156例尿路感染大肠埃希菌耐药性分析

目的探讨大肠埃希菌尿路感染的临床发病特点及对抗生素的耐药情况。方法对2001年1月至2005年12月尿路感染患者尿培养分离出的156株大肠埃希菌进行耐药性分析,用纸片扩散法表型确证试验检测ESBLs。结果大肠埃希菌耐药率最低的抗菌药物是亚胺培南、美罗培南、头孢哌酮/舒巴坦、氧哌嗪青霉素/他唑巴坦,分别为1.28%、1.92%、3.21%、5.13%;对氨苄西林、氟喹诺酮类、庆大霉素、复方新诺明耐药率均>70%。产ESBLs的大肠埃希菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、氧哌嗪青霉素/他唑巴坦的耐药性均<10%,对氨苄西林、头孢菌素类、氟喹诺酮类均表现出很强的耐药性。结论治疗大肠埃希菌感染时,需根据药敏结果选用碳青霉烯类、β-内酰胺类/β-内酰胺酶抑制剂等。     

Mercury induces multiple antibiotic resistance in Escherichia coli through activation of SoxR, a redox-sensing regulatory protein

Sub-inhibitory mercury concentrations are capable of partially activating SoxR, as shown by the augmented expression of a soxS′::lacZ fusion, and a diminished sensitivity to antibiotics caused by mercury treatment. Mercury may elevate the intracellular concentration of superoxide or perhaps act as a putative metal ligand for SoxR.     

风湿性疾病患者尿路感染大肠埃希菌对左氧氟沙星耐药性及危险因素分析

目的研究风湿性疾病中尿路感染大肠埃希菌对左氧氟沙星耐药性及相关危险因素。方法中国医科大学附属第一医院风湿免疫科2009年1月至2013年12月125株住院患者清洁中段尿培养所分离出大肠埃希菌,依据是否耐药分为两组。分析耐药组相关危险因素。结果 5年来大肠埃希菌对左氧氟沙星耐药率呈逐渐上升趋势。耐药组对氨苄西林、环丙沙星、头孢曲松、哌拉西林、复方新诺明的耐药率高于非耐药组,两组间差异有统计学意义（P〈0.05）。慢性病程、既往喹诺酮类药物应用史、既往尿路感染、菌株产ESBLs为耐药危险因素。各风湿性疾病间耐药率比较差异未见统计学意义。结论风湿性疾病尿路感染危险因素与其他疾病尿路感染危险因素类似。临床工作中应加强对危险因素监视和控制。     

女性糖尿病患者合并尿路感染大肠埃希菌耐药性分析

目的 回顾性分析女性糖尿病(DM)合并尿路感染( UTI)大肠埃希菌的耐药情况及产超广谱β-内酰胺酶(ESBLs)的发生率,以指导临床合理选择抗菌药物.方法 对近4年在浙江大学医学院附属第二医院确诊DM合并UTI女性患者的中段尿标本中分离出的95株大肠埃希菌进行耐药性分析,用纸片扩散法表型确证试验检测ESBLs,以女性非糖尿病患者为对照组,并以年份进行分组分析.结果 95株大肠埃希菌ESBLs阳性率为40.0％,明显高于对照组,糖尿病组对氨苄西林、环丙沙星、左氧氟沙星耐药率较高,均＞60.0％,对环丙沙星、左氧氟沙星、头孢曲松、头孢唑林、头孢吡肟、头孢呋辛耐药率明显高于对照组,早期组与近期组的产ESBLs率及耐药率差异无统计学意义.结论 女性糖尿病伴尿路感染大肠埃希菌对多种抗菌药物的耐药率较高,临床应根据药敏试验结果合理使用抗菌药物.     

Occurrence of antibiotic resistance and class 1, 2 and 3 integrons in Escherichia coli isolated from a densely populated estuary (Seine, France)

Over 6 years, Escherichia coli were isolated from water samples from seven Seine estuary stations, characterized by a densely populated watershed (654 isolates). Resistances of these E. coli to 16 antibiotics were determined and compared with the same resistances in E. coli isolated from a small stream (120 isolates) and from the treated effluent of the largest estuary wastewater treatment plant (123 isolates). Between 30.2% and 56.6% of the estuary isolates were resistant, whatever the station or time of sampling; of these, 60.5–80% were resistant to at least two and up to 12 antibiotics. In the three contrasting sites, resistances to tetracycline, amoxicillin and ticarcillin were the commonest. DNA was extracted from 279 estuary isolates (January 2006) and class 1, 2 and 3 integrons were detected by multiplex real-time PCR and confirmed by classic PCR. IntI1 and intI2 genes were found in 11% of isolates. No intI3 gene was detected. The variable regions of the class 1 and 2 integrons sequenced contained predominantly gene cassettes aadA and dfr . However, for slightly over half of the E. coli isolates exhibiting the class 1 integron, the variable region could not be amplified, because part of the 3' conserved sequence was missing.     

Subinhibitory concentrations of nalidixic acid alter bacterial physiology and induce anthropogenic resistance in a commensal strain of Escherichia coli in vitro

The human gut houses a complex group of bacterial genera, including both opportunistic pathogens and commensal micro-organisms. These are regularly exposed to antibiotics, and their subinhibitory concentrations play a pivotal role in shaping the microbial responses. This study was aimed to investigate the effects exerted by sub-MICs of nalidixic acid (NA) on the growth rate, bacterial motility, biofilm formation and expression of outer membrane proteins (OMPs) in a commensal strain of E. coli. The NA-sensitive strain was sequentially passaged under sub-MICs of NA. E-test was used to determine the MIC values of NA. Results indicated significant changes in the growth profile of commensal E. coli upon exposure to NA at sub-MICs. Differential expression of OMPs was observed in cells treated with sub-MICs of NA. Bacterial motility was reduced under 1/2 MIC of NA. Interestingly, successive passaging under 1/2 MIC of NA led to the emergence of resistant E. coli with an increased MIC value of 64 µg ml⁻¹ in just 24 days. The NA-resistant variant was confirmed by comparing its 16S rRNA sequence to that of the sensitive commensal strain. Mutations in the Quinolone Resistance-Determining Regions (QRDRs) of chromosomal gyrA, and Topoisomerase IV-encoding parC genes were detected in NA-resistant E. coli. Our results demonstrate how antibiotics play an important role as signalling molecules or elicitors in driving the pathogenicity of commensal bacteria in vitro.     

Mutator phenotype confers advantage in Escherichia coli chronic urinary tract infection pathogenesis

It has been suggested that mutator phenotype could be associated with an increase in virulence, but to date experimental evidences are lacking. Epidemiological studies have revealed that urinary tract infection isolates encompass the highest proportion of mutator strains within the Escherichia coli species. Using the uropathogenic strain CFT073 and its mutS- mutator mutant, we show that the mutator strain is selected in vitro in urine and in the late stages of infection in a mouse model having urinary tract infection. Thus, we report that, under specific conditions, i.e., urinary tract infection, the mutator phenotype may confer an advantage in pathogenesis.     

The use of ribotyping and antibiotic resistance patterns for identification of host sources of Escherichia coli strains

AIMS: To compare antibiotic resistance and ribotyping patterns ability to identify triplicate isolates sent from a group of 40 Escherichia coli taken from seven host sources. METHODS AND RESULTS: Of the 120 isolates, 22 isolates were resistant to ampicillin, streptomycin, tetracycline and trimethoprim and 98 isolates were susceptible. Antibiotic patterns identified 33 of the triplicates and three of the six groups had isolates from multiple hosts. Ribotyping divided the isolates into 27 ribotype groups with all triplicates grouped into the same ribotype group with one host per group. CONCLUSIONS: Antibiotic susceptibility pattern placed 98 of the isolates in a single group with 50% of the antibiotic susceptibility pattern groups containing multiple host species. Ribotyping groups were host specific with each host having one to seven ribotype groups. SIGNIFICANCE AND IMPACT OF THE STUDY: Antibiotic susceptibility pattern groups have been used for environmental source identification and faecal pollution tracking, however these groups do not always distinguish between host species. Stability of the markers is a potential concern and this system can only be used if antibiotic resistance levels are high in the isolates studied. All isolates have a ribotype group which was stable and like other molecular methods has advantages over antibiotic susceptibility pattern groups which uses a phenotypic method.     

重庆地区儿童感染患者11 039株大肠埃希菌的临床分布及耐药性

目的 分析2010—2015年重庆地区儿童感染的11039株大肠埃希菌的临床分布特征及耐药性,为合理应用抗菌药物和预防控制医院感染提供依据。方法 分析大肠埃希菌对19种抗菌药物的耐药性,采用BD Phoenix 100 MIC法结合K-B纸片扩散法进行药敏试验,按美国临床实验室标准化委员会（CLSI）标准判断结果。结果 大肠埃希菌总检出率为13.53%;大肠埃希菌在呼吸病房和新生儿病房的检出率高于其他病房;以痰标本多见,占62.22%（6869/11039）;大肠埃希菌对氨苄青霉素耐药率最高（90.33%）,对美罗培南、亚胺培南的耐药率低,分别为0.81%和0.78%。ESBLs平均检出率为50.98%（5628/11039）。结论 大肠埃希菌的耐药性呈上升趋势,呼吸病房和新生儿病房是预防控制的重点科室。     

Characterization of class 1 integrons-mediated antibiotic resistance among calf pathogenic Escherichia coli

Escherichia coli isolates from calf diarrhea cases (n=22) in the Beijing surrounding region in China were characterized for disease serotype, virulence factors, antimicrobial susceptibility pattern and class 1 integrons. 59% (n=13) of the isolates were positive for the int I1 gene. The presence and genetic content of class 1 integrons in 13 E. coli isolates were examined by PCR and sequencing. Sequencing analysis revealed six gene cassettes, which encoded resistance to trimethoprim (dfrA1, dfrA17), aminoglycosides (aadB, aadA1 and aadA5) and chloramphenicol (cmlA). The gene cassette arrays dfrA1-orf (45%) and aadB-orf-cmlA (32%) were most prevalent among these isolates. These data revealed the high prevalence of class 1 integrons among calf pathogenic E. coli isolates in the Beijing surrounding region in China, which may provide important and useful surveillance information reflecting specific antibiotic selective pressure.     

Carbon dioxide increases acid resistance in Escherichia coli

AIMS: To investigate how carbon dioxide affects the acid resistance of Escherichia coli. METHODS AND RESULTS: Escherichia coli W3110 was grown in minimal EG medium at pH 7.5, and cells were adapted at pH 5.5 at 37 degrees C with and without supply of carbon dioxide and nitrogen gases. The number of colonies grown on LB medium was measured after cells were challenged in minimal EG medium of pH 2.5 at 37 degrees C under various conditions. When carbon dioxide was supplied at both the acid adaptation and challenge stages, 94% of cells survived after the acid challenge for 1 h, while the survival rates were 50 and 67% when nitrogen gas and glutamate were supplied respectively. After the acid challenge for 3 h, the survival rate observed with the carbon dioxide gas supply was again 2.5-fold higher than those with the nitrogen gas supply. CONCLUSION: Carbon dioxide was shown to participate in the maintenance of high viability under acidic conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides useful information for research into bacterial pathogenesis, fermentation and food preservation.     

Detection of ampicillin and tetracycline resistance genes in uropathogenic Escherichia coli strains by affinity-based nucleic acid hybrid collection

Abstract Uropathogenic Escherichia coli strains were analyzed for the presence of the ampicillin (Ap) and tetracycline (Tc) resistance genes by a novel nucleic acid solution hybridization technique. In this method probe pairs subcloned from the resistance genes are utilized. DNA from single colonies of 20 E. coli strains was released and analyzed without purification by the 3 h hybridization test. The respective resistance genes were easily identified by the test.     

Aerobactin production linked to transferable antibiotic resistance in Escherichia coli strains isolated from sewage

Abstract The production of aerobactin has been suggested to be a virulence factor in Escherichia coli . We have studied the production of aerobactin in 155 E. coli strains, isolated from sewage, which carry conjugative antibiotic resistance plasmids, and 88 (57%) of these strains produced aerobactin, and 59 (38%) co-transferred production of the siderophore and antibiotic resistance. In 35 (22%) of the transconjugants, both characters seemed to be encoded into the same plasmid. Those aerobactin-producing-antibiotic resistance plasmids had different sizes and antibiotic resistance patterns. The ecological implications of these results are discussed.     

Role of collectin-11 in innate defence against uropathogenic Escherichia coli infection

Classical collectins (surfactant protein A and D) play a significant role in innate immunity and host defence in uropathogenic Escherichia coli (UPEC)-induced urinary tract infection (UTI). However, the functions of collectin-11 (CL-11) with respect to UPEC and UTI remain largely unexplored. This study aimed to investigate the effect of CL-11 on UPEC and its role in UTI. We further examined its modulatory effect on inflammatory reactions in proximal tubular epithelial cells (PTECs). The present study provides evidence for the effect of CL-11 on the growth, agglutination, binding, epithelial adhesion and invasion of UPEC. We found increased basal levels of phosphorylated p38 MAPK and human cytokine homologue (keratinocyte-derived chemokine) expression in CL-11 knockdown PTECs. Furthermore, signal regulatory protein α blockade reversed the increased basal levels of inflammation associated with CL-11 knockdown in PTECs. Additionally, CL-11 knockdown effectively inhibited UPEC-induced p38 MAPK phosphorylation and cytokine production in PTECs. These were further inhibited by CD91 blockade. We conclude that CL-11 functions as a mediator of innate immunity via direct antibacterial roles as well as dual modulatory roles in UPEC-induced inflammatory responses during UTI. Thus, the study findings suggest a possible function for CL-11 in defence against UTI.     

佳木斯地区女性泌尿系统感染大肠埃希菌耐药性分析

目的分析女性患者泌尿系统感染大肠埃希菌的耐药性,为临床合理使用抗生素提供依据。方法采用全自动微生物鉴定系统对女性泌尿系统感染患者分离出的病原菌进行鉴定和药敏分析。结果大肠埃希菌非产ESBLs株对氨苄西林、第一、二代头孢菌素类药品高度耐药。大肠埃希菌非产ESBLs株对碳青霉烯类药物美罗培南无耐药,对第三代头孢菌素敏感率高,耐药率低。产ESBLs大肠埃希菌,仅碳青霉烯类抗生素美罗培南敏感。结论女性泌尿系统感染大肠埃希菌的多重耐药性日趋严重,需加强对抗生素使用的规范化管理,合理使用抗菌药物,控制耐药菌的传播和流行。     

Immunization with killed Escherichia coli increases resistance of lipopolysaccharide-hyporesponsive C3H/HeJ mice to experimental urinary tract infection

Abstract C3H/HeJ mice are highly susceptible to experimental ascending urinary tract infection. After a 4-week intraperitoneal immunization regimen with killed Escherichia coli , these mice became more resistant to urinary tract infection. The level of resistance induced by this regimen in this strain was similar to that of the normally more resistant C3HeB/FeJ strain of mouse and was evident from 3 to 14 days after transurethral challenge with E. coli . Increased resistance also developed after a 2- or 3-week immunization regimen, but this resistance was not apparent until 14 days after challenge.     

Fimbriation, surface hydrophobicity and serum resistance in uropathogenic strains of Escherichia coli

Abstract A total of 80 Escherichia coli strains were examined for expression of P-fimbriae, mannose-sensitive haemagglutination (MSHA) and mannose-resistant haemagglutination (MRHA) of human group A erythrocytes and guinea pig erthrocytes, cell surface hydrophobicity and resistance to serum bactericidal activity. Isolates were obtained from urine of children and adults, either with acute pyelonephritis ( n = 15 and n = 12) or lower urinary tract infection (UTI) ( n = 30 and n = 23, respectively). Results obtained showed that, in E. coli strains isolated both from children and adults with lower UTI, significant differences were not found concerning the incidence of P-fimbriae, cell surface hydrophobicity and serum resistance. In pyelonephritogenic E. coli isolated from children and adults, the incidence of P-fimbriae and cell surface hydrophobicity was associated more frequently with the former (87% vs. 42% and 100% vs. 67%, P < 0.05), while serum resistance was associated with the latter (47% vs. 67%, P < 0.05).     

Prevalence of virulence genes in Escherichia coli strains isolated from Romanian adult urinary tract infection cases

A total of 78 E. coli strains isolated from adults with different types of urinary tract infections were screened by polymerase chain reaction for prevalence of genetic regions coding for virulence factors. The targeted genetic determinants were those coding for type 1 fimbriae ( fimH ), pili associated with pyelonephritis ( pap ), S and F1C fimbriae ( sfa and foc ), afimbrial adhesins ( afa ), hemolysin ( hly ), cytotoxic necrotizing factor ( cnf ), aerobactin ( aer ). Among the studied strains, the prevalence of genes coding for fimbrial adhesive systems was 86 %, 36%, and 23% for fimH, pap , and sfa/foc , respectively. The operons coding for Afa afimbrial adhesins were identified in 14% of strains. The hly and cnf genes coding for toxins were amplified in 23% and 13% of strains, respectively. A prevalence of 54% was found for the aer gene. The various combinations of detected genes were designated as virulence patterns. The strains isolated from the hospitalized patients displayed a greater number of virulence genes and a diversity of gene associations compared to the strains isolated from the ambulatory subjects. A rapid assessment of the bacterial pathogenicity characteristics may contribute to a better medical approach of the patients with urinary tract infections.