[1]彭维林,黄慰慰,王茵娜,等.儿童泌尿系统感染患者尿液分离大肠埃希菌的毒力基因及抗生素耐药分析[J].现代检验医学杂志,2025,40(03):158-163.[doi:10.3969/j.issn.1671-7414.2025.03.029]
　PENG Weilin,HUANG Weiwei,WANG Yinna,et al.Virulence Gene and Antimicrobial Resistance Analysis of E.coli Isolated from Urine of Children with Urinary System Infection[J].Journal of Modern Laboratory Medicine,2025,40(03):158-163.[doi:10.3969/j.issn.1671-7414.2025.03.029]
点击复制

儿童泌尿系统感染患者尿液分离大肠埃希菌的毒力基因及抗生素耐药分析()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年03期
页码:
158-163
栏目:
论著
出版日期:
2025-05-15

文章信息/Info

Title:
Virulence Gene and Antimicrobial Resistance Analysis of E.coli Isolated from Urine of Children with Urinary System Infection
文章编号:
1671-7414（2025）03-158-06
作者:
彭维林1,2，黄慰慰1,2，王茵娜1,2，雷 莹1,2，杨惠鑫1,2
(1.泉州市妇幼保健院?儿童医院检验科，福建泉州 362000；2.华侨大学附属妇儿医院检验科，福建泉州 362000)
Author(s):
PENG Weilin1,2，HUANG Weiwei1,2，WANG Yinna1,2，LEI Ying1,2，YANG Huixin1,2
(1. Department of Clinical Laboratory, Quanzhou Maternity and Child Health Care Hospital＆Children’s Hospital，Fujian Quanzhou 362000， China；2. Department of Clinical Laboratory, Maternity and Children’s Hospital of Huaqiao University，Fujian Quanzhou 362000，China)
关键词:
儿童; 泌尿系统感染; 大肠埃希菌; 毒力基因; 抗生素
分类号:
R691.3；R378.21；R446.5
DOI:
10.3969/j.issn.1671-7414.2025.03.029
文献标志码:
A
摘要:
目的分析引起儿童泌尿系统感染（USI）大肠埃希菌（E.coli）分离株的毒力基因及抗生素耐药性，进一步了解USI患儿分离E.coli的流行特征。方法收集2021年1～12月泉州市妇幼保健院?儿童医院收治的泌尿系统感染儿童，从患儿尿液中分离出E.coli，采用仪器检测对15种临床常用抗生素的敏感度，其中33株提示产超广谱β-内酰胺酶（ESBL）的E.coli进行增菌，提取基因组DNA，利用高通量测序技术对菌株全基因组序列进行分析。结果33株E.coli基因序列分析中，获得86种毒力基因，细菌结构性毒力基因占比最多（43/86），包括荚膜、菌毛及细胞膜体系，其次是细菌功能性毒力基因和产毒素基因，而fimH，fdeC，terC毒力基因检出率最高。耐药性分析中，头孢唑林（96.97%）耐药性最强，也发现碳青霉烯类抗生素耐药；并获得39种直接灭活基因、18种位点改变基因和51种外排系统基因。药物外排基因相关信息最多（1273/1815），以RND和MFS超家族外排泵为主，每株E.coli基因组中存在19～43种外排泵耐药基因；且发现多种β-内酰胺酶抗性基因，以CTX-M家族、EC家族、TEM家族为主。结论USI患儿尿液分离产ESBL-E.coli中，仍要继续对β-内酰酶进行监测，毒力基因fimH，fdeC，terC及acrAB/emrAB/mdtABC-TolC外排泵基因携带率较高，应该引起更多关注。
Abstract:
Objective To analyze the virulence genes and antibiotics resistance of Escherichia coli (E. coli) isolates cause urinary tract infection (USI) in children,and further understand the epidemiological characteristics of E. coli isolates in children with USI. Methods Children with urinary system infection admitted to Quanzhou Maternity and Child Health Care Hospital＆Children’s Hospital from January to December 2021 were collected. E. coli was isolated from urine, and the drug sensitivity of the E.coli to 15 commonly used clinical antibiotics was detected by instruments. Among them, 33 strains of E.coli that showed Extended-spectrum beta-lactamase (ESBL) production were increased, genomic DNA was extracted, and the whole genome sequence of the strains was analyzed by high-throughput sequencing technology. Results In the gene sequence analysis of 33 strains of E.coli, 86 virulence genes were obtained, and the bacterial structural virulence genes accounted for the most (43/86), including capsular, fimbriae and cell-membrane system, followed by functional virulence genes and toxigenic genes, while fimH, fdeC and terC virulence genes had the highest detection rates. In the analysis of drug resistance, Cefazolin (96.97%) was the most resistant, and carbapenems were also found to be resistant. In addition, 39 inactivation genes, 18 target alteration genes and 51 e?ux system genes were obtained. The most information related to antibiotic e?ux (1 273/1 815), mainly RND and MFS superfamily e?ux pumps. There were 19～43 drug resistance genes in each E.coli genome. A variety of β-lactamase resistance genes were found, in which CTX-M/EC/TEM gene family dominated. Conclusion In the urine isolation of ESBL-producing E.coli in USI children, the β-lactamase should continue to be monitored. Virulence genes fimH, fdeC, terC and acrAB/emrAB/mdtABC-TolC e?ux pump gene detected higherratio, should be more attention.

参考文献/References:

[1] 全国细菌耐药监测网.2018至2022年0~14岁患儿细菌耐药监测研究[J].中华儿科杂志,2023,61(11): 1001-1010. Chinese Antimicrobial Resistance Surveillance System.Surveillance of bacterial resistance in children aged 0～14 years from 2018 to 2022 [J]. Chinese Journal of Pediatrics, 2023, 61(11): 1001-1010.
[2] 包瑛,骞佩.儿童泌尿系统感染诊治进展[J].中华实用儿科临床杂志,2020,35(5):331-337. BAO Ying, QIAN Pei. Advances in diagnosis and treatment of urinary tract infection in children [J]. Chinese Journal of Applied Clinical Pediatrics, 2020, 35(5): 331-337.
[3] 潘芬,王春,张泓,等.2015～2021年CHINET儿童患者分离的肠杆菌目细菌耐药性变迁[J].中国感染与化疗杂志,2024,24(1):53-63. PAN Fen, WANG Chun, ZHANG Hong, et al. Changing antibiotic resistance profiles of Enterobacterales strains isolated from children: data from CHINET antimicrobial resistance surveillance program，2015-2021[J]. Chinese Journal of Infection and Chemotherapy, 2024, 24(1): 53-63.
[4] GARC?A V, LEST?N L, PARGA A, et al. Genomics， biofilm formation and infection of bladder epithelial cells in potentially uropathogenic Escherichia coli (UPEC) from animal sources and human urinary tract infections (UTIs) further support food-borne transmission [J].One Health(Amsterdam， Netherlands),2023,16:100558.
[5] 尿路感染诊断与治疗中国专家共识编写组.尿路感染诊断与治疗中国专家共识(2015版)-尿路感染抗菌药物选择策略及特殊类型尿路感染的治疗建议[J].中华泌尿外科杂志,2015,36(4):245-248. Chinese Expert Consensus Writing Group for Diagnosis and Treatment of Urinary Tract Infections. Chinese Expert Consensus on diagnosis and treatment of urinary tract infection(2015 Edition)-selection strategy of antimicrobial agents for urinary tract infections and treatment suggestions for special types of urinary tract infections[J]. Chinese Journal of Urology, 2015, 36(4): 245-248.
[6] Clinical and Laboratory Standards Institute. CLSI M100-S30：Performance standards for antimicrobial susceptibility testing - 31st ed [S].Wayne：PA， Clinical and Laboratory Standards Institute，2021.
[7] LIU Bo, ZHENG Dandan, ZHOU S Yiyu, et al. VFDB 2022: a general classification scheme for bacterial virulence factors[J]. Nucleic Acids Research, 2022, 50(D1): D912-D917.
[8] WANG Mingcheng, FAN Yuhua, ZHANG Yenzhen, et al. Characterization of uropathogenic Escherichia coli phylogroups associated with antimicrobial resistance, virulence factor distribution, and virulence-related phenotypes [J]. Infection, Genetics and Evolution， 2023,114:105493.
[9] 吕卓煊,胡权洁,张凤,等.尿路致病性大肠埃希菌致病机制研究进展[J].中华微生物学和免疫学杂志, 2024, 44(10):860-870. L? Zhuoxuan, HU Quanjie, ZHANG Feng, et al. Advances in the pathogenic mechanisms of uropathogenic Escherichia coli [J]. Chinese Journal of Microbiology and Immunology, 2024, 44(10): 860-870.
[10] WHELAN S, LUCEY B, FINN K. Uropathogenic Escherichia coli(UPEC)-associated urinary tract infections: the molecular basis for challenges to effective treatment[J]. Microorganisms, 2023, 11(9): 2169.
[11] LOPATKIN A J, BENING S C, MANSON A L, et al. Clinically relevant mutations in core metabolic genes confer antibiotic resistance[J]. Science (New York, N.Y.), 2021, 371(6531): eaba0862.
[12] GOETZ J A, KUEHFUSS N M, BOTSCHNER A J, et al. Exploring functional interplay amongst Escherichia coli efflux pumps [J]. Microbiology (Reading，England)，2022, 168(11):001261.
[13] 宋少娜,张碧丽,王文红,等.儿童社区获得性泌尿道感染产超广谱β-内酰胺酶大肠埃希菌的耐药性及危险因素分析[J].中华实用儿科临床杂志,2019,34 (17):1331-1334. SONG Shaona, ZHANG Bili, WANG Wenhong, et al. Analysis of drug resistance and risk factors of community-acquired urinary tract infection caused by extended-spectrum β-lactamase-producing Escherichia coli in children [J]. Chinese Journal of Applied Clinical Pediatrics, 2019, 34(17): 1331-1334.
[14] 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(2):12-14, 19. CHEN Fei, CAO Xiaoli, 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(2): 12-14, 19.
[15] 孟文凯,包志瑶,李庆云.肠杆菌科细菌AcrAB-TolC外排泵调控机制及对策的研究进展[J].中国药物与临床,2021,21(19):3280-3282. MENG Wenkai, BAO Zhiyao, LI Qingyun. Research progress on the regulatory mechanism and countermeasures of Enterobacteriaceae AcrAB-TolC e?ux pump[J]. Chinese Remedies & Clinics, 2021, 21(19): 3280-3282.
[16] KEREK ?, T?R?K B, LACZK? L, et al. In vitro microevolution and co-selection assessment of amoxicillin and cefotaxime impact on Escherichia coli resistance development[J]. Antibiotics (Basel, Switzerland), 2024, 13(3): 247.
[17] GONYAR L A, SAUDER A B, MORTENSEN L, et al. The yad and yeh fimbrial loci influence gene expression and virulence in enterohemorrhagic Escherichia coli O157:H7 [J]. mSphere, 2024, 9(7): e0012424.
[18] 陈妍妍,赵青.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[J].热带医学杂志,2024,24 (9):1247-1251, 1273. CHEN Yanyan, ZHAO Qing. Drug resistance characteristics and adhesin gene expression of Escherichia coli in children with urinary tract infection[J]. Journal of Tropical Medicine, 2024, 24(9): 1247-1251, 1273.
[19] ALEKSANDROWICZ A, KJ?RUP R B, GRZYMAJ?O K, et al. FdeC expression regulates motility and adhesion of the avian pathogenic Escherichia coli strain IMT5155[J]. Veterinary Research, 2024, 55(1): 70.
[20] ZHANG Rong, SHEN Yingbo, WALSH T R, et al. Use of polymyxins in Chinese hospitals[J]. the Lancet-Infectious Diseases, 2020, 20(10): 1125-1126.
predicts poor prognosis in multiple myeloma[J].International Journal of Laboratory Hematology, 2023, 45(3): 317-327.
?

相似文献/References:

[1]安 娜,刘运双,陈 曦,等.儿童肺炎支原体感染与血清维生素D水平的相关研究[J].现代检验医学杂志,2016,31(02):117.[doi:10.3969/j.issn.1671-7414.2016.02.035]
　AN Na,LIU Yun-shuang,CHEN Xi,et al.Relationship of the Mycoplasma Pneumonia Infection and Vitamin D levels in Children[J].Journal of Modern Laboratory Medicine,2016,31(03):117.[doi:10.3969/j.issn.1671-7414.2016.02.035]
[2]张月芳,马芳莲,朱亚宁,等.儿童抗幽门螺旋杆菌感染治疗对肠道菌群影响的研究[J].现代检验医学杂志,2015,30(05):32.[doi:10.3969/j.issn.1671-7414.2015.05.010]
　ZHANG Yue-fanga,MA Fang-lian,ZHU Ya-ningb,et al.Research on the Effects of Anti Helicobacter Pylori Infection on Intestinal Flora of Children[J].Journal of Modern Laboratory Medicine,2015,30(03):32.[doi:10.3969/j.issn.1671-7414.2015.05.010]
[3]唐玉蓉,王际亮,孙婷婷,等.儿童特发性血小板减少性紫癜Th亚群细胞因子的测定及意义[J].现代检验医学杂志,2015,30(05):143.[doi:10.3969/j.issn.1671-7414.2015.05.045]
　TANG Yu-ronga,WANG Ji-lianga,SUN Ting-tinga,et al.Determination and Clinical Significance of Th Subsets Cytokines in ITP of Children[J].Journal of Modern Laboratory Medicine,2015,30(03):143.[doi:10.3969/j.issn.1671-7414.2015.05.045]
[4]吉翔,华芸,张学军.哮喘患儿血清白介素与免疫球蛋白检测的临床意义[J].现代检验医学杂志,2015,30(06):127.[doi:10.3969/j.issn.1671-7414.2015.06.039]
　JI Xiang,HUA Yun,ZHANG Xue-jun.Clinical Significance of Combined Detection of Serum Interleukin and Immune Globulin in Children with Asthma[J].Journal of Modern Laboratory Medicine,2015,30(03):127.[doi:10.3969/j.issn.1671-7414.2015.06.039]
[5]王 玲,尹春燕,肖延风,等.噬血细胞综合征(HPS)的早期鉴别诊断和实验室结果分析[J].现代检验医学杂志,2016,31(04):107.[doi:10.3969/j.issn.16717-414.2016.04.030]
　WANG Ling,YIN Chun-yan,XIAO Yan-feng,et al.Analysis of the Etiology and Clinical Features of Bone Marrow in Children with Hemophagocytic Phenomenon[J].Journal of Modern Laboratory Medicine,2016,31(03):107.[doi:10.3969/j.issn.16717-414.2016.04.030]
[6]黄海林,王海平,张 倩,等.昆明地区儿童脑脊液细菌培养阳性结果分析[J].现代检验医学杂志,2016,31(04):151.[doi:10.3969/j.issn.1671-7414.2016.04.044]
　HUANG Hai-lin,WANG Hai-ping,ZHANG Qian,et al.Analysis of Positive Culture of Cerebrospinal Fluid in Children of Kunming Area[J].Journal of Modern Laboratory Medicine,2016,31(03):151.[doi:10.3969/j.issn.1671-7414.2016.04.044]
[7]肖海军,殷晓晴,张慧莲,等.深圳地区儿童A群致病性链球菌感染流行现状及M蛋白基因分型分析[J].现代检验医学杂志,2016,31(06):51.[doi:10.3969/j.issn.1671-7414.2016.06.014]
　XIAO Hai-jun,YIN Xiao-qing,ZHANG Hui-lian,et al.Analysis of the Prevalence Status and M Protein Gene Classification of A Group Pathogenic Streptococcus Infection of Children in Shenzhen Area[J].Journal of Modern Laboratory Medicine,2016,31(03):51.[doi:10.3969/j.issn.1671-7414.2016.06.014]
[8]招湛静,徐威力,姚雪淦.深圳市大鹏新区儿童小细胞低色素性贫血流行现状及病因探讨[J].现代检验医学杂志,2016,31(06):98.[doi:10.3969/j.issn.1671-7414.2016.06.028]
　ZHAO Zhan-jing,XU Wei-li,YAO Xue-gan.Epidemic Situation and Causes of Children of Cellule Low Pigment Anemia in Shenzhen Dapeng New District[J].Journal of Modern Laboratory Medicine,2016,31(03):98.[doi:10.3969/j.issn.1671-7414.2016.06.028]
[9]招湛静,刘爱胜,刘爱玲,等.深圳地区0～7岁儿童微量元素含量现状调查[J].现代检验医学杂志,2017,32(03):149.[doi:10.3969/j.issn.1671-7414.2017.03.042]
　ZHAO Zhan-jing,LIU Ai-sheng,LIU Ai-ling,et al.Present Situation Investigation of Trace Elements of 0~7 Years Old Children in Shenzhen District[J].Journal of Modern Laboratory Medicine,2017,32(03):149.[doi:10.3969/j.issn.1671-7414.2017.03.042]
[10]李秭瑶,刘 悦,王冬至,等.癫痫患儿丙戊酸治疗后血液氨基酸谱水平变化及临床意义[J].现代检验医学杂志,2017,32(05):24.[doi:10.3969/j.issn.1671-7414.2017.05.007]
　LI Zi-yao,LIU Yue,WANG Dong-zhi,et al.Clinical Significance of the Changes of Amino Acid in Children with Epilepsy on Valproate Monotherapy[J].Journal of Modern Laboratory Medicine,2017,32(03):24.[doi:10.3969/j.issn.1671-7414.2017.05.007]

备注/Memo

备注/Memo:
基金项目：泉州市科技计划项目（No.2020C016R）。
作者简介：彭维林(1968-)，男，硕士，主任技师，研究方向：实验室管理和疾病实验诊断，E-mail：wellpeng@163.com。
通讯作者：杨惠鑫(1989-)，男，硕士，主管技师，研究方向：疾病分子诊断，E-mail：997918781@qq.com
更新日期/Last Update: 2025-05-15