摘要
目的 分析老年导尿管相关尿路感染(CAUTI)患者生物被膜菌分布,并探讨生物被膜形成相关基因与耐药性的关系。方法 选取2018年8月-2021年8月海口市中医医院196例老年CAUTI患者为研究对象,收集患者拔管后导尿管标本,分别筛选生物被膜菌株和相应浮游菌株;采用VITEK-32微生物自动分析仪鉴定菌种,并检测分离菌株对常用抗菌药物的敏感性;采用聚合酶链式反应(PCR)法检测ebpA、gelE和fsrB基因表达。结果 196例CAUTI患者共培养分离病原菌384株,其中浮游菌株353株(91.93%),生物被膜菌31株(8.07%)。31株生物被膜菌在普通MH培养基和泊洛沙姆培养基上的耐药率比较,除头孢西丁和多西环素外,其余均有统计学差异(P<0.05)。生物被膜粪肠球菌ebpA基因阳性率高于相应浮游粪肠球菌,而gelE和fsrB基因阳性率低于相应浮游粪肠球菌,差异均有统计学意义(P<0.05)。结论 老年CAUTI患者生物被膜菌主要为粪肠球菌和金黄色葡萄球菌,其在泊洛沙姆培养基上的耐药性相比普通MH培养基具有显著差异;ebpA可能是粪肠球菌生物被膜形成的促进因子,而gelE和fsrB可能是生物被膜形成的抑制因子。
OBJECTIVE To investigate the distribution of biofilm bacteria isolated from elderly patients with urinary catheter-associated urinary tract infection(CAUTI) and explore the relationship between the biofilm formation-related genes and drug resistance. METHODS A total of 196 elderly patients with CAUTI who were treated in Haikou Hospital of Traditional Chinese Medicine from Aug 2018 to Aug 2021 were recruited as the research subjects. The urinary catheter specimens were collected from the patients after extubation, the biofilm bacteria and the corresponding planktonic bacteria strains were screened out. The species of the strains were identified by VITEK-32 microorganisms automatic analyzer, the drug susceptibility testing for the commonly used antibiotics was carried out, and the expressions of ebpA, gelE and fsrB genes were detected by means of polymerase chain reaction(PCR). RESULTS Totally 384 strains of pathogens were isolated from the 196 patients with CAUTI, 353(91.93%) of which were planktonic bacteria, and 31(8.07%) were biofilm bacteria. There were significant differences in the drug resistance rates to all the antibiotics except for cefoxitin and doxycycline between the 31 strains of biofilm bacteria cultured on MH medium and the strains cultured on poloxamer medium(P<0.05). The positive rate of ebpA gene of the biofilm Enterococcus faecalis was significantly higher than that of the corresponding planktonic E.faecalis, while the positive rates of gelE and fsrB genes of the biofilm E.faecalis were significantly lower than those of the corresponding planktonic E.faecalis, and there were significant differences(P<0.05). CONCLUSION E.faecalis and Staphylococcus aureus are the predominant species of biofilm bacteria isolated from the elderly patients with CAUTI. There are significant differences in the drug resistance rates between the strains cultured on poloxamer medium and the strains cultured on the common MH medium;ebpA might be the a promoting factor for the formation of E.faecalis biofilm, while the ge
作者
林秀慧
许政衡
林秀华
王诗佳
张娇珍
LIN Xiu-hui;XU Zheng-heng;LIN Xiu-hua;WANG Shi-jia;ZHANG Jiao-zhen(Haikou Hospital of Traditional Chinese Medicine,Haikou,Hainan 570216,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第5期718-722,共5页
Chinese Journal of Nosocomiology
基金
海南省自然科学面上基金资助项目(821MS158)。
关键词
老年导尿管相关尿路感染
生物被膜菌
耐药性
粪肠球菌
生物被膜形成相关基因
Urinary catheter-associated urinary tract infection
Biofilm bacteria
Drug resistance
Enterococcus faecalis
Biofilm formation-related gene
