产NDM ExPEC毒力与其耐药性和分子分型的关系研究  

The relationship between virulence factors and molecular epidemiology and carbapenem-resistance of New Delhi metallo-β-lactamase-producing extraintestinal pathogenic Escherichia coli

作　　者：冯丽娜[1] 李从荣[1] 姜树朋 杨勇文[1] 蔡璇[1] 李娟[1] 冯锴[1] 郭静[1] FENG Lina;LI Congrong;JIANG Shupeng;YANG Yongwen;CAI Xuan;LI Juan;FENG Kai;GUO Jing(Department of Clinical Laboratory,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China)

机构地区：[1]武汉大学人民医院检验医学中心,湖北武汉430060

出　　处：《国际检验医学杂志》2020年第8期910-915,共6页International Journal of Laboratory Medicine

基　　金：国家临床重点专科建设项目(财社[2010]305)。

摘　　要：目的对产新德里金属β-内酰胺酶(NDM)肠外致病性大肠埃希菌(ExPEC)菌株进行分子分型,研究产NDM ExPEC毒力与其对碳青霉烯类抗菌药物的耐药性和分子分型之间的关系。方法选取分离自该院的15株产NDM ExPEC菌株(实验组)和28株不产NDM ExPEC菌株(对照组)作为研究对象,对产NDM ExPEC菌株进行系统发育分群和多位点序列分型(MLST)研究,PCR方法检测7种毒力基因在这两组菌株中的分布,χ2检验比较分布差异。结果系统发育分群结果显示,15株产NDM ExPEC菌株中,13株属于A群,2株属于D群;MLST分型结果显示,ST410是检出率最高的ST型;实验组毒力基因fimH检出率最高;对照组毒力基因sat、fyuA和ompT检出率高于实验组,差异有统计学意义(P<0.05)。结论该院绝大多数产NDM ExPEC菌株的毒力较弱,表明细菌耐药性强并不意味着其致病性也强。Objective To analyze the relationship between virulence factors and molecular epidemiology and carbapenem-resistance of New Delhi metallo-β-lactamase-producing extraintestinal pathogenic Escherichia coli.Methods 15 NDM-producing ExPEC strains and 28 NDM-none-producing ExPEC strains isolated during the same period were investigated.Phylogenetic groups were determined by a triplex PCR,and MLST determined the alleles and sequence types.Seven virulence genes were detected by PCR,and Chi-square test compared the distribution of the seven virulence genes in the two groups.Results The phylogenetic grouping of the 15 ExPEC strains capable of producing NDM,which were identified using reference methods,were as follows:13 were placed in phylogenetic group A and 2 in phylogenetic group D.MLST indicated that sequence type 410(ST410)was the predominant type.The detection rate of virulence gene fimH was the highest in the experimental group.The detection rates of sat,fyuA and ompT in the control group were higher than those in the experimental group,the difference was statistically significant(P<0.05).Conclusion The virulence of the majority of NDM ExPEC producing strains in our hospital is weaker than that of non NDM ExPEC producing strains,which indicates that the strong resistance of bacteria does not mean that they are also pathogenic.

关 键 词：碳青霉烯酶 新德里金属β-内酰胺酶 肠外致病性大肠埃希菌 多位点序列分型 毒力基因 

分 类 号：R446.5[医药卫生—诊断学]