尿道致病性大肠埃希菌药敏分析及超广谱β-内酰胺酶基因分型研究  

Antibiotics susceptibility and extended spectrum β-lactamase genotypes of clinical Uropathogenic Escherichia coli

作　　者：陈圣高 刘洋[2] 李向阳[3] 

机构地区：[1]浙江省平阳县中医院检验科,浙江平阳县325401 [2]南昌大学第一附属医院检验科,江西南昌330006 [3]温州医学院附属第二医院检验科,浙江温州325400

出　　处：《中华医院感染学杂志》2013年第7期1490-1493,共4页Chinese Journal of Nosocomiology

基　　金：温州市医药卫生科学研究项目(2011B091)

摘　　要：目的对尿道致病性大肠埃希菌(UPEC)检测及药敏分析,为指导和治疗UPEC尿路感染提供依据。方法收集尿液分离的282株大肠埃希菌,采用PCR法检测papC基因、ESBLs基因型别及整合子,比较分析各种基因型比率和差异。结果尿液中检出UPEC papC基因阳性123株,慢性肾盂肾炎和膀胱炎患者UPEC分离率高于非UPEC(χ2值为21.51、19.23,P<0.01);产ESBLs UPEC 81株,占65.85%,非UPEC产ESBLs 51株,占32.08%,差异有统计学意义(χ2=31.78,P<0.01);UPEC与非UPEC均对亚胺培南敏感,UPEC的耐药性高于非UPEC,CTX-M基因检出率达61.7%,其中CTX-M-1基因22株、CTX-M-8基因15株、CTX-M-9基因13株;TEM基因和SHV基因检出率分别为40.7%与13.6%;未检出其他基因型;有11株产≥2种ESBLs,有3株未能确定ESBLs基因型;Ⅰ类整合子intⅠ基因携带率达80.2%。结论 UPEC在尿中分离率高,主要来自慢性肾盂肾炎和膀胱炎患者,产ESBLs率高,以CTX-M型为主,多伴随携带intⅠ基因。OBJECTIVE To analyze the antibiotics susceptibility of clinical Uropathogenic Escherichia coli （UPEC） strains so as to guide the treatment of the urinary tract infections caused by the UPEC. METHODS Totally 282 strains of E. coli isolated from the urine were collected, the papC gene, ESBLs genotyepes, and the integrons were detected by the PCR, and the ratios of the genotypes were compared and analyzed. RESULTS Totally 123 strains of UPEC with papC tested positive, the isolation rate of UPEC was higher in the chronic pyelonephritis patients or the cystitis patients than that of the non-UPEC strains（x2 =21.51, 19.23,P〈0.01）; there were 81 （65. 85%） strains of ESBLs-producing UPEC and 51 （32. 08%） strains of the ESBLs-producing non-UPEC strains, the difference was statistically significant（x2 = 31.78,P〈0.01） ; both the UPEC strains and the non-UP- EC strains were sensitive to imipenem, and the drug resistance rate of the UPEC strains was higher than that of the non-UPEC strains, the detection rate of the CTX-M gene was 61.7 %, there were 22 strains with CTX-M-1, 15 strains with CTX-M-8 and 13 strains with CTX-M-9; the detection rates of the TEM gene and SHV gene were 40.7%and 13.6%, respectively; no other genotypes were detected; there were 11 strains producing more than two kinds of ESBLs and 3 strains with undetermined ESBLs genotypes; the detection rate of int I gene was 80.2%. CONCLUSION The isolation rate of UPEC strains is high in the urine, especially from the patients with chronic pyelonephritis or cystitis. The detection rate of the ESBLs-producing strains is high, with the CTX-M type dominant, accompanied by the int I gene.

关 键 词：致病性大肠埃希菌 产超广谱Β-内酰胺酶 整合子 基因型 

分 类 号：R378.21[医药卫生—病原生物学]