Singh Santosh Kumar, Seema Kumari, Gupta Minakshi
School of Biological Sciences, National Institute of Science Education and Research, Jatni, Odisha, India.
TATA Main Hospital, Jamshedpur, Jharkhand, India.
Microb Pathog. 2016 Nov;100:293-298. doi: 10.1016/j.micpath.2016.10.010. Epub 2016 Oct 13.
Escherichia coli mediated urinary tract infection has been reported to be most prevalent among patients of different class, gender and ages. Currently, multidrug resistant E. coli harboring several virulence factors are most perilous threats for patients especially for elders. The aim of this study was to determine the antibiotic resistance pattern, co-resistance and phenotypic virulence factors present in uropathogenic E. coli isolated from aged patients. Thirty-nine E. coli isolates were collected during May-June 2014 from patients between 50 to 80 years of age. Experiments have been carried out to determine the antibiotic resistance, co-resistances and phenotypic adherent factors present in each isolate. Clonal relatedness was also determined in the AmpC positive uropathogenic E. coli (UPEC). 97.43% isolates were found to be multidrug resistant and 41.02% of them were AmpC producer. AmpC producer group showed higher multiple antibiotic resistance index than AmpC non-producer (p value < 0.01) group. Interestingly, adherence factor Type 1 fimbriae were found among 84.61% of total isolates which were more prevalent in elderly female patients than males. Biofilm production studies revealed that 84.61% of total isolates are more common in elderly males. This study adds value for the proper empiric selection of antibiotic therapy as well as calls for continuous monitoring of the incidence of drug resistance virulent uropathogenic E. coli mediated urinary tract infection in elderly patients.
据报道,大肠杆菌介导的尿路感染在不同阶层、性别和年龄的患者中最为普遍。目前,携带多种毒力因子的多重耐药大肠杆菌对患者尤其是老年人构成了最危险的威胁。本研究的目的是确定从老年患者中分离出的尿路致病性大肠杆菌中的抗生素耐药模式、共同耐药性和表型毒力因子。2014年5月至6月期间,从50至80岁的患者中收集了39株大肠杆菌分离株。已开展实验以确定每个分离株中的抗生素耐药性、共同耐药性和表型黏附因子。还对AmpC阳性尿路致病性大肠杆菌(UPEC)进行了克隆相关性测定。发现97.43%的分离株具有多重耐药性,其中41.02%为AmpC产生菌。AmpC产生菌组的多重抗生素耐药指数高于非AmpC产生菌(p值<0.01)组。有趣的是,在84.61%的总分离株中发现了1型菌毛黏附因子,在老年女性患者中比男性更普遍。生物膜形成研究表明,84.61%的总分离株在老年男性中更为常见。本研究为合理经验性选择抗生素治疗增添了价值,并呼吁持续监测老年患者中耐药性强的尿路致病性大肠杆菌介导的尿路感染的发生率。