[1]陈 菲,曹小利,程 莉,等.尿培养产CTX-M大肠埃希菌的种系分型及耐药和毒力特点分析[J].现代检验医学杂志,2016,31(02):12-14,19.[doi:10.3969/j.issn.1671-7414.2016.02.004]
　CHEN Fei,CAO Xiao-li,CHENG Li,et al.Analysis on the Resistance and Virulence Characteristics and Phylogenetic Groups of CTX-M-Producing Escherichia Coli Isolated from Urine[J].Journal of Modern Laboratory Medicine,2016,31(02):12-14,19.[doi:10.3969/j.issn.1671-7414.2016.02.004]
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尿培养产CTX-M大肠埃希菌的种系分型及耐药和毒力特点分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年02期
页码:
12-14,19
栏目:
论著
出版日期:
2016-06-01

文章信息/Info

Title:
Analysis on the Resistance and Virulence Characteristics and Phylogenetic Groups of CTX-M-Producing Escherichia Coli Isolated from Urine
作者:
陈 菲; 曹小利; 程 莉; 张之烽; 徐学静; 宁明哲; 沈 瀚
南京大学医学院附属鼓楼医院检验科,南京 210008
Author(s):
CHEN Fei; CAO Xiao-li; CHENG Li; ZHANG Zhi-feng; XU Xue-jing; NING Ming-zhe; SHEN Han
Department of Medical Laboratory,the Affiliated Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,China
关键词:
CTX-M;  毒力基因;  耐药;  大肠埃希菌
分类号:
R378.21; R446.5
DOI:
10.3969/j.issn.1671-7414.2016.02.004
文献标志码:
A
摘要:
目的 分析尿培养产CTX-M大肠埃希菌的种系分型,耐药及毒力特点,指导尿路感染的临床用药与控制医院感染。方法 收集鼓楼医院2012年尿培养大肠埃希菌,纸片扩散法测定细菌的药物敏感性,双纸片法确定细菌产ESBLs的情况; PCR扩增CTX-M编码基因和毒力基因iutA,ompT,fyuA,fdeC,fimH,traT,cvaC,kpsMT,pap,pAI,usp和chuA; 多重PCR分析产CTX-M大肠埃希菌的种系分型; 采用肠杆菌属重复基因间隔共有序列-PCR(ERIC-PCR)对细菌进行遗传相关性分析; 对比分析产CTX-M组和非产CTX-M组菌株在抗菌药物耐药性和毒力基因之间的差异。结果162株尿培养大肠埃希菌没有遗传相关性; 126株ESBLs阳性菌株中,91株细菌产CTX-M,其中,57株产CTX-M大肠埃希菌属于D型,16株属于B2型。统计学分析发现,ESBLs阳性菌株中,产CTX-M组细菌的耐药率显著高于不产CTX-M组细菌(除亚胺培南外),毒力基因iutA,chuA和traT在产CTX-M细菌组中的流行显著高于非产CTX-M组,P值依次为:0.001,0.006和0.000。结论 产CTX-M大肠埃希菌是鼓楼医院尿路感染的主要致病菌,大多属于D型,其耐药率显著增高,且与毒力基因iutA,chuA和traT密切相关,是尿路感染患者临床治疗的一个潜在威胁。
Abstract:
Objective To analyze the distribution of phylogenetic groups,resistance and virulence characteristics of CTX-M-producing Escherichia coli isolated from urine.Methods 162 urinary Escherichia coli were collected from Gulou hospital during 2012,diskdiffusion test was implemented to determine the susceptibility,PCR was carriedout to detect the CTX-M encoding genes and multiple virulence genes,and Multiplex PCR was used to determine the phylogenetic groups of CTX-M-producing Escherichia coli.Using Enterobacter repetitive intergenic consensus sequence-PCR(ERIC-PCR)genetic correlation analysis of the bacteria.These strains were classified as the CTX-M-producing group and non-CTX-M-producing group according to the results of CTX-M detection,the difference on the distribution of virulence genes were analyzed by Chi-square test.Results There was no genetic correlation between 162 strains of Escherichia coli.Ninety-one isolates out of 162 urinary E.coli were confirmed to produce CTX-M,57 out of 91 CTX-M-producing E.coli were confirmed to be phylogenetic D group and 16 were B2 group.CTX-M-producing isolates displayed an obviously higher resistance rates to the antimicrobial agents tested except imipenem than the non-CTX-M-producing isolates(P<0.05),the prevalence of virulence genes including iutA,chuA and traT was higher than that among non-CTX-M-producing isolates,the P values were 0.001,0.006 and 0.000,respectively.Conclusion Most of the CTX-M-producing E.coli isolates belonging to phylogenetic D group was the main etiological agents for urinary tract infections,leading to a higher resistance rates toward antimicrobialagents frequently used in clinical treatment,in addition,the prevalence of CTX-M were closely related with the virulence genes iutA,chuA and traT,posing apotential threat to the clinical treatment of urinary tract infections.

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备注/Memo

备注/Memo:
基金项目:江苏省青年基金资助(BK2014099); 中央高校基本科研业务费专项资金资助(021414340283)。 作者简介:陈 菲(1991-),女,本科,技师,主要从事临床医学检验,E-mail:1070299160@qq.com。 通讯作者:沈 瀚,硕士,主任技师,E-mail:shenhan10366@sina.com。
更新日期/Last Update: 2016-02-20