Uzun Cengiz, Oncül Oral, Gümüş Defne, Alan Servet, Dayioğlu Nurten, Küçüker Mine Anğ
Clin Lab. 2015;61(8):941-50.
The aim of this study is to detect the presence of and possible relation between virulence genes and antibiotic resistance in E. coli strains isolated from patients with acute, uncomplicated urinary tract infections (UTI).
62 E. coli strains isolated from patients with acute, uncomplicated urinary tract infections (50 strains isolated from acute uncomplicated cystitis cases (AUC); 12 strains from acute uncomplicated pyelonephritis cases (AUP)) were screened for virulence genes [pap (pyelonephritis-associated pili), sfa/foc (S and F1C fimbriae), afa (afimbrial adhesins), hly (hemolysin), cnf1 (cytotoxic necrotizing factor), aer (aerobactin), PAI (pathogenicity island marker), iroN (catecholate siderophore receptor), ompT (outer membrane protein T), usp (uropathogenic specific protein)] by PCR and for antimicrobial resistance by disk diffusion method according to CLSI criteria.
It was found that 56 strains (90.3%) carried at least one virulence gene. The most common virulence genes were ompT (79%), aer (51.6%), PAI (51.6%) and usp (56.5%). 60% of the strains were resistant to at least one antibiotic. The highest resistance rates were against ampicillin (79%) and co-trimoxazole (41.9%). Fifty percent of the E. coli strains (31 strains) were found to be multiple resistant. Eight (12.9%) out of 62 strains were found to be ESBL positive. Statistically significant relationships were found between the absence of usp and AMP - SXT resistance, iroN and OFX - CIP resistance, PAI and SXT resistance, cnf1 and AMP resistance, and a significant relationship was also found between the presence of the afa and OFX resistance.
No difference between E. coli strains isolated from two different clinical presentations was found in terms of virulence genes and antibiotic susceptibility.
本研究旨在检测从急性单纯性尿路感染（UTI）患者中分离出的大肠杆菌菌株中毒力基因的存在情况及其与抗生素耐药性之间的可能关系。
对从急性单纯性尿路感染患者中分离出的62株大肠杆菌（50株从急性单纯性膀胱炎病例（AUC）中分离；12株从急性单纯性肾盂肾炎病例（AUP）中分离）进行毒力基因[肾盂肾炎相关菌毛（pap）、S和F1C菌毛（sfa/foc）、无纤毛黏附素（afa）、溶血素（hly）、细胞毒性坏死因子1（cnf1）、气杆菌素（aer）、致病岛标记（PAI）、儿茶酚铁载体受体（iroN）、外膜蛋白T（ompT）、泌尿道致病性特异性蛋白（usp）]的PCR筛查，并根据CLSI标准采用纸片扩散法检测其对抗菌药物的耐药性。
发现56株（90.3%）携带至少一种毒力基因。最常见的毒力基因是ompT（79%）、aer（51.6%）、PAI（51.6%）和usp（56.5%）。60%的菌株对至少一种抗生素耐药。最高耐药率是针对氨苄西林（79%）和复方新诺明（41.9%）。发现50%的大肠杆菌菌株（31株）多重耐药。62株中有8株（12.9%）被发现为超广谱β-内酰胺酶（ESBL）阳性。在usp缺失与氨苄西林-复方新诺明耐药、iroN与氧氟沙星-环丙沙星耐药、PAI与复方新诺明耐药、cnf1与氨苄西林耐药之间发现有统计学意义的关系，并且在afa存在与氧氟沙星耐药之间也发现有显著关系。
从两种不同临床表现中分离出的大肠杆菌菌株在毒力基因和抗生素敏感性方面未发现差异。
