摘要
目的 探究老年导管相关尿路感染(catheter-associated urinary tract infection, CAUTI)中微生物群落的动态变化及其抗生素耐药性的发展,以期对CAUTI的预防和治疗策略提供新的理论依据。方法 本前瞻性队列研究共纳入30名老年导管尿路感染患者,分为CAUTI组(n=15)和对照组(n=15)。通过16S rRNA基因测序技术分析微生物种类,使用Kirby-Bauer纸片扩散法进行抗生素敏感性测试,并采用统计学方法比较两组间微生物群落结构和抗生素耐药性的差异。结果 两组患者的一般人口学特征相似。在微生物群落结构分析中,CAUTI组患者样本中大肠埃希菌属、葡萄球菌属和链球菌属的丰度显著高于对照组(大肠埃希菌属9.25%±2.44%vs 8.00%±2.49%,P<0.05;葡萄球菌属9.38%±2.70%vs 7.03%±2.17%,P<0.05;链球菌属10.09%±2.65%vs 8.95%±3.73%,P<0.05)。α多样性指数中,Simpson指数在CAUTI组有显著下降(0.58±0.31 vs 0.77±0.26,P<0.05)。β多样性分析揭示两组微生物群落分布存在显著差异。抗生素敏感性测试结果表明,CAUTI组抑菌圈直径普遍小于对照组(β内酰胺类18.45±1.23 mm vs 20.67±1.56 mm,P<0.05;喹诺酮类21.57±1.78 mm vs 23.89±1.45 mm,P<0.05;大环内酯类19.32±1.65 mm vs 22.43±1.29 mm,P<0.05)。CAUTI组耐药菌株比例显著高于对照组(46.7%vs 20%,P<0.05)。结论 CAUTI患者的尿液和导尿管样本中微生物群落组成存在显著差异,且表现出更高的抗生素耐药性。这些数据表明CAUTI的临床治疗需要更加关注抗生素的合理选择和使用,同时也提示了未来研究需要关注微生物群落对治疗响应的影响。
Objective To investigate the dynamics of microbial communities and the development of their antibiotic resistance in catheter-associated urinary tract infection(CAUTI)in the elderly,in order to provide new theoretical basis for prevention and treatment strategies of CAUTI.Methods A total of 30 elderly patients with catheterized urinary tract infections were included in this prospective cohort study and were divided into CAUTI group(n=15)and control group(n=15).Microbial species were analyzed by 16S rRNA gene sequencing technology,antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method,and statistical methods were used to compare the differences in microbial community structure and antibiotic resistance between the two groups.ResultsThe general demographic characteristics of the two groups of patients were similar,with no statistical differences.In the analysis of microbial community structure,the abundance of Escherichia coli,Staphylococcus and Streptococcus in the patient samples of the CAUTI group was significantly higher than that of the control group(Escherichia coli 9.25±2.44%vs 8.00±2.49%,P<0.05;Staphylococcus 9.38±2.70%vs 7.03±2.17%,P<0.05;Streptococcus 10.09±2.65%vs 8.95±3.73%,P<0.05).Among the alpha diversity indexes,Simpson index decreased significantly in the CAUTI group(0.58±0.31 vs 0.77±0.26,P<0.05).Beta diversity analysis revealed significant differences in the distribution of microbial communities between the two groups.Antibiotic sensitivity test results showed that the diameter of the inhibition zone in the CAUTI group was generally smaller than that in the control group(β-lactams 18.45±1.23 mm vs 20.67±1.56 mm,P<0.05;quinolones 21.57±1.78 mm vs 23.89±1.45mm,P<0.05;macrolide19.32±1.65mm vs 22.43±1.29 mm,P<o.05).The proportion of drug-resistant strains in the CAUTI group was significantly higher than that in the control group(46.7%vs 20%,P<0.05).Conclusion There are significant differences in the composition of microbial communities in urine and catheter samples of CAUTI patients,and they exhibit higher antibiotic resistance.These data indicate that the clinical treatment of CAUTI needs to pay more attention to the rational selection and use of antibiotics,and suggest that future research needs to focus on the impact of microbial communities on treatment response.
作者
邹晓
徐向东
李培越
伍治强
ZOU Xiao;XU Xiangdong;LI Peiyue;WU Zhiqiang(Modern Nursing School of Dazhou Vocational and Technical College,Dazhou 635000,Sichuan,China;Medical Laboratory Department of Dazhou Central Hospital;Department of Geriatry,Dazhou Central Hospital;Department of Thoracic Surgery,First Affiliated Hospital of Chengdu Medical College)
出处
《中国病原生物学杂志》
CSCD
北大核心
2024年第10期1136-1141,1146,共7页
Journal of Pathogen Biology
基金
四川省科技计划项目任务重点研发项目(No.2023YFS0178)。
作者简介
通讯作者:李培越,E-mail:wulalaqi@sina.com;邹晓(1986-),女,四川乐山人,本科,讲师,主要研究:老年疾病。E-mail:xiximami2022@163.com。
