發(fā)布時(shí)間：2019-04-19 18:00

【摘要】：[目的]探討尿源大腸桿菌毒力因子的分布及其與耐藥性之間的關(guān)系。 [方法]本文對(duì)1992～2004年天津市5所醫(yī)院確診為尿路感染的門珍和住院患者尿標(biāo)本中分離的81株大腸桿菌用PCR方法擴(kuò)增其黏附基因群上的papC基因和1型菌毛黏附素fimH基因;采用多重PCR方法擴(kuò)增尿源大腸桿菌溶血素hly、細(xì)胞壞死因子1cnfl、產(chǎn)氣桿菌素aer等毒力因子基因;用紙片擴(kuò)散法(K-B法)對(duì)尿源大腸桿菌進(jìn)行15種抗菌藥物的敏感試驗(yàn)。 [結(jié)果]根據(jù)papC基因擴(kuò)增結(jié)果將尿源大腸桿菌分為兩組,papC陽性組作為具有P菌毛的致腎盂腎炎大腸桿菌(Pyelonephritic E.coli,UPEC)組,papC陰性組作為不具有P菌毛的非UPEC組,前者占50.6%(41/81),后者占49.4%(40/81)。其他毒力因子hly,aer,fimH及cnfl的總檢出率為67.9%(55/81);UPEC組上述四種毒力因子的檢出率依次為63.41%、60.98%、53.66%和34.15%;非UPEC組依次為10%、35%、12.5%和5%;經(jīng)列聯(lián)表資料x~2檢驗(yàn)表明兩組之間四種毒力因子的檢出率均有統(tǒng)計(jì)學(xué)意義(P0.01)。進(jìn)一步分析發(fā)現(xiàn),UPEC組hty和cnfl同時(shí)陽性占31.71%,cnfl陽性菌株中只有一株向hly陰性,cnfl陽性菌株中87.5%攜帶papC基因,hly陽性菌株中86.67%攜帶papC基因。藥敏試驗(yàn)結(jié)果顯示,尿源大腸桿菌對(duì)15種藥物的總耐藥率為87.65%(71/81),耐三種藥物以上的多重耐藥率為69.14%(56/81)。對(duì)青霉素類抗生素氨芐西林和羧芐西林的耐藥率最高,分別為88.89%和85.19%。其次是壞丙沙星、氧氟沙星、復(fù)方磺胺和慶大霉素,分別為56.79%、56.79%、54.32%和45.68%。再次是頭孢唑林、頭孢噻肟、氨曲南和阿米卡星,分別為41.98%、29.63%、23.46%和11.11%。頭孢他啶、頭孢匹肟、呋喃妥因和亞胺培南的耐藥率最低,分別為
[Abstract]:[objective] to investigate the distribution of virulence factors in urine-derived Escherichia coli and its relationship with drug resistance. [methods] 81 strains of Escherichia coli isolated from urine samples of Mengzhen and inpatients with urinary tract infection diagnosed as urinary tract infection in 5 hospitals of Tianjin in 1992-2004 were used to amplify the papC gene and fimH gene of mucin type 1 in the adhesion gene group by PCR. The virulence factor genes such as hemolysin hly, cell necrosis factor 1cnfland pneumogenin aer were amplified by multiplex PCR, and the susceptibility tests of 15 antimicrobial agents were carried out by disk diffusion method. [results] according to the results of papC gene amplification, the urine-derived Escherichia coli was divided into two groups. The papC-positive group was used as the Pyelonephritic E. coli (UPEC) group with P-pili, and the papC-negative group was regarded as the non-UPEC group without P-pili. The former accounted for 50.6% (41 / 81) and the latter 49.4% (40 / 81). The positive rates of other virulence factors hly,aer,fimH and cnfl were 67.9% (63.41%, 60.98%, 53.66% and 34.15%, respectively) in 55 / 81); UPEC group. The non-UPEC group was 10%, 35%, 12.5% and 5%, respectively, and the detection rate of the four virulence factors between the two groups was statistically significant (P0.01). Further analysis showed that the positive rate of both hty and cnfl in UPEC group was 31.71%, only one positive strain of CNF1 was negative to hly, 87.5% of cnfl positive strains carried papC gene, 86.67% of hly positive strains carried papC gene. The results of drug sensitivity test showed that the total resistance rate of urine-derived Escherichia coli to 15 drugs was 87.65% (71 / 81), and the multiple drug resistance rate of more than three drugs was 69.14% (56 / 81). The resistance rates to penicillin antibiotics ampicillin and carbenicillin were 88.89% and 85.19%, respectively. It was followed by ciprofloxacin, ofloxacin, sulfamide and gentamicin (56.79%, 56.79%, 54.32% and 45.68%, respectively). The third was cefazolin, cefotaxime, aztreonam and amikacin, which were 41.98%, 29.63%, 23.46% and 11.11%, respectively. The resistance rates of ceftazidime, cefpixime, furantoin and imipenem were the lowest, respectively.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2006
【分類號(hào)】：R378.2

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