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目的探讨产超广谱β-内酰胺酶(ESBLs)大肠埃希菌(E.coli)耐药基因与尿路感染(UTI)复发的关系。方法238例E.coli致UTI者根据临床疗效分为治愈组和复发组。采用BD Phoenix 100型全自动微生物分析仪进行菌种鉴定和药敏实验;ESBLs确证试验采用Kirby-Bauer(K-B)法;应用聚合酶链反应(PCR)扩增菌株的CTX-M、TEM和SHV型ESBLs基因。结果治愈组ESBLs阳性率为30.3%,复发组ESBLs阳性率为90.0%,2组相比,差异有统计学意义(P<0.01);ESBLs阳性菌株与ESBLs阴性菌株耐药率相比,差异有统计学意义(P<0.01);治愈组30.0%表达CTX-M+TEM,复发组52.8%表达CTX-M+TEM,2组相比,差异有统计学意义(P<0.05)。结论产ESBLs E.coli致尿路感染者复发率较高,而尿路感染复发与产ESBLs E.coli基因型CTX-M+TEM有关。
Objective To investigate the relationship between ESBLs-producing E. coli resistance genes and urinary tract infection (UTI) recurrence. Methods 238 cases of UTI caused by E.coli were divided into cured group and recurrent group according to clinical curative effect. Bacterial identification and antimicrobial susceptibility testing were performed using a BD Phoenix 100 automatic microbiological analyzer. The Kirby-Bauer (KB) method was used to confirm ESBLs. CTX-M, TEM and SHV were amplified by polymerase chain reaction (PCR) Type ESBLs gene. Results The positive rate of ESBLs in the cured group was 30.3%, the positive rate of ESBLs in the recurrent group was 90.0%, and there was significant difference between the two groups (P <0.01). There was significant difference between the ESBLs positive strains and ESBLs negative strains (P <0.01). CTX-M + TEM was expressed in 30.0% of the patients in the cured group and CTX-M + TEM in 52.8% of the patients in the cured group. There was significant difference between the two groups (P <0.05). Conclusions The incidence of recurrent urinary tract infection in ESBLs-producing E. coli is high, while the recurrence of urinary tract infection is related to CTX-M + TEM in ESBLs-producing E. coli.