Liu Lu, Wang Shuang, Yu Xiaolin, Chen Yuzhen, Chen Yanru, Sun Gaoxiang, Liu Ziqing, Cheng Lixiao, Zhang Huaning, Kou Zengqiang
Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Jinan, China.
Shandong Provincial Key Laboratory of Intelligent Monitoring, Early Warning, Prevention and Control for Infectious Diseases, Jinan, China.
Front Microbiol. 2025 Jun 27;16:1577277. doi: 10.3389/fmicb.2025.1577277. eCollection 2025.
Enteroaggregative (EAEC) is an emerging and intricate diarrheagenic bacterial pathogen responsible for acute and persistent diarrhea in children, adults, and travelers. Despite its clinical significance, the global understanding of EAEC outbreaks and pathogen characteristics remains limited due to its complex epidemiological profile.
This study presented a retrospective analysis of a foodborne diarrheal outbreak caused by EAEC in a county school in Shandong Province, China in 2023 by using epidemiological investigation and comprehensive genomic analysis techniques.
A total of 15 EAEC isolates were identified, including 13 from stool samples, one from sauced beef, and one from flies. Epidemiological and phylogenetic analyses pinpointed the EAEC isolates from sauced beef as the primary causative agent of the outbreak. Genomic comparisons revealed significant genetic consistency across nine outbreak-associated strains, particularly in virulence gene profiles, antimicrobial resistance gene profiles, molecular typing, and genetic evolution.
These findings underscored the utility of whole-genome sequencing in elucidating the genetic diversity of EAEC within specific environments and tracing its origins, thereby supporting targeted interventions such as infection control and prevention strategies. Notably, the study also identified an extensively drug-resistant (XDR) EAEC strain from flies in the canteen, harboring both the and resistance genes. This unexpected discovery highlighted the critical importance of applying the "One Health" approach, emphasizing the need for continuous surveillance of antibiotic-resistant bacteria in animals and environmental sources to mitigate potential public health risks.
肠聚集性大肠杆菌（EAEC）是一种新出现的、复杂的致泻性细菌病原体，可导致儿童、成人和旅行者出现急性和持续性腹泻。尽管其具有临床意义，但由于其复杂的流行病学特征，全球对EAEC暴发和病原体特征的了解仍然有限。
本研究采用流行病学调查和综合基因组分析技术，对2023年中国山东省某县学校一起由EAEC引起的食源性腹泻暴发进行回顾性分析。
共鉴定出15株EAEC分离株，其中13株来自粪便样本，1株来自酱牛肉，1株来自苍蝇。流行病学和系统发育分析确定酱牛肉中的EAEC分离株是此次暴发的主要病原体。基因组比较显示，9株与暴发相关的菌株在毒力基因谱、抗菌药物耐药基因谱、分子分型和遗传进化方面具有显著的遗传一致性。
这些发现强调了全基因组测序在阐明特定环境中EAEC的遗传多样性和追踪其来源方面的作用，从而支持感染控制和预防策略等有针对性的干预措施。值得注意的是，该研究还在食堂的苍蝇中鉴定出一株广泛耐药（XDR）的EAEC菌株，其携带了 和 耐药基因。这一意外发现凸显了应用“同一健康”方法的至关重要性，强调需要持续监测动物和环境来源中的耐药细菌，以降低潜在的公共卫生风险。
