尿道致病性大肠埃希菌分离株的耐药性与毒力基因分布及相互间关系研究  

Study on correlation between antibiotics resistance and distribution of virulence genes in uropathogenic Escherichia coliisolates

作　　者：王立平[1,2] 刘世巍[3] 郭洁[3] 王玉飞[2] 徐杰[2,4] 高光俊[1,2] 王璐璐[2,4] 李卓林[2,4] 张正芳[1,2] 陈泽良[2] 李竞[1] 

机构地区：[1]西南大学药学院微生物与生化药学研究室,重庆400716 [2]军事医学科学院疾病预防控制所212室,北京100071 [3]中国中医研究院望京医院,北京100120 [4]吉林大学公共卫生学院医学基因组学研究中心,吉林长春130021

出　　处：《中华医院感染学杂志》2013年第8期1756-1758,1765,共4页Chinese Journal of Nosocomiology

基　　金：国家传染病专项课题(2009ZX10004-205);国家973课题(2009CB522602)

摘　　要：目的探讨尿道致病性大肠埃希菌(UPEC)临床分离株中毒力因子的分布、耐药性及其两者间的关系。方法用PCR扩增的方法筛查95株UPEC临床分离株的fimH、traT、aerJ、papGⅢ、fyuA、pAI、hlyA、papG、papC等毒力基因的分布;用K-B法分析菌株对18种抗菌药物的敏感率。结果 95株UPEC中fimH、traT、aerJ、papGⅢ、fyuA、pAI、hlyA、papG、papC等毒力基因的分布率依次为92.63%、81.05%、65.26%、37.89%、24.21%、30.53%、3.16%、11.58%、21.05%;选取的95株UPEC对青霉素类、β-内酰胺酶抑制复合物、头孢类、氨基糖苷类、氟喹诺酮类的耐药率依次为74.74%、33.68%、32.63%、36.84%、76.84%,均>30.00%;而6大类不同抗菌药物中,仅碳青霉烯类的敏感率为100.00%;毒力基因分布与耐药性之间差异有统计学意义(P<0.05)。结论 UPEC分离株以Ⅰ型菌毛为主,同时含有多个毒力基因;大多数UPEC表现为多药耐药;毒力基因数与耐药性之间密切相关,临床应注意抗菌药物的规范合理使用,防止UPEC耐药性的产生和传播,降低耐药菌引起的危害。OBJECTIVE To study the distribution of the virulence factors and its correlation with the antibiotic resistance of the uropathogenic Escherichia coli（UPEC）.METHODS The virulence genes,including fimH,traT,aerJ,papGⅢ,fyuA,pAI,hlyA,papG and papC of the 95 strains of UPEC isolated from urine,were screened by PCR.The drug susceptibility testing of 18 antibiotics was performed by K-B methods.RESULTS Among the 95 strains of UPEC,the positive rates of fimH,traT,aerJ,papGⅢ,fyuA,pAI,hlyA,papG and papC gene were 92.63%,81.05%,65.26%,37.89%,24.21%,30.53%,3.16%,11.58%,and 21.05%,respectively.The drug resistance rates of the 95 strains of UPEC to penicillins,β-lactamase inhibition compounds,cephalosporins,aminoglycosides,and fluoroquinolones were 74.74%,33.68%,32.63%,36.84%,and 76.84%,respectively,all higher than 30.00%.The drug susceptibility rate to carbapenems was 100.00% among the 6 categories of antibiotics.There was statistical difference between the distribution of virulence genes and antibiotic resistance（P0.05）.CONCLUSION The UPEC isolates are dominant in type I fimbriae and contain multiple virulence genes,and the majority of the UPEC are multidrug-resistant.There is a close relationship between the virulence genes and the antibiotic resistance,thus it is necessary for the hospital to pay attention to the reasonable use of antibiotics so as to prevent the emergence and spread of the drug-resistant UPEC.

关 键 词：尿道 致病性大肠埃希菌 毒力基因 耐药性 

分 类 号：R378.21[医药卫生—病原生物学]