尿道致病性大肠杆菌毒力因子与其抗生素耐药性之间的 关系  

Relationship between virulence factors of urethral pathogenic Escherichia coli(UPEC)and antibiotic resistance

作　　者：王景雨 周春雷[1] 王猛[1] 江雁[1] 董贺楠 穆红[1] WANG Jing-yu;ZHOU Chun-lei;WANG Meng;JIANG Yan;DONG He-nan;MU Hong(Department of Clinical Laboratory,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院检验科,天津300192

出　　处：《天津医科大学学报》2022年第6期648-653,共6页Journal of Tianjin Medical University

基　　金：天津市卫健委科技项目(TJWJ2021QN016);天津市医学重点学科建设项目(2021)。

摘　　要：目的:探讨细胞毒性坏死因子1(CNF1)、溶血素A(HlyA)和菌毛蛋白FimH 3种毒力因子在尿道致病性大肠杆菌(UPEC)中的表达与其抗生素耐药性之间的关系。方法:选取天津市第一中心医院84例尿道感染(UTI)患者尿液样本中分离的UPEC,通过PCR实验检测其毒力因子基因的表达,并通过药物敏感性实验分析其耐药性,进一步探索UPEC毒力因子的表达与其抗生素耐药性之间的关系。结果:本研究通过PCR实验在71例(84.52%)UPEC分离株中检测到毒力基因的表达,其中cnf1^(+)UPEC菌株10例(11.90%),hlyA^(+)UPEC菌株9例(10.71%),fimH^(+)UPEC菌株69例(82.14%)。观察到45例(53.57%)UPEC为超广谱β-内酰胺酶(ESBL)阳性。cnf1^(+)UPEC菌株中ESBL阳性为6例(60.00%),hlyA^(+)UPEC菌株中ESBL阳性为7例(77.78%),fimH^(+)UPEC菌株中ESBL阳性为38例(55.07%),ESBL阳性率均高于其相应的阴性菌株。表达毒力因子CNF1、HlyA、FimH的UPEC分离株对多种抗生素的耐药率均高于其阴性分离株。结论:毒力因子的表达与UPEC对多种抗生素的高耐药性之间存在相关性。Objective:To investigate the relationship between the expression of three virulence factors including cytotoxic necrosis factor 1(CNF1),hemolysin A(HlyA)and pilin FimH,and its antibiotic resistance in uropathogenic Escherichia coli(UPEC).Methods:The UPEC isolated from the urine samples of 84 patients with urinary tract infection(UTI)in Tianjin First Central Hospital were selected,the expression of virulence factor genes was detected by PCR experiment,and the drug resistance was analyzed by drug sensitivity test.The relationship between the expression of UPEC virulence factors and their antibiotic resistance was further explored.Results:In this study,the expression of virulence genes was detected in 71(84.52%)UPEC isolates by PCR experiment,including 10(11.90%)cnf1^(+)UPEC strains,9(10.71%)hlyA^(+)UPEC strains,and 69 fimH^(+)UPEC strains(82.14%).45 cases(53.57%)of UPEC were observed to be extended-spectrumβ-lactamase(ESBL)positive.The positive rate of ESBL was 6 cases(60.00%)of cnf1^(+)UPEC strains,7 cases(77.78%)of hlyA^(+)UPEC strains,and 38 cases(55.07%)of fimH^(+)UPEC strains.The positive rate of ESBL was higher than the corresponding negative UPEC strains.In addition,the resistance rates of UPEC isolates expressing virulence factors CNF1,HlyA and FimH to various antibiotics were higher than their negative isolates.Conclusion:There is a correlation between the expression of virulence factors and the high resistance of UPEC to multiple antibiotics.

关 键 词：尿道致病性大肠杆菌 尿道感染 毒力因子 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]