目的检测和分析河南省2010-2012年腹泻人群5种致泻性大肠埃希菌(EAEC/EPEC/ETEC/EIEC/EHEC)感染及分布情况,为致泻性大肠埃希菌病的监测、暴发预警、溯源调查提供基线与参考数据。方法采集病人腹泻标本,用麦康凯(Mac)平板进行分离培养,通过KIA/MIU小生化对大肠埃希菌做初步鉴定。采用热裂解法制备DNA模板,多重PCR鉴定5种致泻性大肠埃希菌。结果 1 934例腹泻病人中检测出5种致泻性大肠埃希菌共139例,总阳性率7.19%。其中EAEC检出56例(阳性率2.90%),EPEC检出67例(阳性率3.46%),EHEC检出7例(阳性率0.36%),ETEC检出9例(阳性率0.47%),未检出EIEC。139例感染者中,以EAEC与EPEC感染为主,分别占40.3%和48.2%;其次为ETEC与EIEC,所占比例较小。腹泻患者中男性1 218例,女性716例,男女性别比为1.7︰1。男性检出大肠埃希菌感染94例,检出率为7.72%;女性检出45例,检出率为6.28%。农村患者1 332例,检出大肠埃希菌感染99例,检出率为7.43%;城市602例,检出大肠埃希菌感染40例,检出率为6.64%。≤5岁儿童1 345例,占69.54%。139例DEC阳性者中≤5岁为103例,占74.10%。致泻大肠埃希菌检出率最高为1~岁组(10.81%),最低为40~岁组(4.94%)。≤5岁患者DEC阳性率为7.36%。结论 5种致泻性大肠埃希菌为河南省细菌性腹泻主要的病原,感染以5岁以下儿童为主,男性高于女性,农村高于城市。5种致泻性大肠埃希菌携带有不同的毒力基因,显现其侵袭力和致病力具有多样性与复杂性,值得高度重视与深入研究。 Objective To detect and analyze the infection and distribution of five kinds of diarrheal Escherichia coli (EAEC / EPEC / ETEC / EIEC / EHEC) in diarrhea population from 2010 to 2012 in Henan Province. Early warning, traceability surveys provide baseline and reference data. Methods Samples of patients with diarrhea were collected, separated and cultured with MacConkey (Mac) plates, and preliminary identification of Escherichia coli by KIA / MIU micro-biochemistry. DNA templates were prepared by pyrolysis method and five kinds of diarrheal Escherichia coli were identified by multiplex PCR. Results A total of 139 diarrhea-causing Escherichia coli strains were detected in 1 934 diarrhea patients, with a total positive rate of 7.19%. Among them, 56 were detected by EAEC (positive rate was 2.90%), 67 were detected by EPEC (positive rate was 3.46%), 7 were detected by EHEC (positive rate was 0.36%), 9 were detected by ETEC (positive rate was 0.47%), EIEC was detected. Of the 139 infected patients, EAEC and EPEC were predominant, accounting for 40.3% and 48.2% respectively, followed by ETEC and EIEC, accounting for a relatively small proportion. There were 1 218 males and 716 females with a ratio of male to female 1.7: 1. 94 cases of Escherichia coli infection were detected in men, the detection rate was 7.72%; 45 cases were detected in women, the detection rate was 6.28%. There were 1 332 cases of rural patients with 99 cases of Escherichia coli infection, the detection rate was 7.43%. In 602 cases of urban area, 40 cases of Escherichia coli infection were detected, the detection rate was 6.64%. 1 345 children ≤ 5 years old, accounting for 69.54%. 139 cases of DEC positive ≤5 years old was 103 cases, accounting for 74.10%. The highest detection rate of diarrhea Escherichia coli is 1 ~ (10.81%), the lowest is 40 ~ (4.94%). The positive rate of DEC in patients ≤5 years old was 7.36%. Conclusions Five kinds of diarrheal Escherichia coli are the main pathogens of bacterial diarrhea in Henan province. The infection is mainly children under 5 years old, which is higher than that of females in males and higher in rural areas than in urban areas. Five kinds of diarrhea-causing Escherichia coli carrying different virulence genes, showing the diversity and complexity of its invasiveness and virulence, deserve attention and in-depth study.