多重耐药尿道致病性大肠埃希菌的毒力和耐药基因研究

Study on the virulence and drug resistance genes of Uropathogenic Escherichia coli with multidrug resistance

目的统计尿道致病性大肠埃希菌的抗生素敏感性,研究多重耐药尿道致病性大肠埃希菌毒力与耐药基因的分布。方法收集浙江省中医院2015年1月-12月分离的尿道致病性大肠埃希菌,K-B法检测其对不同抗生素的敏感性,PCR扩增与UPEC密切相关的毒力基因(fimH、sfaDE、papEF、afaBfimH、sfaDE、papEF、afaBC、iucD和kpsMTⅡ)和ESBLs基因(blaCTX-M-1、blaCTX-M-2、blaCTX-M-9、blaCTX-M-8、blaCTX-M-25、blaSHV、blaTEM、blaVEB-1和blaPER-1)。结果 136株尿道致病性大肠埃希菌中115株为多重耐药株,对碳青霉烯类敏感性最高,青霉素类敏感性最低。ESBLs基因以TEM和CTX-M-9为主,毒力基因结果显示UPECⅠ型菌毛基因fimH的检出率最高,为91.1%,其次为铁载体基因incD和kpsMTⅡ。结论尿道致病性大肠埃希菌临床耐药率较高,且大多含毒力基因,毒力基因与耐药基因之间存在相关性,大肠埃希菌毒力基因可加重耐药,应引起临床重视。

Objective To study the antibiotic susceptibility of Uropathogenic Escherichia coli（ UPEC）, and find the distribution and correlation of the virulence and drug resistance genes of multi drug resistant Uropathogenic Escherichia coli. Mothods Uro- pathogenic Escherichia coli isolated from Zhejiang Province Traditional Chinese Medical Hospital from January to December in 2015 was collected. Antimicrobial susceptibility testing was performed by the Kirby - Bauer method. PCR was used to amplify the virulence genes closely related with UPEC （fimH, s faDE, papEF, afaBfimH, sfaDE, papEF, afaBC, iucD and kpsMT II） and ESBLs genes（ blaCTX - M -1, blaCTX - M - 2 , blaCTX - M - 9 , blaCTX - M - 8 , blaCTX - M - 25 , blaSHV, blaTEM , blaVEB - 1 and blaPER - 1 ）. Results 115 of 136 strains of Uropathogenic Escherichia coli were the multiresistant strains. The sensitivity to carbapenems was the highest, and that of penicillin was the lowest. The ESBLs gene were mainly TEM and CTX - M-9. The results showed that the detection rate of UPEC I type I fimbriae gene fimH was the highest, up to 91.1%, followed by the genes of incD and kpsMT II. Conclusion The UPEC isolates exhibited high rates of resistance. Most of them exhibited virlence genes. There was a correlation between virulence genes and resistance genes. The virulence genes of Escherichia coli can increase the resistance, which should be paid more attention to.