老年尿毒症感染尿道致病性大肠埃希菌药敏分析及毒力基因分布研究  

Drug sensitivity analysis and virulence gene distribution of pathogenic Escherichia coli isolated from senile uremic infection

作　　者：马银丽 蒋银 杨丹 MA Yinli;JIANG Yin;YANG Dan(Department of Inspection,the First People's Hospital of Fuyang District of Hangzhou City,Hangzhou311400,China)

机构地区：[1]杭州市富阳区第一人民医院检验科,浙江杭州311400

出　　处：《中国现代医生》2020年第6期104-107,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY657)。

摘　　要：目的研究临床老年尿毒症患者分离的尿道致病性大肠埃希菌(UPEC)的毒力基因分布情况及耐药特征,为老年尿毒症患者UPEC尿路感染的治疗提供临床研究资料。方法采用法国梅里埃生物VitekⅡ系统鉴定2016年1月~2019年1月我院非植入导尿管老年尿毒症患者所分离117株UPEC,并行药敏试验,根据药敏试验结果分为对照组52株,多重耐药组65株。多重PCR检测两组菌株粘附因子、铁载体相关因子、保护性物质及毒素等毒力基因分布情况。结果美罗培南、亚胺培南、阿米卡星、呋喃妥因对大肠埃希菌均较为敏感;对照组及多重耐药组中fimH、feoB检出较高均在70%以上,经χ2检验分析,对照组与多重耐药组毒力基因sfa、afa、iha有统计学差异(P<0.05)。结论sfa、afa、iha均为粘附因子家族基因,可能与大肠埃希菌的耐药有关。Objective To study the distribution of virulence genes and drug resistance characteristics of urethral pathogenic Escherichia coli(UPEC)isolated from clinical elderly uremia patients,and to provide clinical research data for the treatment of UPEC urinary tract infections in elderly patients with uremia.Methods The French Merrier BiotekⅡsystem was used to identify 117 UPECs isolated from elderly uremia patients with non-implantable urinary catheters in our hospital from January 2016 to January 2019.Parallel sensitivity testing was performed.According to the drug sensitivity test results,they were divided into 52 strains in the control group and 65 strains in the multi-drug resistance group.Multiplex PCR was used to detect the distribution of virulence genes such as adhesion factors,iron carrier-related factors,protective substances and virulence gene in two groups.Results Meropenem,imipenem,amikacin,and furantoin were more sensitive to Escherichia coli.In the control group and the multi-drug resistance group,the detection of fimH and feoB was higher than 70%.Chi-square test analysis showed that the virulence genes sfa,afa,and iha in the control group and the multidrug resistance group were statistically different(P<0.05).Conclusion Sfa,afa,and iha are genes of adhesion factor family that may be related to drug resistance of Escherichia coli.

关 键 词：老年尿毒症 尿道致病性大肠埃希菌 毒力基因 耐药 粘附素 

分 类 号：R691.3[医药卫生—泌尿科学]