Distribution of the community-acquired bacterial diarrheal pathogens and drug resistance in 16 provinces or cities in China during 2009-2013

CUI En-bo; CHEN Su-ming; ZHANG Cheng-long; WANG Yong; JIA Tian-ye; BAO Chun-mei; ZHANG Ju-ling; WANG Huan; PANG Jun-li; QU Fen; MAO Yuan-li

Abstract：Objective To analyze the characteristics of the community-acquired bacterial diarrheal pathogen spectrum and drug resistance in China during 5 years. Methods The strains isolated from the stool samples of patients with community-acquired bacterial diarrhea were collected from 16 provinces or cities in China during 2009-2013. The bacteria were incubated with Salmo-nella, Shigella agar, gentamicin agar and MacConkey agar plate and identification of pathogens suspected to be the cause of diarrhea was performed by VITEKⅡinstrument and biochemical reaction trace coding tube. Then, Salmonella, Shigella, Vibrio and diarrhea-genic Escherichia coli were serotyped by serum agglutination test. K-B method was used for antimicrobial susceptibility testing of bacterial pathogens. Results A total of 10 881 strains of diarrheal pathogens, including 7 genus, 22 species and 90 serotypes were isolated from diarrheal patients from 16 provinces or cities in China during 5 years. There were 7632 (70.14%) strains of Shigella, 1351 (12.42%) strains of Vibrio, 981 (9.02%) strains of Salmonella , 341 (3.13%) strains of diarrheagenic Escherichia coli, 302 (2.78%) strains of Aeromonas, 269 (2.47%) strains of Plesiomonas, and 5 (0.05%) strains of Yersinia enterocolitica. The major serotypes of Shigella were F2a, F4a and F1a belonging to group B and the major serotypes of Salmonella were Salmonella enteritidis and Salmonella typhimurium. Drug sensitivity monitoring showed that Shigella had better sensitivity to cefotaxime, cefepime, cefmetazole, imipenem and fosfomycin, with the sensitivity rates of 89.7%, 92.3%, 96.7%, 100%and 97.7%; the sensitive rates of Salmonella to cefotaxime, cefepime, aztreonam, imipenem and fosfomycin were 94.0%, 97.9%, 94.4%, 100% and 96.4%; the sensitive rates of Aeromonas to cefepime, levofloxacin, imipenem and fosfomycin were 80.9%, 80.0%, 92.6% and 84.0%; diarrheagenic Escherichia coli had poor sensitivity to antibiotics generally; Vibrio had good sensitivity to antibiotics excluding ampicillin. Conclusions Shigella, Vibrio and Salmonella are the major community-acquired bacterial diarrheal pathogens in China. Empiric antibiotic therapy should be directed against these pathogens, and targeted therapy should take the results of drug sensitivity testing into consideration.