rosmm黑龙江医学第43卷2019年第11期
HEILONGJIANG MEDICAL JOURNAL Vol.43No.11Nov.2019
王剑飞1，王媛媛1，魏殿军2
1.天津医科大学第二医院，天津300211；江苏经贸职业技术学院学报
3d打印课程设计2.河北燕达医院，河北廊坊065201上海电力学院易班
拓跋力微>真如中学
摘要目的研究尿路致病性大肠埃希菌（UPEC）1型菌毛、P型菌毛的黏附情况及抗菌药物的药敏情况，分析二者的相互关系，为UPEC的和预防提供新思路。方法收集UPEC菌株，采用梅里埃公司VitekⅡ进行细菌鉴定与13种常见抗菌药物的药敏试验，通过1型菌毛与酵母细胞的黏附实验、P型菌毛与人红细胞的黏附实验，分别检测1型菌毛、P型菌毛的黏附情况，比较两种菌毛黏附特性与药敏之间的关系。结果根据两种菌毛的黏附特性分为四组（1型阳性P型阳性组、1型阳性P型阴性组、1型阴性P型阳性组、1型阴性P型阴性组），比较各组间的药敏差异，结果显示头孢呋辛（χ2=16.42，P =0.001）在1型阴性P型阳性组耐药率低于其他组。分析单种菌毛黏附特性与药敏的关系，结果显示头孢呋辛（χ2=6.01，P= 0.014）在1型菌毛黏附阳性组的耐药率高于阴性组。对药敏情况与两种菌毛黏附特性进行相关性分析时发现，1型菌毛黏附阳性菌株相较于阴性菌株，头孢西丁、哌拉西林/三唑巴坦的耐药率降低，头孢呋辛的耐药率增加，P型菌毛黏附阳性菌株相较于阴性菌株，头孢呋辛的耐药率降低。结论通过比较UPEC1型菌毛、P型菌毛黏附与药敏的关系，在临床UP‐EC所致尿路系统感染时，为抗菌药物的选择提供了新的方向。
关键词：尿路致病性大肠埃希菌；１型菌毛黏附；P型菌毛黏附；药敏情况
doi：10.3969/j.issn.1004-5775.2019.11.014
学科分类代码：320.2499中图分类号：R691.3文献标识码：B
Association Between Type1Fimbriae Adhesion，Type P Fimbriae Adhesion and Drug Resistance of Uropathogenic Esche⁃richia Coli/WANG Jian-fei，WANG Yuan-yuan，WEI Dian-jun//The Second Hospital of Tianjin Medical University，Tianjin，300211，China
Abstract Objective To investigate the relationship between type1fimbriae adhesion，type P fimbriae adhesion and drug-resis⁃tant of Uropathogenic Escherichia coli（UPEC），so as to provide the basi
s for clinical UPEC prevention and therapy.Methods Collect⁃ing UPEC strains and using the Merieux Company VitekⅡto detect drug susceptibility of13commonly used antibiotics.Type1fim⁃briae and type P fimbriae adhesion was detected respectively by yeast agglutination test and red blood cell agglutination.The relation⁃ships between two kinds of fimbriae adhesion and drug susceptibility was alayzed.Results According to the adhesion characteristic of the two kinds of fimbriae，they were divided into four groups（type1positive type P positive group，type1positive type P negative group and type1negative type P positive group and type1negative type P negative group），and the differences of drug sensitivity among groups were compared.The results showed that the drug resistance rate of cefuroxime（χ2=16.42，P=0.001）in type1positive type P positive group was lower than other groups.Through analyzing the relationship between the adhesion characteristics of single species and drug susceptibility，the results showed that the drug resistance rate of cefuroxime（χ2=6.01，P=0.014）in type1fimbriae adhesion positive group was higher than negative group.The correlation between drug sensitivity and the adhesion characteristic of the two kinds of fimbriae was found that the drug resistance rate of ceficidin，piperacillin/trizobactam decreased，and the drug resistance rate of cefuroxime increased in type1fimbriae adhesion positive group compared with the negative group.The drug resistance rate of cefuroxime decreased in type P fimbriae adhesion positive group compared with the negative group.Conclusion By comparing the rel
a⁃tionship between UPEC type1fimbriae adhesion，type P fimbriae adhesion and drug sensitivity，a new direction was provided for the selection of antimicrobial agents in the clinical treatment of UPEC induced urinary tract infection.
Key words：UPEC；Type1fimbriae adhesion；Type P fimbriae adhesion；Drug susceptibility
泌尿系统感染是人类最常见的感染性疾病之一，在美国，每年有超过1500万人遭受尿路感染［1］。尿路致病性大肠埃希菌（Uropathogenic Escherichia coli，UPEC）是引起尿路感染的最主要致病菌［2］。抗菌药物是尿路感染的最常用手段。近年来，随着广谱抗菌药物的滥用，UPEC的耐药基因不断发生变异，耐药性越来越强，普通抗菌药物的效果并不佳。
UPEC的致病能力主要由其携带的毒力因子［3］导致，菌毛是其重要的毒力因子，可以使菌体黏附定植在宿主细胞表面，在泌尿系统的感染和发病中起了重要作用［4］。其
*基金项目：河北省2019年度医学科学研究课题（20191061）。
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