Fonseca-Martínez Sofía Alejandra, Martínez-Vega Ruth Aralí, Farfán-García Ana Elvira, González Rugeles Clara Isabel, Criado-Guerrero Libeth Yajaira
Maestría en Microbiología, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia.
Escuela de Medicina, Universidad de Santander, Bucaramanga, Santander, Colombia.
Infect Drug Resist. 2023 Jun 12;16:3707-3718. doi: 10.2147/IDR.S391378. eCollection 2023.
Urinary tract infection (UTI) is the most frequent bacterial infection. Some uropathogenic (UPEC) genes have been associated with disease severity and antibiotic resistance. The aim was to determine the association of nine UPEC virulence genes with UTI severity and antibiotic resistance of strains collected from adults with community-acquired UTI.
A case-control study (1:3) (38 urosepsis/pyelonephritis and 114 cystitis/urethritis) was conducted. The , and (the last five are siderophore genes) virulence genes were determined by PCR. The information of antibiotic susceptibility pattern of the strains was collected from medical records. This pattern was determined using an automated system for antimicrobial susceptibility testing. Multidrug-resistant (MDR) was defined as resistance to three or more antibiotic families.
was the most frequently detected virulence gene (94.7%), and was the least frequently detected (9.2%); 55.3% (83/150) of the strains were MDR. The evaluated genes were not associated with UTI severity. Associations were found between the presence of and carbapenem resistance (Odds ratio [OR] = 7.58, 95% confidence interval [CI], 1.50-35.42), and fluoroquinolone resistance (OR = 2.35, 95% CI, 1.15-4.84, and (OR = 2.8, 95% CI, 1.20-6.48) and (OR = 2.95, 95% CI, 1.33-6.69) with penicillin resistance. In addition, was the only gene associated with MDR (OR = 2.09, 95% CI,1.03-4.26).
There was no association among virulence genes and UTI severity. Three of the five iron uptake genes were associated with resistance to at least one antibiotic family. Regarding the other four non-siderophore genes, only was associated with antibiotic resistance to carbapenems. It is essential to continue studying bacterial genetic characteristics that cause the generation of pathogenic and multidrug-resistant phenotypes of UPEC strains.
尿路感染（UTI）是最常见的细菌感染。一些尿路致病性大肠杆菌（UPEC）基因与疾病严重程度和抗生素耐药性有关。目的是确定9种UPEC毒力基因与从社区获得性UTI成人中分离出的菌株的UTI严重程度和抗生素耐药性之间的关联。
进行了一项病例对照研究（1:3）（38例尿脓毒症/肾盂肾炎和114例膀胱炎/尿道炎）。通过聚合酶链反应（PCR）检测 fimH、papC、sfa/foc、afa/dra、iroN、fyuA、sitA、iroB和iutA（后五个是铁载体基因）毒力基因。从病历中收集菌株的抗生素敏感性模式信息。使用自动抗菌药物敏感性测试系统确定该模式。多重耐药（MDR）定义为对三种或更多抗生素家族耐药。
fimH是最常检测到的毒力基因（94.7%），而iroB是最不常检测到的（9.2%）；55.3%（83/150）的菌株为多重耐药。评估的基因与UTI严重程度无关。发现iroN的存在与碳青霉烯类耐药相关（比值比[OR]=7.58，95%置信区间[CI]，1.50 - 35.42），afa/dra与氟喹诺酮类耐药相关（OR = 2.35，95% CI，1.15 - 4.84），sfa/foc（OR = 2.8，95% CI，1.20 - 6.48）和fyuA（OR = 2.95，95% CI，1.33 - 6.69）与青霉素耐药相关。此外，afa/dra是与多重耐药相关的唯一基因（OR = 2.09，95% CI，1.03 - 4.26）。
毒力基因与UTI严重程度之间无关联。五个铁摄取基因中的三个与对至少一个抗生素家族的耐药相关。关于其他四个非铁载体基因，只有iroN与碳青霉烯类抗生素耐药相关。继续研究导致UPEC菌株产生致病和多重耐药表型的细菌遗传特征至关重要。
