Wang Qinghai, Zhao Kai, Guo Chen, Li Hong, Huang Tao, Ji Jianlei, Sun Xiaoxia, Cao Yanwei, Dong Zhen, Wang Hongyang
Department of Kidney Transplantation, The Affiliated Hospital of Qingdao University, Qingdao, 266000, People's Republic of China.
Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, 266000, People's Republic of China.
Infect Drug Resist. 2021 Sep 29;14:4039-4046. doi: 10.2147/IDR.S332897. eCollection 2021.
This study aimed to determine the prevalence of antibiotic resistance and virulence genes of strains among patients with urinary tract infections (UTIs) after kidney transplantation from deceased donors.
Between January 2014 and June 2018, 64 patients who received kidney transplants from deceased donors at our institution developed a UTI due to . Polymerase chain reaction was used to detect virulence genes in strains. The Kirby-Bauer method was used to evaluate the antibiotic susceptibility pattern of the isolates.
Among the study cohort, 46 (71.9%) UTIs were community-acquired (CA), and 18 (28.1%) were hospital-acquired (HA). The percentages of isolated strains that showed antibiotic resistance were as follows: 92.2% to ampicillin, 76.6% to cefalotin, 81.3% to carbenicillin, 29.7% to ciprofloxacin, 62.5% to cotrimoxazole, 35.9% to gentamicin, 34.4% to levofloxacin, 28.1% to norfloxacin, 68.8% to pefloxacin, 57.8% to trimethoprim/sulfamethoxazole, and 20.3% to amikacin. HA showed higher resistance to ciprofloxacin, cotrimoxazole, trimethoprim/sulfamethoxazole and amikacin, compared with CA (<0.05). The most prevalent virulence genes among the strains were (64.1%), followed by (56.3%), (46.9%), (45.3%), (31.3%), (25%), (23.4%), (15.6%), (14.1%), (9.4%), and (4.7%). The and genes were found more frequently in the HA than in the CA (<0.05).
The strains, especially HA , isolated from UTI patients after kidney transplantation from deceased donors showed resistance to multiple antibiotics and harbored numerous virulence genes. These findings provide insight for genetic characterizations and epidemiological studies of strains causing UTIs in patients after kidney transplantation from deceased donors.
本研究旨在确定在接受已故供体肾脏移植的患者中，尿路感染（UTI）菌株的抗生素耐药性和毒力基因的流行情况。
2014年1月至2018年6月期间，在我们机构接受已故供体肾脏移植的64例患者因[具体原因未提及]发生了UTI。采用聚合酶链反应检测菌株中的毒力基因。采用 Kirby-Bauer 方法评估分离株的抗生素敏感性模式。
在研究队列中，46例（71.9%）UTI为社区获得性（CA），18例（28.1%）为医院获得性（HA）。显示抗生素耐药性的分离菌株百分比分别为：氨苄西林92.2%、头孢噻吩76.6%、羧苄西林81.3%、环丙沙星29.7%、复方新诺明62.5%、庆大霉素35.9%、左氧氟沙星34.4%、诺氟沙星28.1%、培氟沙星68.8%、甲氧苄啶/磺胺甲恶唑57.8%、阿米卡星20.3%。与CA菌株相比，HA菌株对环丙沙星、复方新诺明、甲氧苄啶/磺胺甲恶唑和阿米卡星的耐药性更高（<0.05）。菌株中最常见的毒力基因是[具体基因未提及]（64.1%），其次是[具体基因未提及]（56.3%）、[具体基因未提及]（46.%).9%）、[具体基因未提及]（45.3%）、[具体基因未提及]（31.3%）、[具体基因未提及]（25%）、[具体基因未提及]（23.4%）、[具体基因未提及]（15.6%）、[具体基因未提及]（14.1%）、[具体基因未提及]（9.4%）和[具体基因未提及]（4.7%）。HA菌株中[具体基因未提及]和[具体基因未提及]基因的发现频率高于CA菌株（<0.05）。
从接受已故供体肾脏移植后的UTI患者中分离出的菌株，尤其是HA菌株，对多种抗生素耐药，并携带众多毒力基因。这些发现为对接受已故供体肾脏移植患者中引起UTI的菌株进行基因特征分析和流行病学研究提供了见解。
