中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
5期
543-545
,共3页
马全玲%Kamalsaid Abdallah%魏爱琳%魏殿军
馬全玲%Kamalsaid Abdallah%魏愛琳%魏殿軍
마전령%Kamalsaid Abdallah%위애림%위전군
泌尿道感染%埃希氏菌属%遗传%抗药性
泌尿道感染%埃希氏菌屬%遺傳%抗藥性
비뇨도감염%애희씨균속%유전%항약성
Urinary tract infections%Escherichia%Heredity%Drug resistance
目的 研究老年人尿路感染大肠埃希菌遗传谱系分型与4种常用抗生素耐药性间的关系. 方法 收集天津市3所综合性医院133株老年尿路感染的大肠埃希菌临床分离院内感染株,菌株的药敏试验采用Kirby-Bauer(K-B纸片扩散法)；用煮沸法提取菌株DNA;采用两步三重聚合酶链式反应(PCR)技术对菌株进行遗传谱系分型. 结果 133株老年人尿路感染的大肠埃希菌,对抗生素耐药率最高的是左氧氟沙星占54.1％(72株),最低的是哌拉西林和(或)他唑巴坦占15.0％(20株),差异有统计学意义(Z=51.57,P＜0.01)；遗传谱系分型中A型、B1型、B2型、D型的检出率分别为33株(24.8％)、20株(15.0％)、24株(18.0％)和56株(42.1％),D型与其他类型比较,差异有统计学意义(Z=31.23,P＜0.01).遗传谱系B2型菌株多见于左氧氟沙星敏感株,耐药株、敏感株分别为29.5％(18/61)、8.3％(6/72),差异有统计学意义(x2=10.01,P＜0.01),D型菌株多见于左氧氟沙星耐药株,分别为31.1％ (19/61)与51.4％(37/72),差异有统计学意义(x2=5.55,P＜0.05)；未发现大肠埃希菌4个基因型与其他3种抗生素耐药性有关(均P＞0.05). 结论 遗传谱系分型中D型检出率最高,与左氧氟沙星耐药相关,通过遗传谱系分型可初步判断老年人尿路感染的大肠埃希菌的耐药性.
目的 研究老年人尿路感染大腸埃希菌遺傳譜繫分型與4種常用抗生素耐藥性間的關繫. 方法 收集天津市3所綜閤性醫院133株老年尿路感染的大腸埃希菌臨床分離院內感染株,菌株的藥敏試驗採用Kirby-Bauer(K-B紙片擴散法)；用煮沸法提取菌株DNA;採用兩步三重聚閤酶鏈式反應(PCR)技術對菌株進行遺傳譜繫分型. 結果 133株老年人尿路感染的大腸埃希菌,對抗生素耐藥率最高的是左氧氟沙星佔54.1％(72株),最低的是哌拉西林和(或)他唑巴坦佔15.0％(20株),差異有統計學意義(Z=51.57,P＜0.01)；遺傳譜繫分型中A型、B1型、B2型、D型的檢齣率分彆為33株(24.8％)、20株(15.0％)、24株(18.0％)和56株(42.1％),D型與其他類型比較,差異有統計學意義(Z=31.23,P＜0.01).遺傳譜繫B2型菌株多見于左氧氟沙星敏感株,耐藥株、敏感株分彆為29.5％(18/61)、8.3％(6/72),差異有統計學意義(x2=10.01,P＜0.01),D型菌株多見于左氧氟沙星耐藥株,分彆為31.1％ (19/61)與51.4％(37/72),差異有統計學意義(x2=5.55,P＜0.05)；未髮現大腸埃希菌4箇基因型與其他3種抗生素耐藥性有關(均P＞0.05). 結論 遺傳譜繫分型中D型檢齣率最高,與左氧氟沙星耐藥相關,通過遺傳譜繫分型可初步判斷老年人尿路感染的大腸埃希菌的耐藥性.
목적 연구노년인뇨로감염대장애희균유전보계분형여4충상용항생소내약성간적관계. 방법 수집천진시3소종합성의원133주노년뇨로감염적대장애희균림상분리원내감염주,균주적약민시험채용Kirby-Bauer(K-B지편확산법)；용자비법제취균주DNA;채용량보삼중취합매련식반응(PCR)기술대균주진행유전보계분형. 결과 133주노년인뇨로감염적대장애희균,대항생소내약솔최고적시좌양불사성점54.1％(72주),최저적시고랍서림화(혹)타서파탄점15.0％(20주),차이유통계학의의(Z=51.57,P＜0.01)；유전보계분형중A형、B1형、B2형、D형적검출솔분별위33주(24.8％)、20주(15.0％)、24주(18.0％)화56주(42.1％),D형여기타류형비교,차이유통계학의의(Z=31.23,P＜0.01).유전보계B2형균주다견우좌양불사성민감주,내약주、민감주분별위29.5％(18/61)、8.3％(6/72),차이유통계학의의(x2=10.01,P＜0.01),D형균주다견우좌양불사성내약주,분별위31.1％ (19/61)여51.4％(37/72),차이유통계학의의(x2=5.55,P＜0.05)；미발현대장애희균4개기인형여기타3충항생소내약성유관(균P＞0.05). 결론 유전보계분형중D형검출솔최고,여좌양불사성내약상관,통과유전보계분형가초보판단노년인뇨로감염적대장애희균적내약성.
Objective To study the relationship between Escherichia coli (E.coli.) phylogenetic groups and the antimicrobial resistance in elderly patients with urinary tract infections.Methods 133 Escherichia coli were collected from elderly patients with urinary tract infections in 3 general hospitals in Tianjin.Kirby Bauer method was used to test susceptibility of E.coli.to four antibiotics.Escherichia coli DNA was extracted by boiling method.Phylogenetic groups (A,B1,B2 and D) of the E.coli was isolated by the two-step triplex-PCR.Results In all the strains,levofloxacin resistance rate was the highest (54.1％,72 strains),piperacillin/tazobactam resistance rate was the lowest (15.0％,20 strains) (Z=51.57,P＜0.01).The detection rates of Escherichia coli phylogenetic group A,B1,B2 and D were 24.8％ (33 strains),15.0％ (20 strains),18.0％ (24 strains),42.1％(56 strains) (Z=31.2,P＜0.01).Levofloxacin-sensitive strains were more common in Escherichia coli phylogenetic group B2 strains,and there was a significant difference in the strain number between the resistant and sensitive strains [29.5％ (18/61) vs.8.3％ (6/72),x2 =10.01,P＜0.01].Levofloxacin-resistant strains were more common in Escherichia coli phylogenetic group D strains,and there was a significant difference in the strain number between the resistant and sensitive strains [31.1％ (19/61) and 51.4 ％ (37/72),x2 =5.55,P＜0.05].There was no significant relationship between the Escherichia coli phylogenetic groups and the other three antibiotic resistance (all P＞0.05).Conclusions The detection rates of group D are the highest in the Escherichia coli phylogenetic groups,and it has a relationship with levofloxacin resistant.The antimicrobial resistance can be estimated by phylogenetic analysis in elderly patients with E.coli urinary tract infections.
