异体输血患者术后感染病原菌和大肠埃希菌感染毒力因子的分布及与耐药性的关系  

Interaction relationship between distribution of infectious pathogens and virulence factors and resistance in allogeneic transfusion patients

作　　者：张忠印 吉飞跃 周小玉[3] ZHANG Zhong-yin;JI Fei-yue;ZHOU Xiao-yu(Department of Blood Transfusion,Haian People's Hospital,Nantong,Jiangsu 226600,China;Central Laboratory of Hai'an People's Hospital;Department of Blood Transfusion,Jiangsu Provincial People's Hospital)

机构地区：[1]海安市人民医院输血科,江苏南通226600 [2]海安市人民医院中心实验室 [3]江苏省人民医院输血科

出　　处：《中国病原生物学杂志》2022年第8期964-967,共4页Journal of Pathogen Biology

摘　　要：目的探讨异体输血患者术后感染病原菌和大肠埃希菌感染毒力因子分布及与耐药性的交互关系。方法选取本院2017-2020年外科手术患者125例,其中采用回收式自身输血的患者73例(自身输血组),异体输血的患者52例(异体输血组)。对两组患者术后感染病原菌进行鉴定,PCR检测术后大肠埃希菌感染毒力因子,对两组患者病原菌分离株的耐药性进行药敏试验,采用皮尔逊相关性分析异体输血患者术后感染病原菌及大肠埃希菌感染毒力因子与耐药性的交互关系。结果异体输血组52例患者共分离出50株病原菌,其中革兰阳性球菌占34.00%(17/50),革兰阴性杆菌占48.00%(24/50),真菌占18.00%(9/50);自身输血组73例患者共分离出61株病原菌,其中革兰阳性球菌占31.15%(19/61),革兰阴性杆菌占49.18%(30/61),真菌占19.67%(12/61)。两组比较差异有统计学意义(P<0.05)。异体输血组术后各大肠埃希菌感染毒力因子fimH、traT、aerJ、Einv、papGⅢ、pAI、cnf1、fyuA、cnf2、papC、papG、hlyA检出率均高于自身输血组(P<0.05);异体输血组病原菌分离株对氨苄青霉素、氨曲南、氨节西林舒巴坦、头孢唑林头孢他啶、头孢吡肟、左氧氟沙星、呋喃妥因、复方新诺明的耐药率均高于自身输血组(P<0.05);皮尔逊相关性分析结果显示,术后感染病原菌分布数和大肠埃希菌感染毒力因子分布数均与耐药性有相关性(r=0.336,0.427,均P<0.05)。结论异体输血组术后大肠埃希菌感染产生的毒力因子多于自身输血组,异体输血组病原菌分离株对大多数抗菌药物的耐药率高于自身输血组,术后感染病原菌分布数和大肠埃希菌感染毒力因子分布数均与耐药性有交互关系。Objective To explore the distribution of virulence factors of pathogenic bacteria and Escherichia coli infection in patients with allogeneic blood transfusion and the interaction with drug resistance.Methods A total of 125 surgical patients in our hospital from 2017 to 2020 were selected,of which 73 patients received self-transfusion with recovery type(autotransfusion group)and 52 patients received allogeneic blood transfusion(allogeneic blood transfusion group).The postoperative infection pathogens of the two groups of patients were identified,the virulence factor of E.coli infection was detected by PCR,the drug resistance test of the pathogenic bacteria isolates of the two groups of patients was carried out,and the Pearson correlation analysis was used for allogeneic blood transfusion patients.The interaction between virulence factors and drug resistance of pathogenic bacteria and E.coli after infection.Results A total of 50 pathogens were isolated from 52 patients in the allogeneic blood transfusion group,of which gram-positive cocci accounted for 34.00%(17/50),gram-negative bacilli accounted for 48.00%(24/50),and fungi accounted for 18.00%(9/50);A total of 61 pathogens were isolated from 73 patients in the autotransfusion group,of which gram-positive cocci accounted for 31.15%(19/61),gram-negative bacilli accounted for 49.18%(30/61),and fungi accounted for 19.67%(12/61).The difference between the two groups was statistically significant(P<0.05).The detection rates of the virulence factors fimH,traT,aerJ,Einv,papGⅢ,pAI,cnf1,fyuA,cnf2,papC,papG,and hlyA of each E.coli infection in the allogeneic blood transfusion group were higher than those of the autotransfusion group(P<0.05);The resistance rates of pathogenic bacteria isolates in the allogeneic blood transfusion group to ampicillin,aztreonam,ampicillin and sulbactam,cefazolin,ceftazidime,cefepime,levofloxacin,nitrofurantoin,and compound trimethoprim were higher than those in the autotransfusion group(P<0.05);Pearson correlation analysis results showed that

关 键 词：异体输血 自身输血 术后感染 病原菌 大肠埃希菌 毒力因子 耐药性 

分 类 号：R378[医药卫生—病原生物学]