糖尿病合并尿道感染患者分离尿道致病性大肠埃希菌毒力因子、耐药性及NLRP3表达  

Virulence factors, drug resistance and expression of NLRP3 in uropathogenic Escherichia coli isolates from diabetes mellitus patients complicated with urinary tract infection

作　　者：吉娆媛 吴智明[2] 云长缨 何林 JI Rao-yuan;WU Zhi-ming;YUN Chang-ying;HE Lin(Orthopedics and Diabetes Hospital in Haikou,Haikou,Hainan 57031l,China;不详)

机构地区：[1]海口市骨科与糖尿病医院检验科,海南海口570311 [2]海南医学院第二附属医院检验科,海南海口570311

出　　处：《中华医院感染学杂志》2023年第6期842-846,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生健康行业科研基金资助项目(20A200148)。

摘　　要：目的 探讨糖尿病合并尿道感染患者尿道致病性大肠埃希菌(UPEC)毒力因子特点和耐药性,并分析UPEC对核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)表达的影响。方法 选取2019年1月-2021年5月海口市骨科与糖尿病医院105例糖尿病合并UPEC感染患者为感染组,46例无泌尿系统感染的糖尿病患者为非感染组。收集感染组尿液分离UPEC以及非感染组粪便分离大肠埃希菌。检测大肠埃希菌毒力因子,并进行药敏试验。检测NLRP3 mRNA及NLRP3蛋白表达量、血清半胱氨酸蛋白酶(Caspase)-1、核转录因子(NF)-κB、白细胞介素(IL)-1β、IL-18水平。结果 感染组UPEC毒力因子相关基因papC、fimH、hly、cnf1、aer的检出率分别为100.00%、51.43%、60.00%、35.24%、62.86%,非感染组检出率为0.00%、15.22%、10.87%、6.52%、28.26%(P<0.05)。感染组NLRP3 mRNA及NLRP3蛋白表达量均高于非感染组(P<0.05)。感染组血清Caspase-1、NF-κB、IL-1β和IL-18水平均高于非感染组(P<0.05)。结论 UPEC毒力因子相关基因papC、fimH、hly、cnf1、aer检出率较高,多药耐药严重,糖尿病患者UPEC感染的机制可能与NLRP3炎症小体激活有关。OBJECTIVE To explore the virulence factors and drug resistance of uropathogenic Escherichia coli(UPEC) in diabetes mellitus patients complicated with urinary tract infection and analyze the influence of UPEC on expression of nucleotide binding oligomerization domain like receptors family pyrin domain protein 3(NLRP3). METHODS A total of 105 diabetes mellitus patients complicated with UPEC infection who were treated in Orthopedics and Diabetes Hospital in Haikou from Jan 2019 to May 2021 were assigned as the infection group, and 46 diabetes mellitus patients who did not have urinary system infection were chosen as the no infection group. The UPEC strains were isolated from urine specimens of the infection group, and E.coli strains were isolated from stool specimens of the no infection group. The virulence factors of the E.coli strains were detected, and the drug susceptibility testing was performed. The expression levels of NLRP3 mRNA and NLRP3 proteins were detected, and the levels of serum caspase-1, nuclear factor-κB(NF-κB), interleukin-1β(IL-1β) and interleukin-18(IL-18) were detected. RESULTS The detection rates of UPEC virulence factors-related genes papC, fimH, hly, cnf1 and aer of the infection group were respectively 100.00%, 51.43%, 60.00%, 35.24% and 62.86%;the detection rates of the no infection group were respectively 0.00%, 15.22%, 10.87%, 6.52% and 28.26%(P<0.05). The expression levels of NLRP3 mRNA and NLRP3 proteins of the infection group were significantly higher than those of the on infection group(P<0.05). The levels of serum Caspase-1, NF-κB, IL-1β and IL-18 of the infection group were significantly higher than those of the no infection group(P<0.05). CONCLUSION The detection rates of the UPEC virulence factors-related genes papC, fimH, hly, cnf1 and aer are high, the strains are highly multidrug-resistant. The mechanisms of UPEC infection in the diabetes mellitus patients may be associated with the activation of NLRP3 inflammasome.

关 键 词：糖尿病 尿道致病性大肠埃希菌 毒力因子 核苷酸结合寡聚化结构域样受体蛋白3 耐药性 

分 类 号：R587.1[医药卫生—内分泌]