摘要
目的:通过检测不同来源肠外致病性大肠埃希菌(ExPEC)多种毒力因子基因检出情况及耐药情况,初步探讨两者相关性,了解Ex PEC毒力与耐药相互关系。方法:187株分离自尿液及其他部位的菌株,分别检测其毒力因子基因的存在情况及耐药情况,χ~2检验比较不同来源菌株毒力因子基因检出率及耐药率有否差异,Logistic回归模型分析菌株毒力因子检出率与菌株耐药率相关性。结果:ExPEC中毒力基因kpsMT Ⅱ、pap C、PapEF、papG allele II(Internal)、papA、cnf1、sfa/focDE、K5和rfc在非尿液来源比尿液来源检出率更高;尿液来源环丙沙星、左旋氧氟沙星和哌拉西林/他唑巴坦的耐药情况均显著高于非尿液来源菌株;Logistic回归模型分析表明共有11种毒力基因与其相对应的抗菌药物耐药有相关性,其中9种毒力基因抑制菌株耐药发生,1种毒力基因促进菌株耐药发生,另有1种毒力基因在不同药物中有相反作用。结论:ExPEC由于受到环境与抗菌药物的选择压力不同,其毒力因子检出情况及耐药情况也会有差异,ExPEC毒力因子与菌株耐药情况关系密切。
Objective ：To investigate the association of extra-intestinal pathogenic E.coli （ExPEC） clinical isolates and resistance. Methods：A total of 187 ExPEC clinical isolates were investigated. Multiplex PCR and the minimum inhibitory concentrations （MICs） of antimicrobials were performed to detect the virulence factors and resistance among the 187 E. coli strains isolates. The comparisons of proportions between groups were carried out by using χ^2 test and Logistic regression. Results：The virulence factor genes kpsMT II, papC, PapEF, papG allele II （Internal）, papA, cnf1, sfa/focDE, K5 and rfc had higher detection rates in non-urinary tract group than urinary tract group. The antimicrobial drugs CIP, LVX and TZP had higher resistance rates in urinary tract group than non-urinary tract group. Logistic regression analysis showed 9 kinds of virulence factor genes detected were independent protective factors for resistance of ExPEC, and one was independent risk factors for resistance of ExPEC. And another one had the two functions. Conclusion：Due to the different microenvironment and the selection pressure of antibiotics, the detection rate of virulence factor genes and the resistance rate of ExPEC are different, and the two are closely related.
作者
刘双庆
李娟
陈妍妍
曹阳
魏殿军
LIU Shuang-qing LI Juan CHEN Yan-yan CAO Yang WEI Dian-jun(Department of Clinical Laboratory, The Second Hospital , Tianjin Medical University, Tianjin 300211,China Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Logistics University of Chinese People＇s Armed Police Force,Tianjin 300162,China)
出处
《天津医科大学学报》
2017年第4期349-353,共5页
Journal of Tianjin Medical University
