儿童尿路感染大肠埃希菌耐药性特点及黏附素基因表达研究  

Drug resistance characteristics and adhesin gene expression of Escherichia coli in children with urinary tract infection

作　　者：陈妍妍 赵青 CHEN Yanyan;ZHAO Qing(Department of Clinical Laboratory,Baoding Hospital,Beijing Children's Hospital,Capital Medical University,Hebei Key Laboratory of Infectious Diseases Pathogenesis and Precise Diagnosis and Treatment,Baoding,Hebei 071000,China)

机构地区：[1]首都医科大学附属北京儿童医院保定医院检验科,河北省儿童感染性疾病发病机制及精准诊治研究重点实验室,河北保定071000

出　　处：《热带医学杂志》2024年第9期1247-1251,1273,共6页Journal of Tropical Medicine

基　　金：河北省重点科技研究计划项目(2241ZF369,20232038)。

摘　　要：目的探讨儿童尿路感染大肠埃希菌耐药性特点及黏附素基因表达。方法选择2019年10月1日-2022年10月1日首都医科大学附属北京儿童医院保定医院尿液样本分离的非重复感染大肠埃希菌160株,并进行药敏试验。根据药敏试验结果分为敏感组(n=80)和耐药组(n=80)。PCR检测fimH、fimA、fimB、papA、papB、papC、papGII基因,实时荧光定量PCR方法检测相对表达量,酵母细胞黏附试验和红细胞凝集试验检测I型菌毛及P型菌毛的黏附能力。结果敏感组对氨苄西林、磺胺甲噁唑/甲氧苄啶、左氧氟沙星的耐药率>10%,对环丙沙星、头孢唑林、妥布霉素和氨曲南的耐药率<10%,对其他抗生素则完全敏感;耐药组对头孢哌酮/舒巴坦和亚胺培南耐药率≤4%,对其他抗生素的耐药率均>50%。耐药组P型菌毛papGII基因检出率(40.00%)显著高于敏感组(15.00%),差异有统计学意义(χ^(2)=12.541,P<0.05);两组papA、papB和papC基因检出率差异均无统计学意义(P均>0.05)。敏感组fimH、fimB、papB、papC和papGII基因表达量高于耐药组,差异均有统计学意义(t=20.575、33.727、3.095、19.461、4.275,P均<0.05);两组fimA、papA基因表达量比较差异均无统计学意义(P均>0.05)。敏感组菌株I型菌毛的黏附率高于耐药组,差异有统计学意义(χ^(2)=13.231,P<0.05)。结论耐药组I型菌毛的黏附能力下降与菌株的适应性代价有关,fim及pap基因簇编码的其他基因的转录和缺失可能对Ⅰ型菌毛及P型菌毛的黏附功能产生影响。Objective To investigate the drug resistance characteristics and adhesion gene expression of Escherichia coli in children with urinary tract infection.Methods A total of 160 non⁃repeated Escherichia coli strains isolated from urine samples in Baoding Hospital,Beijing Children's Hospital,Capital Medical University from October 1,2019 to October 1,2022 were selected for drug sensitivity test.According to the results of drug sensitivity test,they were divided into sensitive group(n=80)and resistant group(n=80).The fimH,fimA,fimB,papA,papB,papC and papGII genes were detected by PCR.The relative expression levels were detected by real⁃time fluorescence quantitative PCR.The adhesion ability of type I fimbriae and type P fimbriae was detected by yeast cell adhesion test and red blood cell agglutination test.Results The resistance rate of the sensitive group to ampicillin,sulfamethoxazole/trimethoprim and levofloxacin was>10%,the resistance rate to ciprofloxacin,cefazolin,tobramycin and amtronam was<10%,and the resistance rate to other biochemicals was completely sensitive.The resistance rate of resistant group to cefoperazone/sullbactam and imipenem was≤4%,and the resistance rate to other biochemicals was>50%.The detection rate of papGII gene in the resistant group(40.00%)was significantly higher than that in the sensitive group(15.00%)(χ^(2)=12.541,P<0.05);There was no significant difference in the detection rate of papA,papB and papC genes between two groups(all P>0.05).The expression levels of fimH,fimB,papB,papC and papGII genes in the sensitive group were higher than those in the resistant group(t=20.575,33.727,3.095,19.461,4.275;all P<0.05);There was no significant difference in the expression levels of fimA and papA genes between the two groups(both P>0.05).The adhesion rate of type I pili in the sensitive group was higher than that in the resistant group(χ^(2)=13.231,P<0.05).Conclusions The decrease of adhesion ability of type I fimbriae in the resistant group was related to the adaptive cost of the stra

关 键 词：儿童 尿路感染 大肠埃希菌 耐药性 黏附素基因 

分 类 号：R378.2[医药卫生—病原生物学]