| Objective:Adhesion factors was considered to be the most important virulence factors of Uropathogenic Escherichia coli (UPEC). Adhesion factors can make it adheres, colonizates and even invades into epithelial cells of various organs of the urinary system, causing recurrent urinary tract infections(UTI). This study took the UPEC as the research object, and analysed the homology of Escherichia coli(E.coli) from urine and fecal of the same patient with urinary tract infections and fimH gene sequence; and carried out the investigation of the adhesions of UPEC. Explore the correlation between the adhesins and urinary tract infection at the genetic level.Materials and Methods:1、The strains of E. coli were from the urine urine of outpatient and inpatient with urinary tract infection and the urine and fecal of outpatient with UTI.2、Antibiotic susceptibility to5antibiotics(ampicillin, ciprofloxacin, cefotaxime, cefoperazone, gentamycin) was tested by K-B method.3、Homology analysis of the E. coli from the urine and fecal of the same patient was analyzed by pulsed field gel electrophoresis (PFGE).4、Related genes of adhesinof the E.coli were amplificated by polymerase chain reaction (PCR), and analysed the sequence of fimH gene from the same patient.Results:1、89E.coli from recurrent UTI(70) and acute cystitis patients(19). E. coli from urine and fecal of9patients with UTI were cultured at the same time.2、E. coli of urine and fecal of5patients respectively had the same antibiotic medicine sensitive spectrum.3、The E.coli strains that the antibiotic medicine sensitive spectrum were same of the same patients had the same PFGE pattern, and the strips and the corresponding strip sizes were same. The strains that the antibiotic medicine sensitive spectrum were different of the same patient did not have same different PFGE patterns.4、The sequence of fimH gene of the strains from urine and fecal that had same PFGE patterns of the same patient have high homology (>99.9%). There were7 point mutation in the product of the strains from urine compared with the strains from fecal of the same patient. The point mutation was79(T-A),129(T-C)、157(G-A)、298(A-T)、640(C-A)、701(T-C)、817(T-C). Accodding to the gene sequence we got the amino acids sequence and found out there were amino acids sequence change:Arg43'Cys, Gly53'Arg, Ile100'Phe, Cys234、273'Arg.5、In the89strains, the positive rate of fimH gene was91%(81/89), the rate of recurrent UTI group and the acute uncomplicated cystitis group were respectively91.4%(64/70) and89.4%(17/19), P=0.792; the positive rate of afaC gene was71.9%(64/89), difference between two groups (57/70vs7/19)was statistically significant; Ag43related genes flu detection rate was67.4%, and the positive rate of flu gene of recurrent UTI group was obviously higher than that of acute uncomplicated cystitis group, P=0.013; the detection rate of type P fimbria and type S fimbria were both low,23.5%、6.7%respectively, and difference between recurrent UTI group and acute uncomplicated cystitis group was not statistically significant.Conclusions:1、Antibiotic medicine sensitive spectrum and the PFGE pattern showed that some of the E.coli that caused UTI are derived from its own gut. The sequence analysis of the fimH gene shows that the expression or phenotypic changes of fimH may be associated with urinary tract infection disease.2、Type I fimbriae, Afa/Dr Family adhesion and Ag43are associated with UTI, and the latter two may be the important cause of recurrent UTI. Type I fimbriae, Afa/Dr family adhesion and Ag43are mainly popular adhesion species of UPEC in our hospital, and type I fimbriae is the most popular adhesion species. |
PDF Full Text Request