变形菌属引发导尿管相关尿路感染的研究

Catheter-associated Urinary Tract Infection Caused by Proteus spp

目的 通过导尿管相关尿路感染 (UTIs)患者尿道口、导尿管生物被膜和尿液中分离的变形菌属的耐药性和同源性的研究 ,探索变形菌属引发UTIs的机制。方法 对 1999年 12月～ 2 0 0 1年 3月收集的 16 5例UTIs患者尿道口、导尿管和尿液标本变形菌属分离株 ,进行快速鉴定生物被膜 ,药敏实验和脉冲电场凝胶电泳 (PFGE)分析。结果 16 5例UTIs患者中尿道口、尿液和导尿管生物被膜中分别分离出变形菌属 32株 (19.4 % )、18株(10 9% )和 15株 (9.0 9% ) ;12例患者在尿道口、尿液和导尿管生物被膜中均分离到变形菌属 ,且药敏结果相似 ,差异无显著性 (P >0 .0 5 ) ;PFGE结果显示 7例患者的 3部位变形菌属分离株分别为同一菌株或不同亚型菌株。结论 变形菌属生物被膜的形成和逆行感染是引发UTIs的原因。

OBJECTIVE To explore the mechanism of Proteus spp catheter-associated urinary tract infection through the antibiotic-resistance and homogenicity analysis of the clinical Proteus isolates. METHODS Silver-staining method, antibiotics susceptibility test and pulsed-field gel electrophoresis (PFGE) were performed to the Proteus isolates collected from Dec 1999 to Mar 2001. RESULTS Among 165 catheter-associated urinary tract infection patients, 32 Proteus strains (19.4%) were isolated from urinary meatus, 18 strains (10.9%) from urine and 15 strains (9.09%) from urinary catheter biofilm. There were 12 patients that in each patient 3 Proteus strains were isolated separately from urinary meatus, urine and urinary catheter biofilm. The antibiotic susceptibility among the three group isolates from above three sites of the 12 patients had no significant difference (P>0.05). Among 7 of 12 patients, the Proteus isolates of each patient produced same or closely related PFGE pattern which meant same type or subgroup strains. CONCLUSIONS Forming biofilm and retrograde infection are the main reasons for Proteus to cause catheter-associated urinary tract infection.