与儿童复杂性尿路感染相关的多重耐药尿路致病性O25b菌株的分子流行病学
Molecular Epidemiology of Multidrug-Resistant Uropathogenic O25b Strains Associated with Complicated Urinary Tract Infection in Children.
作者信息
Contreras-Alvarado Laura M, Zavala-Vega Sergio, Cruz-Córdova Ariadnna, Reyes-Grajeda Juan Pablo, Escalona-Venegas Gerardo, Flores Víctor, Alcázar-López Virginia, Arellano-Galindo José, Hernández-Castro Rigoberto, Castro-Escarpulli Graciela, Xicohtencatl-Cortes Juan, Ochoa Sara A
机构信息
Laboratorio de Investigación en Bacteriología Intestinal, Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, Ciudad de México 06720, Mexico.
Laboratorio de Investigación Clínica y Ambiental, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico.
出版信息
Microorganisms. 2021 Nov 5;9(11):2299. doi: 10.3390/microorganisms9112299.
BACKGROUND
Uropathogenic (UPEC) has increased the incidence of urinary tract infection (UTI). It is the cause of more than 80% of community-acquired cystitis cases and more than 70% of uncomplicated acute pyelonephritis cases.
AIM
The present study describes the molecular epidemiology of UPEC O25b clinical strains based on their resistance profiles, virulence genes, and genetic diversity.
METHODS
Resistance profiles were identified using the Kirby-Bauer method, including the phenotypic production of extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs). The UPEC serogroups, phylogenetic groups, virulence genes, and integrons were determined via multiplex PCR. Genetic diversity was established using pulsed-field gel electrophoresis (PFGE), and sequence type (ST) was determined via multilocus sequence typing (MLST).
RESULTS
UPEC strains ( = 126) from hospitalized children with complicated UTIs (cUTIs) were identified as O25b, of which 41.27% were multidrug resistant (MDR) and 15.87% were extensively drug resistant (XDR). The O25b strains harbored the (95.23%), (91.26%), II (80.95%), (95.23%), (88.09%), (84.92%), and (47.61%) genes. Moreover, 64.28% were producers of ESBLs and had high genetic diversity. ST131 (63.63%) was associated primarily with phylogenetic group B2, and ST69 (100%) was associated primarily with phylogenetic group D.
CONCLUSION
UPEC O25b/ST131 harbors a wide genetic diversity of virulence and resistance genes, which contribute to cUTIs in pediatrics.
背景
尿路致病性大肠埃希菌（UPEC）增加了尿路感染（UTI）的发病率。它是超过80%的社区获得性膀胱炎病例以及超过70%的非复杂性急性肾盂肾炎病例的病因。
目的
本研究基于UPEC O25b临床菌株的耐药谱、毒力基因和遗传多样性描述其分子流行病学。
方法
采用 Kirby-Bauer 方法鉴定耐药谱，包括超广谱β-内酰胺酶（ESBLs）和金属β-内酰胺酶（MBLs）的表型产生。通过多重PCR确定UPEC血清型、系统发育组、毒力基因和整合子。使用脉冲场凝胶电泳（PFGE）建立遗传多样性，并通过多位点序列分型（MLST）确定序列类型（ST）。
结果
从患有复杂性尿路感染（cUTIs）的住院儿童中鉴定出126株UPEC菌株为O25b，其中41.27%为多重耐药（MDR），15.87%为广泛耐药（XDR）。O25b菌株携带 fimH（95.23%）、papC（91.26%）、sfa/focDE（80.95%）、afa/draBC（95.23%）、ibeA（88.09%）、kpsMTII（84.92%）和 cnf1（47.61%）基因。此外，64.28%为ESBLs生产者且具有高遗传多样性。ST131（63.63%）主要与系统发育组B2相关，ST69（100%）主要与系统发育组D相关。
结论
UPEC O25b/ST131具有广泛的毒力和耐药基因遗传多样性，这导致了儿科患者的cUTIs。
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