尿路感染大肠埃希菌耐药特点与种系分型和遗传相关性分析

Analysis on the resistant characterization,phylogenetic grouping and genetic relatedness of Escherichia coli in urinary tract infection

目的分析尿路感染大肠埃希菌的耐药特点、种系分型和遗传相关性,并对比其在医院和社区感染中的差异。方法对2010年非重复分离185株尿路感染大肠埃希菌进行敏感性测定、超广谱β-内酰胺酶(ESBLs)筛查、种系分型、同源性及统计学分析。结果细菌对多种药物的耐药率>49.0%。185株细菌均有很大的遗传多样性,产酶率为78.4%。D型大肠埃希菌最为常见(49.7%),其ESBLs的产生率与头孢噻肟等的耐药性相关(P<0.05)。上述各因子在医院和社区感染菌株中差异无统计学意义(P>0.05)。结论本研究尿路感染主要由D型大肠埃希菌引起,这些细菌呈遗传多样性,高产ESBLs,对多种抗菌药物耐药。

Objective To analyze the resistant characterization, phylogenetic grouping and genetic relatedness of Escherichia coli in urinary tract infection, and compare the differences of these factors among the hospital and community infections. Methods A total of 185 non-duplicate Escherichia coli in urinary tract infection were analyzed for sensitivities, extended spectrum beta-lactamases （ESBLs） screening, phylogenetic grouping and genetic relatedness, and the results were analyzed statistically. Results The resistance rates to multiple antibiotics were 〉 49.0%. A total of 185 isolates displayed a high diversity, and the prevalence of ESBLs was 78.4%. Phylogroup D Escherichia coli was the most frequent（49.7% ）, and the correlation between the production rate of ESBLs and resistance to cefotaxime was observed （P 〈 0.05 ）. Additionally, there was no statistical significant on the distribution of the factors between the hospital and community infections （P 〉 0. 05 ）. Conclusions Urinary tract infection is mainly caused by the phylogroup D Escherichia coli which displays a high diversity of genetic relatedness. High-produced ESBLs are multiple resistant to antibiotics.