2016—2020年内蒙古某教学医院尿液标本分离菌的耐药性分析及部分大肠埃希菌多位点序列分型  

Antimicrobial resistance profile of the bacterial isolates from urine in the period from 2016 to 2020 and multilocus sequence typing of Escherichia coli isolates in a teaching hospital in Inner Mongolia Autonomous Region

作　　者：宿瑞俊[1] 郑文琪[1] 申慧敏 吕莹莹 郭素芳[1] SU Ruijun;ZHENG Wenqi;SHEN Huimin;Lü Yingying;GUO Sufang(Department of Laboratory Medicine,the Affiliated Hospital of Inner Mongolian Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院检验科,呼和浩特010050

出　　处：《中国感染与化疗杂志》2022年第5期597-603,共7页Chinese Journal of Infection and Chemotherapy

基　　金：内蒙古自然科学基金面上项目(2021MS08082)。

摘　　要：目的了解尿路感染病原菌的分布、耐药变迁及大肠埃希菌多位点序列分型(MLST)。方法回顾性分析2016—2020年内蒙古医科大学附属医院尿液标本分离菌耐药情况。对2020年部分大肠埃希菌进行多重PCR种系分型;对B2型菌株进行MLST。结果该院5年间培养分离尿路感染病原菌共计9008株,革兰阴性菌7219株,占80.1%,革兰阳性菌1789株,占19.9%。前5位的菌种分别是大肠埃希菌、屎肠球菌、肺炎克雷伯菌、粪肠球菌和无乳链球菌。粪肠球菌对测试抗菌药物的耐药率均显著低于屎肠球菌,未发现对利奈唑胺和万古霉素耐药的粪肠球菌,发现耐万古霉素的屎肠球菌。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗生素仍高度敏感,但均出现耐药菌株。铜绿假单胞菌对测试抗菌药物的耐药率均显著低于鲍曼不动杆菌。204株大肠埃希菌中B2型占47.1%,MLST分为6个ST型别(ST1193、ST131、ST95、ST12、ST3910、ST4)。ST1193是最主要型别,占54.9%,其次是ST131,占35.2%。结论尿液标本分离菌以革兰阴性菌为主,大肠埃希菌是引起尿路感染最主要的病原菌。ST1193分离率最高,其次是ST131,二者对左氧氟沙星耐药率高达87.2%和88.0%。Objective To understand the distribution and antimicrobial resistance profile of pathogenic bacteria isolated from urine,and multilocus sequence typing(MLST)of Escherichia coli isolates.Methods The bacteria isolated from urine in the Affiliated Hospital of Inner Mongolia Medical University in the period from 2016 to 2020 were reviewed retrospectively.Multiplex PCR was used for phylogenetic typing of E.coli strains isolated in 2020.MLST was used for E.coli phylogenetic B2 strains.Results A total of 9008 bacterial strains were isolated from urinary tract infection in the 5-year period,including 7219(80.1%)strains of gram-negative bacteria and 1789(19.9%)strains of gram-positive bacteria.The top 5 bacterial species were E.coli,Brucella,Klebsiella pneumoniae,Enterococcus faecalis and Streptococcus agalactiae.E.faecalis showed significantly lower resistance rates than E.faecium to all the antibacterial agents.None of E.faecalis isolates were resistant to linezolid or vancomycin.Vancomycin-resistant strain was identified in E.faecium.E.coli and K.pneumoniae were still highly susceptible to carbapenems,but carbapenem-resistant isolates were emerging.P.aeruginosa demonstrated significantly lower resistance rates than A.baumannii to all the antibacterial agents tested.The E.coli phylogenetic B2 strains accounted for 47.1%of E.coli isolates.MLST resulted in 6 ST types among B2 isolates(ST1193/131/95/12/3910/4).ST1193 was the most dominant type,accounting for 54.9%,followed by ST131(35.2%).Conclusions Gram-negative bacteria are the main pathogens of urinary tract infections.E.coli is the most important pathogen causing urinary tract infections.ST1193 is the most prevalent E.coli strain,followed by ST131.About 87.2%of ST1193 E.coli strains and 88.0%of ST131 strains were resistant to levofloxacin.

关 键 词：尿路感染 细菌耐药性 大肠埃希菌 多位点序列分型 

分 类 号：R378[医药卫生—病原生物学]