糖尿病肾病患者尿路大肠埃希菌感染状况及其耐药和毒力基因分析  

Infection status,drug resistance and virulence gene of urinary tract Escherichia coli in patients withdiabetes nephropathy

作　　者：杨自坚 韩晶[1] 韩琨元 Yang Zijian;Han Jing;Han Kunyuan(Medical Laboratory Centre,Anyang People's Hospital,Anyang 455000,China;Department Anaesthesiology,Anyang People's Hospital,Anyang 455000,China)

机构地区：[1]河南省安阳市人民医院医学检验中心,455000 [2]河南省安阳市人民医院麻醉科,455000

出　　处：《临床医学》2024年第11期7-11,共5页Clinical Medicine

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230858)。

摘　　要：目的 探讨糖尿病肾病患者合并尿路大肠埃希菌感染状况及其耐药和毒力基因情况。方法 选择2022年1月至2023年12月安阳市人民医院收治的116例糖尿病肾病合并尿路大肠埃希菌感染患者为观察组,同时选取100例单纯尿路大肠埃希菌感染患者为对照组。比较两组产超广谱-内酰胺酶(ESBLs)菌株检出率、抗菌药物耐药率及毒力基因差异。结果 观察组ESBLs菌株检出率为41.38%(48/116),明显高于对照组(19.00%,19/100,P<0.05)。观察组环丙沙星、左氧氟沙星、头孢吡肟和头孢曲松耐药率分别为62.93%、61.21%、41.38%和40.52%,明显高于对照组(39.00%,36.00%,25.00%,27.00%,P<0.05)。观察组ESBLs菌株氨曲南、环丙沙星、左氧氟沙星、头孢吡肟、头孢曲松和庆大霉素耐药率分别为64.58%、87.50%、83.33%、66.67%、72.92%和64.58%,明显高于非ESBLs菌株(P<0.05)。观察组和对照组毒力基因iut A基因、pap GalleleⅡ(Internal)基因、pap C基因和kps MⅡ基因检出率比较,差异未见统计学意义(P>0.05)。结论 相较于单纯尿路大肠埃希菌感染,糖尿病肾病合并尿路大肠埃希菌毒力基因无明显差异,但ESBLs检出率较高,对环丙沙星、左氧氟沙星等抗菌药物耐药性较高,且ESBLs菌株耐药性高。Objective To investigate the status of urinary tract Escherichia coli infection,drug resistance and virulence genes in patients with diabetes nephropathy.Methods A total of 116 patients with diabetes nephropathy complicated with urinary tract Escherichia coli infection treated in Anyang People's Hospital from January 2022 to December 2023 were selected as the observation group,and 100 patients with simple urinary tract Escherichia coli infection were selected as the control group.The detection rate of Extended-Spectrumβ-Lactamases(ESBLs),antibiotic resistance rate,and virulence gene differences between two groups were compared.Results The detection rate of ESBLs strains in the observation group was 41.38%(48/116),which was significantly higher than that in the control group(19.00%,19/100,P<0.05).The drug resistance rates of ciprofloxacin,levofloxacin,Cefepime and Ceftriaxone in the observation group were 62.93%,61.21%,41.38%,and 40.52%,respectively,which was significantly higher than those in the control group(39.00%,36.00%,25.00%,27.00%,P<0.05).The drug resistance rates to ampicillin,ciprofloxacin,levofloxacin,Cefepime,Ceftriaxone and gentamicin of ESBLs strains in the observation group were 64.58%,87.50%,83.33%,66.67%,72.92%,and 64.58%,respectively,which were significantly higher than those of non ESBLs strains(27.94%,45.59%,45.59%,23.53%,17.65%,30.88%,P<0.05).There was no significant difference in the detection rates of virulence genes iut A gene,pap Gallery II(Internal)gene,pap C gene,and kps M II gene between the observation group and the control group(P>0.05).Conclusions Compared with simple urinary tract Escherichia coli infection,there is no significant difference in virulence genes of urinary tract Escherichia coli in patients with diabetes nephropathy,but the detection rate of ESBLs is high,and the resistance to ciprofloxacin,levofloxacin and other antibiotics is high,and the resistance of ESBLs strains is high.

关 键 词：糖尿病肾病 尿路感染 大肠埃希菌 耐药 毒力基因 

分 类 号：R446.5[医药卫生—诊断学] R587.2[医药卫生—临床医学] R692.9