shiga toxin levels in STEC cultures to an extent similar to E. coli 1307, but commensal E. coli strains and several other known probiotic bacteria (enterococci, Bacillus sp., Lactobacillus acidophilus ) showed no, or only small, inhibitory effects. Escherichia coli 1307 lacks obvious fitness factors, such as aerobactin, yersiniabactin, microcins and a polysaccharide capsule, that are considered to promote the growth of pathogenic bacteria. We therefore propose strain E. coli 1307 as a candidate probiotic for use in the prevention and treatment of infections caused by STEC.     

Phenotypical characteristics of Shiga-like toxin Escherichia coli isolated from sheep dairy products

AIMS: To analyse phenotypical characteristics of Shiga toxin-producing Escherichia coli (STEC) strains from ovine origin. METHODS AND RESULTS: A total of 13 STEC strains (eight O157 and five non-O157) isolated from sheep dairy products were used in this study. Biochemical traits, motility, haemolytic activity, resistance to tellurite-cefixime, maximum growth temperature and antibiotic resistance were determined. The STEC strains were grouped into nine biochemical and physiological biotypes (five for the O157 and four for the non-O157 strains). All STEC strains showed resistance to bacitracin, cloxacilin, penicillin and tylosin. CONCLUSIONS: Different biotypes and antibiotic resistance patterns of STEC isolated from sheep dairy products were observed. SIGNIFICANCE AND IMPACT OF THE STUDY: This work will be a contribution to the better characterization of STEC isolated from sheep dairy products, which have, to date, been scarcely studied, and to the better understanding of the risks associated with its consumption.     

Role of internalization in the pathogenicity of Shiga toxin-producing Escherichia coli infection in a gnotobiotic murine model

We investigated the role of bacterial internalization in the killing caused by Shiga toxin-producing Escherichia coli (STEC) infection using a gnotobiotic murine model. A high number of internalized STEC was found in the colonic epithelial cells of STEC-infected mice by both an ex vivo assay and transmission electron microscopy. Most of these mice were killed within 10 days after infection. However, the implantation of lactic acid bacteria in such mice before infection markedly decreased the number of internalized STECs and also completely protected these hosts from killing by a STEC infection. The inhibition of such internalization by immunoglobulin also prevented the hosts from being killed. The Shiga toxin levels in these hosts indicated an inhibition of the penetration of Shiga toxins produced in the colon to the underlying tissue. These results suggested that the internalization plays an important role in the pathogenicity caused by STEC infection in a gnotobiotic murine model.     

Characterisation of Shiga toxin-producing Escherichia coli (STEC) isolated from seafood and beef

Shiga toxin-producing Escherichia coli (STEC) strains isolated in Mangalore, India, were characterised by bead-enzyme-linked immunosorbent assay (bead-ELISA), Vero cell cytotoxicity assay, PCR and colony hybridisation for the detection of stx1 and stx2 genes. Four strains from seafood, six from beef and one from a clinical case of bloody diarrhoea were positive for Shiga toxins Stx1 and Stx2 and also for stx1and stx2 genes. The seafood isolates produced either Stx2 alone or both Stx1 and Stx2, while the beef isolates produced Stx1 alone. The stx1 gene of all the beef STEC was found to be of recently reported stx1c type. All STEC strains and one non-STEC strain isolated from clam harboured EHEC-hlyA. Interestingly, though all STEC strains were negative for eae gene, two STEC strains isolated from seafood and one from a patient with bloody diarrhoea possessed STEC autoagglutinating adhesion (saa) gene, recently identified as a gene encoding a novel autoagglutinating adhesion.     

Variants of eae and stx genes of atypical enteropathogenic Escherichia coli and non-O157 Shiga toxin-producing Escherichia coli from calves

AIMS: To determine the subtypes of stx and eae genes of Shiga toxin-producing Escherichia coli (STEC) and enteropathogenic Escherichia coli (EPEC) from calves and to ascertain the typical and atypical nature of EPEC. METHODS AND RESULTS: One hundred and eighty-seven faecal samples from 134 diarrhoeic and 53 healthy calves were investigated for the presence of stx, eae and ehxA virulence genes by polymerase chain reaction and enzyme-linked immunosorbent assay. Subtype analysis of stx(1) exhibited stx(1c) in 13 (31.70%) isolates, while that of stx(2) revealed stx(2c) in eight (24.24%) and stx(2d) in two (6.06%) isolates. Subtyping of eae gene showed the presence of eae-beta, eae-eta and eae-zeta in two, three and four isolates respectively. None of the E. coli isolates possessed stx(2e), stx(2f), eae-alpha, eae-delta, eae-epsilon and eae-xi. All EPEC isolates were atypical. CONCLUSIONS: stx(1), stx(1c), stx(2), stx(2c), stx(2d), eae-beta, eae-eta and eae-zeta subtypes are prevalent in STEC and EPEC isolates in India. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first subtype analysis of stx(2) and eae genes of animal E. coli isolates in India and emphasizes the need to investigate their transmission to humans.     

Detection, isolation and characterization of Shiga toxin-producing Escherichia coli in retail-minced beef using PCR-based techniques, immunoassays and colony hybridization

AIMS: To provide information on detection of Shiga toxin-producing Escherichia coli (STEC) in retail-minced beef using an approach combining (i) PCR-based techniques and automated immunoassay for stx screening and detection of the five major serogroups associated with human infection, and (ii) immunomagnetic separation (IMS) and colony hybridization assays for bacterial strain isolation. METHODS AND RESULTS: Twenty-seven out of 164 minced beef samples were stx-positive by PCR-ELISA, nine of which were also positive by real-time PCR for at least one marker of the five main serogroups tested (O26, O103, O111, O145 and O157). Two E. coli O103 stx-negative strains were isolated from two out of 10 IMS and nine STEC strains that did not belong to the five main serogroups were isolated by colony hybridization. CONCLUSIONS: PCR techniques are applicable for rapid screening of samples containing both an stx gene and an O-group marker of the five main pathogenic STEC serogroups. Isolation of STEC strains belonging to the main non-O157 serogroups remains difficult. SIGNIFICANCE AND IMPACT OF THE STUDY: This study presents an evaluation of a multi-faceted approach for the detection of the most frequently reported human pathogenic STEC serogroups. The advantages and limits of this strategy are presented.     

Characterization of Shiga toxin-producing Escherichia coli isolated from aquatic environments

This study reports the phenotypic and genotypic characterization of 144 Shiga toxin-producing Escherichia coli (STEC) strains isolated from urban sewage and animal wastewaters using a Shiga toxin 2 gene variant (stx(2))-specific DNA colony hybridization method. All the strains were classified as E. coli and belonged to 34 different serotypes, some of which had not been previously reported to carry the stx(2) genes (O8:H31, O89:H19, O166:H21 and O181:H20). Five stx(2) subtypes (stx(2), stx(2c), stx(2d), stx(2e) and stx(2g)) were detected. The stx(2), stx(2c), stx(2d) and stx(2e) subtypes were present in urban sewage and stx(2e) was the only stx(2) subtype found in pig wastewater samples. The stx(2c) and stx(2g) were more associated with cattle wastewater. One strain was positive for the intimin gene (eae) and five strains of serotypes were positive for the adhesin encoded by the saa gene. A total of 41 different seropathotypes were found. On the basis of occurrence of virulence genes, most non-O157 STEC strains are assumed to be low-virulence serotypes.