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大肠埃希菌 B2 群与整合子流行于儿童复发性尿路感染。

The Escherichia coli phylogenetic group B2 with integrons prevails in childhood recurrent urinary tract infections.

机构信息

Department of Microbiology, University of Tartu, Tartu.

出版信息

APMIS. 2014 May;122(5):452-8. doi: 10.1111/apm.12167. Epub 2013 Sep 11.

Abstract

The aim of our study was to characterize the phylogenetic groups of Escherichia coli, antibiotic resistance, and containment of class 1 integrons in the first attack of pyelonephritis and in subsequent recurrences in young children. Altogether, 89 urine E. coli isolates from 41 children with urinary tract infection (UTI) were studied for prevalence and persistence of phylogenetic groups by pulsed-field gel electrophoresis (PFGE), antibacterial resistance by minimal inhibitory concentrations (MIC) and class 1 integrons by PCR. Phylogenetic group B2 was most common (57%), followed by D (20%), A (18%) and B1 (5%). Overall resistance to betalactams was 61%, trimethoprim-sulfamethoxazole 28%, and was not associated with phylogenetic groups. According to PFGE, the same clonal strain persisted in 77% of patients. The persistence was detected most often in phylogenetic group B2 (70%). Phylogenetic group B2 more often contained class 1 integrons than group A. Integron positive strains had higher MIC values of cefuroxime, cefotaxime, and gentamicin. In conclusion, phylogenetic group B2 was the most common cause of the first episode of pyelonephritis, as well as in case of the persistence of the same strain and contained frequently class 1 integrons in childhood recurrent UTI. An overall frequent betalactam resistance was equally distributed among phylogenetic groups.

摘要

本研究旨在描述首次肾盂肾炎发作和随后在儿童中复发时大肠杆菌的系统发育群、抗生素耐药性和 1 类整合子的情况。共对 41 例尿路感染(UTI)患儿的 89 株尿大肠杆菌进行研究,采用脉冲场凝胶电泳(PFGE)检测系统发育群的流行率和持续性,采用最小抑菌浓度(MIC)检测抗菌耐药性,采用 PCR 检测 1 类整合子。B2 群是最常见的(57%),其次是 D 群(20%)、A 群(18%)和 B1 群(5%)。β-内酰胺类的总耐药率为 61%,甲氧苄啶-磺胺甲恶唑为 28%,与系统发育群无关。根据 PFGE,77%的患者中有相同的克隆株持续存在。在 B2 群中最常检测到持续性(70%)。B2 群比 A 群更常含有 1 类整合子。整合子阳性株对头孢呋辛、头孢噻肟和庆大霉素的 MIC 值更高。总之,B2 群是首次肾盂肾炎发作的最常见原因,也是同一菌株持续存在和儿童复发性 UTI 中经常含有 1 类整合子的原因。总的来说,β-内酰胺类的耐药性在系统发育群中分布均匀。

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