泌尿外科术后大肠埃希菌尿道感染及其耐药基因和毒力基因检测

目的探讨泌尿外科术后大肠埃希菌尿道感染现状,并对大肠埃希菌耐药基因和毒力基因进行检测。方法选择亳州市中医院泌尿外科2017年2月-2020年2月收治的术后尿道感染患者80例,收集尿样分离培养大肠埃希菌,并对大肠埃希菌株进行抗菌药物敏感性试验;使用聚合酶链反应提取耐药基因和毒力基因,并对基因做分型处理。结果大肠埃希菌现状:收集尿样80份,培养出大肠埃希菌64株,检出率80.00%。大肠埃希菌耐药率:环丙沙星(67.19%)、氨苄西林(96.88%)、头孢噻吩(54.69%)、头孢他啶(64.06%)、头孢西丁(56.25%)、庆大霉素(51.56%)、磺胺甲噁唑/甲氧苄啶(18.75%)、萘啶酸(10.94%)、呋喃妥因(1.56%)、亚胺培南(7.81%);78.13%为多药耐药。耐药基因阳性率:TEM(76.56%)、aac(3)-II(50.00%)、CTX-M(62.50%)、qacE△1-sull(43.75%)、OXA-1(17.18%)、PER(10.93%)、aac(6)-I(20.31%)、SHV(15.63%)、qnr(6.25%)、gyrA(64.06%)。(4)毒力基因阳性率:fimH(93.75%)、fyuA(68.75%)、traT(67.18%)、iutA(60.94%)、kpsMTII(57.81%)、aer(56.25%)、papC(18.75%)、papGII(15.63%)、hlyA(7.81%)。结论泌尿外科术后尿道感染患者尿样中大肠埃希菌株检出率较高,临床上应及时对菌株进行药敏试验,规范合理使用抗菌药物。

Postoperative Escherichia coli urinary tract infection in urology department patients and detection of drug resistance genes and virulence genes

OBJECTIVE To explore the current status of postoperative Escherichia coli urinary tract infection in urology department patients and detect the drug resistance genes and virulence genes of the E.coli strains.METHODS A total of 80 patients with postoperative urinary tract infection who were treated in Bozhou Hospital of Traditional Chinese Medicine from Feb 2017 to Feb 2020 were enrolled in the study,the urine specimens were collected for culture of E.coli,the drug susceptibility testing was performed for the E.coli strains,and the drug resistance genes and virulence genes were extracted by using polymerase chain reaction,and the genotypes of the genes were identified.RESULTS Totally 64 strains of E.coli were isolated from 80 urine specimens,with the isolation rate 80.00%.The drug resistance rates of the E.coli strains to ciprofloxacin,ampicillin,cefalotin,ceftazidime,cefoxitin,gentamicin,sulfamethoxazole-trimethoprim,nalidixic acid,nitrofurantoin and imipenem were 67.19%,96.88%,54.69%,64.06%,56.25%,51.56%,18.75%,10.94%,1.56%and 7.81%,respectively.78.13%of the strains were multidrug-resistant.The positive rates of the drug resistance genes TEM,aac(3)-II,CTX-M,qacE△1-sull,OXA-1,PER,aac(6)-I,SHV,qnr and gyrA were 76.56%,50.00%,62.50%,43.75%,17.18%,10.93%,20.31%,15.63%,6.25%and 64.06%,respectively.The positive rates of the virulence genes fimH,fyuA,traT,iutA,kpsMTII,aer,papC,papGII and hlyA were 93.75%,68.75%,67.18%,60.94%,57.81%,56.25%,18.75%,15.63%and 7.81%,respectively.CONCLUSION The isolation rate of E.coli strains is high in the urine specimens of the urology department patients with postoperative urinary tract infection.It is necessary for the hospital to carry out the drug susceptibility testing for the strains in a timely manner and reasonably use antibiotics.