هرود ،ﯽﻫﺎﮕﺸﯾﺎﻣزآ مﻮﻠﻋ ﻪﻠﺠﻣ مرﺎﻬﭼ
) هرﺎﻤﺷ 2 ( نﺎﺘﺴﻣز و ﺰﯿﯾﺎﭘ 1389
ﯽﻘﯿﻘﺤﺗ
ردﻪﯾﺮﺒﻤﯿﻓهﺪﻨﻨﮐﺪﮐيﺎﻬﻧژﯽﻧاواﺮﻓﻊﯾزﻮﺗ
E.coli
يرارداهﺎﮕﺘﺳدﺖﻧﻮﻔﻋﻪﺑﻼﺘﺒﻣنارﺎﻤﯿﺑزاهﺪﺷاﺪﺟ
هﺪﯿﮑﭼ
فﺪﻫ و ﻪﻨﯿﻣز :
ﻖـﻓﻮﻣنﻮﯿـﺳاﺰﯿﻧﻮﻠﮐردﻞـﺣاﺮﻣﻦﯾﺮﺗﯽﺳﺎﺳاءﺰﺟﯽﻧﺎﺑﺰﯿﻣحﻮﻄﺳﻪﺑلﺎﺼﺗاﯽﯾﺎﻧاﻮﺗ
ﺪﺷﺎﺑﯽﻣﯽﺑوﺮﮑﯿﻣيﺎﻬﻧژﻮﺗﺎﭘ
. يﺎﻫﻪﯾﻮﺳ
E.coli يدﺎـﯾزداﺪـﻌﺗياراديرارداهﺎﮕﺘـﺳدﺖـﻧﻮﻔﻋهﺪـﻨﻨﮐدﺎﺠﯾا
عﻮﻧﻪﯾﺮﺒﻤﯿﻓﻞﺜﻣﻪﯾﺮﺒﻤﯿﻓ
I ،
P ،ﻪﯾﺮﺒﻤﯿﻓ
S
-،ﻪﯾﺮﺒﻤﯿﻓ
FIC
،ﻪﯾﺮﺒﻤﯿﻓ
Dr ﯽـﻣلﺎـﯾﺮﺒﻤﯿﻓايﺎـﻫﻦﯿﺴﻫداوﻪﯾﺮﺒﻤﯿﻓ
ﺪﻨﺷﺎﺑ
.
ﺖﻧﻮﻔﻋﺪﻟﻮﻣﯽﻠﮐﺎﯿﺷﺮﺷاردﺎﻫﻪﯾﺮﺒﻤﯿﻓهﺪﻨﻨﮐﺪﮐيﺎﻫنژﯽﻧاواﺮﻓﻦﯿﯿﻌﺗفﺪﻫﺎﺑﻪﻌﻟﺎﻄﻣﻦﯾا رديراردا
ﺖﺳاهﺪﺷمﺎﺠﻧاناﺮﻬﺗ
.
ﯽﺳرﺮﺑ شور :
ﻖﯿﻘﺤﺗﻦﯾارد
363
ﻪﻧﻮﻤﻧ
ﯽـﻃرديرارداهﺎﮕﺘـﺳدﺖـﻧﻮﻔﻋﻪﺑﻼﺘﺒﻣداﺮﻓازايراردا
يﺎﻬﻟﺎﺳ
89 -87
ﺪـﺷيروآﻊـﻤﺟناﺮـﻬﺗبﺮـﻏﯽﻨﯿﻟﺎﺑيﺎﻬﻫﺎﮕﺸﯾﺎﻣزآزا
. ﯽﯾﺎﯿﻤﯿـﺷﻮﯿﺑيﺎﻬـﺷورزاهدﺎﻔﺘـﺳاﺎـﺑ
دراﺪﻧﺎﺘﺳا
E.coli ندﻮﺑ
200
ﺪﯾدﺮﮔﺪﯿﯾﺎﺗﻪﻧﻮﻤﻧ
.
ﺲﭘ
جاﺮﺨﺘـﺳازا
DNA شورﻪـﺑﺎـﻫﻪـﻧﻮﻤﻧزا
Boiling
،
ﺎﯾﺮﺒﻤﯿﻓيﺎﻬﻧژرﻮﻀﺣ
fim ,sfa ,pap ,foc ,afa
شورﻪﺑ
PCR
ﺖﻓﺮﮔراﺮﻗﯽﺳرﺮﺑدرﻮﻣ
.
ﻪﺘﻓﺎﯾ ﺎﻫ :
ﻪـﯾﺮﺒﻤﯿﻓيﺎـﻬﻧژعﻮﯿﺷناﺰﯿﻣ
pap ,sfa, afa, foc, fim ﻦﯿـﺑرد
200 ﺐـﯿﺗﺮﺗﻪـﺑﻪﯾﻮـﺳ
188 ) 94 (%
،
34 ) 17 (%
،
20 ) 10 (%
،
62 ) 31 (%
،
71 ) 35,5 (%
ﯿﻌﺗ ﺪﯾدﺮﮔﻦﯿ
.
يﺮﯿﮔ ﻪﺠﯿﺘﻧ :
نژﻪﮐدادنﺎﺸﻧﻪﻌﻟﺎﻄﻣﻦﯾاﺞﯾﺎﺘﻧ
fim
و
pap ﻪـﯾﺮﯿﻤﯿﻓهﺪـﻨﻨﮐﺪﮐيﺎﻬﻧژﻦﯾﺮﺘﻌﯾﺎﺷ
ﺪﺷﺎﺑﯽﻣناﺮﻬﺗﺮﻬﺷرديرارداﺖﻧﻮﻔﻋزاهﺪﺷاﺪﺟيﺎﻫﯽﻠﮐﺎﯿﺷﺮﺷارد
. ردﯽﺗﺎـﻋﻼﻃاﺪـﻧاﻮﺗﯽـﻣﻪﻠﺌﺴـﻣﻦﯾا
ﺖﯾﺮﯾﺪـﻣ،يرارداﺖـﻧﻮﻔﻋﯽﺳﺎﻨﺷﺐﯿﺳآردﺎﻬﻧآﺖﯿﻤﻫاﺎﺑﻪﻄﺑار
UTI
ﻫارو
ﺪـﯿﻟﻮﺗﺪـﻨﻧﺎﻤﻫﯽﻧﺎـﻣرديﺎـﻫرﺎﮑ
دروآﻢﻫاﺮﻓﻦﯾﻮﻧيﺎﻫﻦﺴﮐاو
.
يﺪﯿﻠﮐ يﺎﻫ هژاو :
ﯽﻠﮐﺎﯿﺷﺮﺷا،ﻪﯾﺮﺒﻤﯿﻓ،يرارداﺖﻧﻮﻔﻋ
ﯽﻤﻇﺎﻧﯽﻠﻋ
رﺎﯾدﺎﺘﺳا ، هوﺮﮔ يژﻮﻟﻮﯿﺑ ، ﺸﻧاد هﺎﮕ دازآ
ﯽﻣﻼﺳا ﺪﺣاو ﻦﺑﺎﮑﻨﺗ
يردﺎﻧﺎﺴﻬﻣ
هﺎﮕﺸﻧاد،يژﻮﻟﻮﯿﺑوﺮﮑﯿﻣﺪﺷراﯽﺳﺎﻨﺷرﺎﮐ دازآ
ﯽﻣﻼﺳا ﻦﺑﺎﮑﻨﺗﺪﺣاو
رﻮﭘﺮﻔﻌﺟﯽﻔﻄﺼﻣ
رﺎﯾدﺎﺘﺳا ، هوﺮﮔ يژﻮﻟﻮﯿﺑ هﺎﮕﺸﻧاد، دازآ
ﯽﻣﻼﺳا ﺪﺣاو ﻦﺑﺎﮑﻨﺗ
ﯽﺴﮔﺮﻧيﺮﯿﻣﺪﻋﺎﺳﺮﯿﻣ
رﺎﯾدﺎﺘﺳا ، هوﺮﮔ يژﻮﻟﻮﯿﺑ ، هﺎﮕﺸﻧاد دازآ
ﯽﻣﻼﺳا ﺪﺣاو ﻦﺑﺎﮑﻨﺗ
ﯽﻔﯾﺮﺷبﻮﺷآﺮﻬﺷ
،ﯽﮑﺷﺰﭘهﺪﮑﺸﻧاد،ﯽﮑﺷﺰﭘيژﻮﻟﻮﯿﺑﺪﺷراﯽﺳﺎﻨﺷرﺎﮐ ﻪﯿﮐﺮﺗ،ارﺎﮑﻧآهﺎﮕﺸﻧاد
لﻮﺌﺴﻣهﺪﻨﺴﯾﻮﻧ :
ﯽﻤﻇﺎﻧ ﯽﻠﻋ
ﻦﻔﻠﺗ :
09126051565
ﮏﯿﻧوﺮﺘﮑﻟاﺖﺴﭘ :
alinazemy@yahoo.com
سردآ
:
ﻊــﻤﺘﺠﻣ ،دﺎــﺑآ ﯽــﻟو ،ﻦﺑﺎــﮑﻨﺗ ،نارﺪــﻧزﺎﻣ هوﺮـﮔ ،ﻦﺑﺎـﮑﻨﺗ ﺪﺣاو ﯽﻣﻼﺳا دازآ هﺎﮕﺸﻧاد ﯽﺷزﻮﻣآ
ﻮﯿﺑ يژﻮﻟ
ﻪﻟﺎﻘﻣلﻮﺻو :
26 / 2 / 90
ﯽﯾﺎﻬﻧحﻼﺻا :
15 / 5 / 90
ﻪﻟﺎﻘﻣشﺮﯾﺬﭘ :
23 / 5 / 90
ﻪﻣﺪﻘﻣ coli . E
ونﺎﺴـﻧاشراﻮـﮔهﺎﮕﺘـﺳدلﺎـﻣﺮﻧرﻮـﻠﻓءﺰـﺟ
دﻮـﺷﯽـﻣبﻮﺴﺤﻣمﺮﮕﻧﻮﺧتﺎﻧاﻮﯿﺣ
) 1 و 2 .( ﮐﺎـﺑﻦـﯾا ﺎـﻫيﺮﺘ
رﺮـﺿﯽـﺑٌﻻﻮﻤﻌﻣﻪﭼﺮﮔا
زاﻪﯾﻮـﺳﻦﯾﺪـﻨﭼ،ﺪﻨـﺷﺎﺑﯽـﻣ E.coli
ﯽﮑﯿﺘﻧژﻞﻣاﻮﻋ
)
ﺲﻧﻻوﺮﯾويﺎﻬﻧژ
( ﻪـﺑﻪـﮐﺪﻧاهدروآﺖﺳدﻪﺑار
ﺪﺸـﺨﺑﯽﻣناﻮﯿﺣونﺎﺴﻧاياﺮﺑﯽﯾاﺰﯾرﺎﻤﯿﺑﺖﯿﺻﺎﺧﺎﻬﻧآ
) 3
و
4 .(
دﺎــﺠﯾالﻮﺌﺴــﻣﺎــﻬﻧژﻮﺗﺎﭘﻦــﯾا عﻮــﻧﺪــﻨﭼ
ﯽﻨﯿﻟﺎــﺑﺖــﻧﻮﻔﻋ ﻞــﺜﻣ
يﺎــﻬﺘﻧﻮﻔﻋ،ﯽﻟﺎﻬــﺳاوﮏــﯾﺮﺘﻧايﺎــﻬﯾرﺎﻤﯿﺑ يرارداهﺎﮕﺘــﺳد
،
ﺖﯾﮋﻨﻨﻣوﺲﯿﺴﭙﺳ
.
زاماﺪﮐﺮﻫﯽﯾاﺰﯾرﺎﻤﯿﺑتﺎﯿﺻﻮﺼﺧسﺎﺳاﺮﺑ
ياﺰﯾرﺎـﻤﯿﺑيﺎـﻫﻪﯾﻮـﺳ،نﺎـﺑﺰﯿﻣﯽﻨﯿﻟﺎﺑﻢﺋﻼﻋوﺎﻬﻧآ E.coli
ﻪـﺑ
ﻢﯿﺴﻘﺗﭗﯾﺎﺗﻮﺗﺎﭘﺎﯾهوﺮﮔﻦﯾﺪﻨﭼ ﺪﻧﻮﺷﯽﻣ ) 5 .( يﺎﻬﺘﻧﻮﻔﻋ Extraintestinal )
ياهدورجرﺎﺧ
(
ﻪﻠﯿﺳوﻪﺑ
زااﺰـﺠﻣﭗﯾﺎﺗﻮﺗﺎﭘﻪﺳ E.coli ﯽـﻣدﺎـﺠﯾا ﺪﻧﻮـﺷ : 1( يﺎـﻫﻪﯾﻮـﺳ
UPEC(uropathogenic E.coli) هﺎﮕﺘـﺳديﺎـﻫﺖـﻧﻮﻔﻋﻪـﮐ
ﺪــﻨﮐﯽــﻣدﺎــﺠﯾاﻪــﺑﺮﮔوﮓــﺳ،نﺎﺴــﻧارداريراردا
) 3 و 6( ، 2(
ﺴــﻣيﺎــﻫﻪﯾﻮــﺳ لﻮﺌ
يدازﻮــﻧﺖــﯾﮋﻨﻨﻣدﺎــﺠﯾارد (MENEC)
) 3 و 7( ، 3 ( ناﻮـﯿﺣونﺎﺴـﻧاردارﯽﻤـﺳﯽﺘﭙـﺳﻪـﮐﯽﯾﺎﻫﻪﯾﻮﺳ
ﺪﻨﻨﮐﯽﻣدﺎﺠﯾا
) 8 و 9 .( UPEC ﻪــﯿﻟواﻞــﻣﺎﻋ هﺎﮕﺘــﺳدﺖــﻧﻮﻔﻋ يراردا ) UTI ( د ر
ﺖـــﺳاﻪـــﺘﻓﺎﯾﻪﻌـــﺳﻮﺗيﺎﻫرﻮﺸــﮐ ) 6 و 9 و 10 و 11 .( UTI ءﺰـــﺟ
دﻮـﺷﯽـﻣبﻮﺴﺤﻣنﺎﺴﻧاﯽﻧﻮﻔﻋيﺎﻬﯾرﺎﻤﯿﺑﻦﯾﺮﺘﺠﯾار
) 12 .(
رد
ﺎﮑﯾﺮﻣآهﺪﺤﺘﻣتﻻﺎﯾا USA) ( ﻪﻟﺎﺳﺮﻫ 6/ 1 نﻮـﯿﻠﯿﻣ ﻪـﻨﯾﺰﻫرﻻد
ﺎﻫﺖﻧﻮﻔﻋﻦﯾانﺎﻣردفﺮﺻ ددﺮﮔﯽﻣ
. دﻮـﺷﯽـﻣهدزﻦﯿـﻤﺨﺗ
ﻪـﮐ
50 -40 %
ﻢﻟﺎــﺳنﺎــﻧززا
دﻮــﺧﯽﮔﺪــﻧزهرودلﻮــﻃردﻎﻟﺎـﺑ
رﺎﺒﮑﯾﻞﻗاﺪﺣ UTI
ﺪﻨﻨﮐﯽﻣﻪﺑﺮﺠﺗار
) 13 .( ﯽﻧﻮـﻔﻋيرﺎﻤﯿﺑﻦﯾا
ﻦﺘﻓﺮـﮔاﺮـﻓﺎـﺑﺐـﻠﻏاﺎﻣادﻮﺷﯽﻣعوﺮﺷﻪﻧﺎﺜﻣﺖﻧﻮﻔﻋﺎﺑٌﻻﻮﻤﻌﻣ
ﻪـﺑﺮـﺠﻨﻣﺖـﺳاﻦـﮑﻤﻣمﺎﺠﻧاﺮـﺳوﺪﻨﮐﯽﻣاﺪﯿﭘﻪﻌﺳﻮﺗﺎﻫﻪﯿﻠﮐ ﺪﺑﺎﯾهارﻢﻫنﻮﺧﻪﺑﯽﺘﺣودﻮﺷيﻮﯿﻠﮐﯽﯾﺎﺳرﺎﻧ
) 11 .( ﯽﯾﺎــﻧاﻮﺗ UPEC
هﺎﮕﺘــﺳدرادﻢــﺋﻼﻋﺖــﻧﻮﻔﻋدﺎــﺠﯾاياﺮــﺑ
ﺪــﺷﺎﺑﯽــﻣﺲﻧﻻوﺮــﯾوﻞــﻣﺎﻋعﻮــﻧوددﻮــﺟوﻞــﯿﻟدﻪــﺑيراردا
:
ﺎﻫﻦﯿﺴﻫدا
) عﻮﻧﻪﯾﺮﺒﻤﯿﻓﻞﺜﻣ I ، P -،ﻪـﯾﺮﺒﻤﯿﻓ S ،ﻪـﯾﺮﺒﻤﯿﻓ F1C -وﻪــﯾﺮﺒﻤﯿﻓ ( ...
ﺎــﻫﻦﯿﺴــﮐﻮﺗو
)
زوﺮــﮑﻧرﻮﺘﮐﺎــﻓ،ﻦﯾﺰﯿﻟﻮــﻤﻫﻞــﺜﻣ
رﻮﻣﻮﺗهﺪﻨﻫد ) ( 11 و 14 و 15 .(
ايرارداهﺎﮕﺘﺳدمﻮﯿﻠﺗﯽﭘاﻪﺑلﺎﺼﺗا
ﻪﻠﺣﺮﻣﻦﯿﻟو UTI
ﯽـﻣ
يﺎــﻫوﺮﯿﻧﻪــﺑﺖﺒﺴــﻧيﺮﺘﮐﺎــﺑﺎــﺗدﻮــﺷﯽــﻣﺚــﻋﺎﺑﻦــﯾاوﺪــﺷﺎﺑ ﺪــﺷﺎﺑموﺎــﻘﻣراردانﺎــﯾﺮﺟﮏﯿﻣﺎﻨﯾدورﺪــﯿﻫ
) 5 (
عﻮــﺿﻮﻣﻦــﯾاو
ﺖـﻓﺎﺑﻪـﺑﻢﺟﺎـﻬﺗوﺮﯿﺜﮑﺗياﺮﺑﺎﻬﻧآﯽﯾﺎﻧاﻮﺗﻦﺘﻓﺎﯾﺶﯾاﺰﻓاﺚﻋﺎﺑ ددﺮﮔﯽﻣيﻮﯿﻠﮐ
) 12 و 14 .( UPEC
ﺎـﯾﯽـﻠﯿﭘمﺎـﻧﻪـﺑﺪﻨﺘﺴـﻫﯽﻟﺎﺼـﺗايﺎـﻫرﻮﺘﮐﺎﻓياراد
ﺮﺒﻤﯿﻓ
يﺰـﯿﻣآﺖـﯿﻘﻓﻮﻣرﻮـﻃﻪـﺑﺎـﺗﺪﻫدﯽﻣهزﺎﺟاﺎﻬﻧآﻪﺑﻪﮐ،ﻪﯾ
زﺎﻏآارﺖﻧﻮﻔﻋ
ﺪﻨﻨﮐ
) 12 .( ﯽﻟﺎـﯾﺮﺒﻤﯿﻓيﺎـﻬﻧژﯽـﺘﻧآﺎﻫﻦﯿﺴﻫدا
ﻞﺼـﺘﻣهدورسﻮﮐﻮﻣﻪﺑﺎﺗﺪﻧزﺎﺳﯽﻣردﺎﻗاريﺮﺘﮐﺎﺑﻪﮐﺪﻨﺘﺴﻫ دﻮﺷ
) 16 .(
رددﻮﺟﻮﻣلﻮﻤﻌﻣيﺎﻫﻦﯿﺴﻫدازا UPEC
ناﻮﺗﯽﻣ
ﻪﺑ P عﻮﻧﺎﯾﺮﺒﻤﯿﻓ،ﺎﯾﺮﺒﻤﯿﻓ
1
، S ،ﺎﯾﺮﺒﻤﯿﻓ F1C
هداﻮﻧﺎـﺧوﺎـﯾﺮﺒﻤﯿﻓ
ﻦﯿﺴـــﻫدا Dr
) 17 (
ﻦﯿﺴـــﻫداﻞﻣﺎـــﺷﻪـــﮐ Dr
يﺎـــﻫﻦﯿﺴـــﻫداو
دﺮـﺑمﺎـﻧ،ﺪـﺷﺎﺑﯽـﻣلﺎﯾﺮﺒﻤﯿﻓا
) 18 .( ،ﺐـﯿﺗﺮﺗﻪـﺑ،ﺎـﻫﺎﯾﺮﺒﻤﯿﻓﻦـﯾا
يﺎﻬﻧژﻂﺳﻮﺗ afa ,foc ,sfa ,fim ,pap
ﺪﻧﻮـﺷﯽﻣﺪﮐ
) 19 .(
رد
UPEC عﻮﻧﺎﯾﺮﺒﻤﯿﻓ،
1
ﺖﺳاتﺪﺣﻞﻣﺎﻋﻦﯾﺮﺘﻤﻬﻣ
.
زايداﺪﻌﺗ
ﺎﯾﺮﺘﮐﺎﺑوﺮﺘﻧا هداﻮﻧﺎــﺧيﺎﻀــﻋا ﺪــﻨﻨﮐﯽــﻣﺪــﯿﻟﻮﺗارنژﻦــﯾاﻪــﺳ
.
عﻮﻧﻪﯾﺮﺒﻤﯿﻓ
1 زاﺶﯿﺑﻪﻠﯿﺳوﻪﺑ
90 % يﺎﻫﻪﯾﻮﺳ E.coli ﯽﻣنﺎﯿﺑ دﻮﺷ . وهﺪـﺷﺢـﺷﺮﺗيﺎـﻫﻦﯿﺌﺗوﺮﭘﻮـﮑﯿﻠﮔﻪﺑلﺎﺼﺗاﻪﯾﺮﺒﻤﯿﻓﻦﯾا
هﺪﺷﻞﺼﺘﻣلﻮﻠﺳﻪﺑﻪﮐارياهﺪﺷﻪﻠﯾزﻮﻧﺎﻣيﺎﻫﻦﯿﺌﺗوﺮﭘﻮﮑﯿﻠﮔ
ﺪــﻨﮐﯽـﻣﺖﻃﺎــﺳوﺪـﻧا
.
P
ﮏــﯾﺮﻣﯽـﻠﭘوﺮﺘﻫﻢﺋﺎﻤــﺿ؛ﻪـﯾﺮﺒﻤﯿﻓ
ﺎﻣﻪﻠﯿﻣﺖﺨﺳ
لﻮﻠﺳﺢﻄﺳزاﻪﮐﺪﻨﺘﺴﻫيﺪﻨﻧ E.coli
هدزنوﺮـﯿﺑ
زاﺮﺘﺸـﯿﺑردﻪـﮐﺖـﺳاهﺪـﺷهدادنﺎﺸﻧوﺪﻧا
70 %
ﯽﻠﮐﺎﯿـﺷﺮﺷا
درادرﻮﻀــﺣﮏــﯿﻧژﻮﺘﯾﺮﻔﻧﻮﻠﯿﭘ
) 20 .(
F1C
ﻪﻠﯿــﺳوﻪــﺑﻪــﯾﺮﺒﻤﯿﻓ
نژﺮﺘــﺳﻼﮐ foc
ﺮــﯿﻏﯽﻟﺎﺼــﺗارﻮﺘﮐﺎــﻓﮏــﯾ،دﻮــﺷﯽــﻣﺪــﮐ
ٌﺎـﺒﯾﺮﻘﺗﻪﻠﯿـﺳوﻪـﺑﻪـﮐﺖـﺳاهﺪـﻨﻨﮐﻪﻨﯿﺗﻮﻠﮔﺎﻤﻫ
14 %
زا E.coli
ﮐدﺎــﺠﯾا
ويرارداهﺎﮕﺘــﺳدﺖــﻧﻮﻔﻋهﺪــﻨﻨ
7 %
يﺎــﻫﻪﯾﻮــﺳ زا
ﯽﻋﻮﻓﺪﻣ E.coli
دﻮﺷﯽﻣنﺎﯿﺑ
.
ﻪﺑﺎﺸﻣﯽﮑﯿﺘﻧژﺮﻈﻧزاﻪﯾﺮﺒﻤﯿﻓﻦﯾا
S
ﺮﮕﯾﺪﮑﯾﺎﺑنﺎﺷﺎﻫرﻮﺘﭙﺳرﺖﯿﺻﺎﺼﺘﺧاﺮﻈﻧزاﺎﻣاﺖﺳاﻪﯾﺮﺒﻤﯿﻓ ﺪﻨﺗوﺎﻔﺘﻣ ) 21 .( S يﺎـﻫﺶـﺨﺑيوﺎـﺣيﺎﻫرﻮﺘﭙـﺳرﻪـﺑﻪـﯾﺮﺒﻤﯿﻓ
ردودﻮـﺷﯽﻣﻞﺼﺘﻣﮏﯿﻟﺎﯿﺳﺪﯿﺳايﺪﻨﻗ E.coli
دﺎـﺠﯾا
هﺪـﻨﻨﮐ
درادرﻮﻀﺣﺖﯾﺮﻔﻧﻮﻠﯿﭘوﺲﯿﺘﺴﯿﺳ
) 17 .( ،ﺎـﻫﻦﯿﺴﻫدالﺎﯾﺮﺒﻤﯿﻓا
ﻧزا ـ ﺧﺮﻈ
ـ ﺼ ـ ﯿﺻﻮ ـ ﻣتﺎ ـ ﻓرﻮ ـ ﻟﻮ ـ ﺑويژﻮ ـﯿـ ﺷﻮ ـﯿـ ﯿﻤ ـ ﺮﮕﯾدﺎﺑﯽﯾﺎ
ﻦﯿﺴﻫدا ﺎﻫ
نژﻂـﺳﻮﺗوﺪـﻧرادتوﺎـﻔﺗ afa
وﺪـﻧدﺮﮔﯽـﻣﺪـﮐ
يرارداهﺎﮕﺘــﺳدﺖــﻧﻮﻔﻋدﺎــﺠﯾاردﻪــﮐﺖــﺳاهﺪــﺷهدادنﺎﺸــﻧ ﺪﻨﺷﺎﺑﯽﻣﺶﻘﻧياراد
) 11 .(
ﺑﻪﺟﻮﺗﺎﺑ
تروﺮـﺿ،ﻪـﻌﻣﺎﺟرديرارداﺖـﻧﻮﻔﻋعﻮﯿـﺷﻪ
ﺖـﯿﻤﻫازانارﺎـﻤﯿﺑﻊﻗﻮﻣﻪﺑنﺎﻣردوﺺﯿﺨﺸﺗ،يﺮﮕﻟﺎﺑﺮﻏمﺎﺠﻧا ﺪﺷﺎﺑﯽﻣرادرﻮﺧﺮﺑﯽﯾﻻﺎﺑ
. رديرﺎـﮕﻧاﻞﻬـﺳﺎـﺑﻪﮐﻞﯿﻟدﻦﯾاﻪﺑ
ياﺮـﺑهﺪـﻨﯾآرديﺮﯾﺬـﭘﺎﻧناﺮـﺒﺟتﻼﮑﺸﻣ،ﺖﻧﻮﻔﻋﻦﯾانﺎﻣرد
دادﺪـﻫاﻮﺧخرواهداﻮﻧﺎـﺧورﺎﻤﯿﺑ
. ﺎـﺑﺮـﺿﺎﺣﻖـﯿﻘﺤﺗﻦﯾاﺮﺑﺎـﻨﺑ
ﻪـﯿﻟواﻞﻣاﻮﻋءﺰﺟﻪﮐ،ﺎﯾﺮﺒﻤﯿﻓيﺎﻬﻧژعﻮﯿﺷناﺰﯿﻣﯽﺳرﺮﺑفﺪﻫ
هﺎﮕﺘﺳدﺖﻧﻮﻔﻋدﺎﺠﯾاويرارداهﺎﮕﺘﺳدرديﺮﺘﮐﺎﺑلﺎﺼﺗاياﺮﺑ يراردا
)
UTI
(
ﺖــﺳاﻪــﺘﻓﺮﯾﺬﭘترﻮــﺻ،ﺪﻨــﺷﺎﺑﯽــﻣ
.
ﻦﺘﺴــﻧادﺎــﺑ
وﻢــﻬﻣﺶـﻘﻧﻪــﺑﻪـﺟﻮﺗﺎــﺑوﻪـﻌﻣﺎﺟردﺎــﻬﻧژﻦـﯾاعﻮﯿــﺷناﺰـﯿﻣ
اﺮﻃﺮﮑﻓﻪﺑناﻮﺗﯽﻣﺖﻧﻮﻔﻋدﺎﺠﯾاردﺎﻬﻧآيروﺮﺿ
ﻦﺴـﮐاوﯽﺣ
يﺮﺘﮐﺎﺑردﻪﯾﺮﺒﻤﯿﻓﻦﯾاﻪﯿﻠﻋﯽﯾﺎﻫ UPEC
دﺎﺘﻓا
.
ﯽﺳرﺮﺑشور
زا 363
ردﻪﮐيرارداهﺎﮕﺘﺳدﺖﻧﻮﻔﻋ ﻪﺑكﻮﮑﺸﻣدﺮﻓ
يﺎﻬﻟﺎﺳ ﯽﻃ
89 -1387
بﺮﻏ رد ﻊﻗاو هﺎﮕﺸﯾﺎﻣزآ ﻦﯾﺪﻨﭼ ﻪﺑ
ﻞﻤﻌﻟارﻮﺘﺳدﻖﺒﻃﻪﮐﺪﺷﻪﺘﺳاﻮﺧ،ﺪﻧدﻮﺑهدﻮﻤﻧﻪﻌﺟاﺮﻣناﺮﻬﺗ ﻠﺳﺎﻨﺗماﺪﻧايﻮﺸﺘﺴﺷزاﺲﭘدراﺪﻧﺎﺘﺳا ﻪﻧﻮﻤﻧ،ندﺮﮐﮏﺸﺧوﯽ
ددﺮﮔ يروآ ﻊﻤﺟ
. يزﺎﺳاﺪﺟ رﻮﻈﻨﻣ ﻪﺑ ﺲﭙﺳ E.coli
،
ﻂﯿﺤﻣ رد اﺰﺠﻣ رﻮﻃ ﻪﺑ ﺎﻫ ﻪﻧﻮﻤﻧ زا ماﺪﮐﺮﻫ ﺖﺸﮐ يﺎﻫ
ورﺎﮔآدﻼﺑ،ﯽﮑﻧﺎﮑﻣ EMB
يﺎﻫﺖﺴﺗﺎﺑوﺪﻧﺪﺷهدادﺖﺸﮐ
ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﺰﯿﻟﺎﻧآ درﻮﻣ دراﺪﻧﺎﺘﺳا ﯽﯾﺎﯿﻤﯿﺷﻮﯿﯾ
.
راردا ﺖﺸﮐ
داﺪﻌﺗﻪﮐدﻮﺑﻪﺟﻮﺗدرﻮﻣﯽﻧﺎﻣز cfu/ml
105 ﺖﺸﮐﻂﯿﺤﻣرد
ﺪﺷﺎﺑهدﺮﮐ ﺪﺷر
) 22 .(
ﺪﯾدﺮﮔﺺﺨﺸﻣرﺎﮐﻦﯾا مﺎﺠﻧا زاﺲﭘ
ﻪﮐ
200
يﺮﺘﮐﺎﺑيوﺎﺣﻪﻧﻮﻤﻧ E.coli
ﺪﺷﺎﺑﯽﻣ
.
ﺲﭙﺳ DNA ﻦﯾا
شورزاهدﺎﻔﺘﺳاﺎﺑﺎﻫيﺮﺘﮐﺎﺑ Boiling
ﻦﯾﺪﺑ،ﺪﯾدﺮﮔجاﺮﺨﺘﺳا
ردو ﺪﺷ ﻪﺘﺷادﺮﺑيﺮﺘﮐﺎﺑﻦﯾا زاﯽﻧﻮﻠﮐيراﺪﻘﻣ ﻪﮐ ترﻮﺻ تﺪﻣﻪﺑودراوهﺰﯿﻧﻮﯾدبآ
5
ﻘﯿﻗد ردﻪ °C
95
ﺪﺷهﺪﯿﻧﺎﺷﻮﺟ
ناﻮﻨﻋﻪﺑﯽﯾورلﻮﻠﺤﻣ،ژﻮﻔﯾﺮﺘﻧﺎﺳزاﺲﭘو DNA
ردﻮﮕﻟا
20
ﺶﻨﮐاو مﺎﺠﻧا رﻮﻈﻨﻣ ﻪﺑ داﺮﮔ ﯽﺘﻧﺎﺳ PCR
ﺪﺷ يراﺪﻬﮕﻧ
.
يﺎﻫنژيزﺎﺳ رﺎﮑﺷآ fim ,pap ,sfa ,foc ,afa
زاهدﺎﻔﺘﺳاﺎﺑ
ﮏﯿﻨﮑﺗ single-PCR ﺪﺷ مﺎﺠﻧا
.
ياﺮﺑ ،زﺎﯿﻧ درﻮﻣ يﺎﻫﺮﻤﯾاﺮﭘ
ﯽﻨﯿﺴﻫداﻪﯿﺣﺎﻧ ﻧژﻦﯾا
ﺪﯾدﺮﮔﯽﺣاﺮﻃﺎﻬ
.
ﺮﻤﯾاﺮﭘﺎﻨﺜﺘﺳادرﻮﻣﺎﻬﻨﺗ
طﻮﺑﺮﻣ
نژﻪﺑ pap ﻪﮐﯽﻔﻠﺘﺨﻣيﺎﻫﺖﻧﺎﯾراوﻪﺑﻪﺟﻮﺗﺎﺑﻪﮐدﻮﺑ
ﺪﺷﺎﺑﯽﻣ ارادنژ ﻦﯾا ﯽﻨﯿﺴﻫداﻪﯿﺣﺎﻧ
) 17 (
طﻮﺑﺮﻣ ﻪﯿﺣﺎﻧ ياﺮﺑ،
ﻪﺑ Usher ﺪﺷﯽﺣاﺮﻃنژﻦﯿﻤﻫ
.
ﺶﻨﮐاوﺮﻫرد single-PCR
ﻔﻨﻣوﺖﺒﺜﻣلﺮﺘﻨﮐهاﺮﻤﻫﻪﺑﺮﻈﻧدرﻮﻣيﺎﻫﻪﻧﻮﻤﻧيور ءاﺮﺟاﯽ
ﺪﺷ
.
ﻂﺳﻮﺗزﺎﯿﻧدرﻮﻣﯽﯾﺎﯿﻤﯿﺷداﻮﻣوﺎﻫﻢﯾﺰﻧآ ﺖﮐﺮﺷ
نژﺎﻨﯿﺳ
ﺪﯾدﺮﮔ ﻢﻫاﺮﻓ
.
ﺮﻠﮑﯾﺎﺳ لﺎﻣﺮﺗ ﮏﯾ رد ﺮﯿﺜﮑﺗ
)
Eppendrof,
Germany
(
لوﺪﺟ رد هﺪﺷ ﻪﺋارا شور ﻖﺒﻃ ﺮﺑ
2
ترﻮﺻ
ﺖﻓﺮﮔ
.
لژردزرﻮﻓوﺮﺘﮑﻟاﺎﺑﺮﻈﻧدرﻮﻣهﺪﺷﺮﯿﺜﮑﺗتﺎﻌﻄﻗﺰﯾﺎﺳ زرﺎﮔآ
2 %
ﺻﺎﺼﺘﺧاﺮﮐرﺎﻣﺰﯾﺎﺳﮏﯾزاهدﺎﻔﺘﺳاﺎﺑ ﯽ
)
100 bp
DNA ladder, MBI, Fermentas, Lithuania (
ﯽﺳرﺮﺑدرﻮﻣ
ﺪﻨﺘﻓﺮﮔراﺮﻗ
.
ﺎﻫﻪﺘﻓﺎﯾ ﯽﻣﺎـﻤﺗيورﺮـﺑﯽﯾﺎﯿﻤﯿـﺷﻮﯿﺑيﺎﻫﺖﺴﺗزاﺲﭘ 363
ﻪـﻧﻮﻤﻧ
ﻪـﮐﺪـﯾدﺮﮔﺺﺨﺸﻣ،يراردا
200
يوﺎـﺣﻪـﻧﻮﻤﻧ E.coli
ﯽـﻣ
ﺪﻨــﺷﺎﺑ
. ﺶﻨــﮐاومﺎــﺠﻧاﺎــﺑﺲﭙــﺳ PCR
يورﺮــﺑ DNA يﺎــﻫ
،ﺎـــﻫﻪـــﻧﻮﻤﻧﻦـــﯾازاهﺪـــﺷجاﺮﺨﺘــﺳا ﻪـــﮐﺪـــﯾدﺮﮔﺺﺨﺸـــﻣ
188
ﻪﯾﻮـــــﺳ
) 94 (%
fim+ ،
62 ) 31 (%
sfa+ ،
34 ) 17 (%
foc+
،
71
) 5/ 35 (%
pap+
و
20 ) 10 (%
afa+ ﺪﻧدﻮﺑ
. ﯽﻬﺟﻮـﺗﺐـﻟﺎﺟرﻮﻃﻪﺑ
ﺎﻬﻨﺗﻪﮐﺪﺷﺺﺨﺸﻣ
5/ 1 % ﺮـﻫﺪـﻗﺎﻓﯽﺳرﺮﺑدرﻮﻣيﺎﻫﻪﻧﻮﻤﻧزا
ﺪﻨﺘﺴـﻫدﻮﺧﺢﻄﺳيورﻦﯿﺴﻫداﻪﻧﻮﮔ
. ﺪـﺷﺺﺨﺸـﻣﯽـﻓﺮﻃزا
ﻦﯿﺑزاﻪﮐ
200
،ﻪﻧﻮﻤﻧ
188
ﻀـﺣﺮـﻈﻧزاﻪﻧﻮﻤﻧ نژرﻮ
fim
ﺖـﺒﺜﻣ
ﻦﯿﺑﻦﯾاردﻪﮐﺪﻨﺷﺎﺑﯽﻣ
96 نژيارادﺎـﻬﻨﺗﻪﯾﻮﺳ fim
ﯽﻘﺑﺎـﻣو
يﺎـﻬﻧژزاﯽـﮑﯾﻞﻗاﺪﺣيارادنژﻦﯾاﺮﺑهوﻼﻋ pap ,sfa ,foc
,afa ﺪﻨﺘﺴـﻫ
. نژﻪـﮐﺪـﺷﺺﺨﺸـﻣﻪـﻌﻟﺎﻄﻣﻦـﯾارد sfa
رد
62
ﻪﻧﻮﻤﻧ
) 31 (%
دراددﻮﺟو
. ﻦﯿـﺑزا
62 ،ﺖـﺒﺜﻣﻪـﻧﻮﻤﻧ
28 ) 14 (% ﻪـﺑ
ناﺮﭘايارادنﺎﻣﺰﻤﻫرﻮﻃ pap
و sfa و
31 ) 5/ 15 (%
ناﺮﭘاياراد
sfa و afa
ﺪﻨﺷﺎﺑﯽﻣ . ﻪﯾﻮﺳﻦﯿﺑردﻪﮐدادنﺎﺸﻧﻪﻌﻟﺎﻄﻣﻦﯾاﻪﺠﯿﺘﻧ
نژعﻮﯿﺷﯽﺳرﺮﺑدرﻮﻣيﺎﻫ fim
ﻪـﺑاريرﺎـﻣآﺪـﺻردﻦﯾﺮﺘﺸﯿﺑ
نژﻦـﯾاﺪـﻗﺎﻓﻪـﮐﺎﻫﻪﯾﻮﺳﯽﻗﺎﺑردوﺖﺳاهدادصﺎﺼﺘﺧادﻮﺧ نژعﻮﯿﺷ،ﺪﻨﺷﺎﺑﯽﻣ sfa
ﺖﺳاﺮﺗﻻﺎﺑﺎﻫنژﺮﮕﯾدﻪﺑﺖﺒﺴﻧ
.
ﻨﻣﻪﺑ
ﺖﺤﺻﺪﯿﯾﺄﺗرﻮﻈ
ﺮﯿﺜﮑﺗ
لﻮﺼـﺤﻣ،ﺎﻬﻧژ PCR
ﻦﯿـﯿﻌﺗياﺮـﺑ
ﺖﮐﺮﺷﻪﺑﯽﻟاﻮﺗ Macrogene
لﺎﺳراﯽﺑﻮﻨﺟهﺮﮐ ﺪـﯾدﺮﮔ
. ﺲـﭘ
ﯽﻟاﻮــﺗيزﺎــﺳﻒــﯾدرزا ردطﻮــﺑﺮﻣ
nBlast ﺖﯾﺎــﺳ، NCBI ،
ﺪﯾدﺮﮔﺪﯿﯾﺄﺗﺮﻈﻧدرﻮﻣﻪﻌﻄﻗﺖﺤﺻ
.
نژ
ﺮﻤﯾاﺮﭘﯽﻟاﻮﺗ )
/
3 ﻪﺑ
/
5 (
هﺪﺷﺮﯿﺜﮑﺗﻪﻌﻄﻗلﻮﻃ )
bp (
ﺲﻧﺮﻓر
Fim GTT GTT CTG TCG GCT CTG TC
TAA ATG TCG CAC CAT CCA G 400
ﻪﻌﻟﺎﻄﻣﻦﯾا
Sfa CCG TAA AGA TGT CTG CGA G
AGC AAG TCT GGC AAC GAG 100
ﻪﻌﻟﺎﻄﻣﻦﯾا
Afa GCT GGG CAG CAA ACT GAT AAC TCT C
CAT CAA GCT GTT TGT TCG TCC GCC G 750
15
Foc GGT GGA ACC GCA GAA AAT AC
GAA CTG TTG GGG AAA GAG TG 388
23
pap GAC GGC TGT ACT GCA GGG TGT GGC G
ATA TCC TTT CTG CAG GGA TGC AAT A 328
15
لوﺪﺟ 1 . نژ يﺎﻫﺮﻤﯾاﺮﭘ ﯽﻟاﻮﺗ ﺮﻈﻧ درﻮﻣ يﺎﻫ
ناﺮﻬﺗ رد يراردا ﺖﻧﻮﻔﻋ زا هﺪﺷ اﺪﺟ يﺎﻫ ﯽﻠﮐ ﺎﯿﺷﺮﺷا رد
Primer(pmol) Total volume
DMSO each of the four
dNTPs(mM) MgCl2(mM)
template DNA(μl) Genes
10 25
-0.4
2 3
fim
10 25
-0.4
2 3
sfa
20 25
-0.2
2.3 3
afa
100 30
5% 0.2
2 5
foc
20 25
- 0.2
1.5 1
pap
لوﺪﺟ 2 . ياﺮﺑ هدﺎﻔﺘﺳا درﻮﻣ داﻮﻣ راﺪﻘﻣ PCR
نژ ﺮﻈﻧ درﻮﻣ يﺎﻫ ناﺮﻬﺗ رد يراردا ﺖﻧﻮﻔﻋ زا هﺪﺷ اﺪﺟ يﺎﻫ ﯽﻠﮐ ﺎﯿﺷﺮﺷا رد
ﺮﯾﻮﺼﺗ 1 . رﺮﺑ درﻮﻣ يﺎﻬﻧژ ﺮﯿﺜﮑﺗ ﻪﺠﯿﺘﻧ ﯽﺳ
. طﻮﻄﺧ 1 ﺎﺗ 5 يﺎﻬﻧژ ﻪﺑ طﻮﺑﺮﻣ ﺐﯿﺗﺮﺗ ﻪﺑ afa
،
fim
،
foc
،
pap
،
sfa و ﺪﻨﺷﺎﺑ ﯽﻣ
ﺮﮐرﺎﻣ ﺰﯾﺎﺳ ﭗﭼ ﺖﻤﺳ ﺮﯾﻮﺼﺗ 100
ﺪﻫد ﯽﻣ نﺎﺸﻧ ار يزﺎﺑ ﺖﻔﺟ .
Virulence factor gene Number of positive isolates(%)
fim 188(94%)
sfa 62(31%)
afa 20(10%)
foc 34(17%)
pap 71(35.5%)
لوﺪﺟ 3 . يﺎﻬﻧژ رﻮﻀﺣ ﺞﯾﺎﺘﻧ fim
،
foc
،
pap ، sfa ، afa ﻖﯾﺮﻃ زا PCR ﯽﻠﮐ ﺎﯿﺷﺮﺷا رد
ناﺮﻬﺗ ﺮﻬﺷ رد راردا ﺖﻧﻮﻔﻋ زا هﺪﺷ اﺪﺟ يﺎﻫ
ﺚﺤﺑ
ﯽﻠﮐ ﺎﯿﺷﺮﺷا
دﺎﺠﯾا ﻞﻣﺎﻋ ﮏﯾ ناﻮﻨﻋ ﻪﺑ ﺖﻧﻮﻔﻋ هﺪﻨﻨﮐ
دﻮﺷ ﯽﻣ بﻮﺴﺤﻣ نﺎﺴﻧا رد يراردا هﺎﮕﺘﺳد
.
دراﻮﻣ ﺮﺜﮐا رد
ﯽﻣرﻮﺼﺗ و ﺪﻧراددﻮﺟو عﻮﻓﺪﻣردﮏﯿﻧژﻮﺗﺎﭘورﻮﯾ يﺎﻬﻧﻮﻠﮐ يﺎﻫ ﻪﯾﻮﺳ ندﻮﺑ ﮏﯿﻧژﻮﺗﺎﭘ ياﺮﺑ هﻮﻘﻟﺎﺑ ﯽﯾﺎﻧاﻮﺗ ﻪﮐ ددﺮﮔ E.coli ﺪﺷﺎﺑ ﺲﻧﻻوﺮﯾو يﺎﻫرﻮﺘﮐﺎﻓ رﻮﻀﺣ ﻪﺑ ﻪﺘﺴﺑاو ، )
19
و
24
و
25 .(
ﯿﻟوا ﻪﮐ ﺪﻧروﺎﺑ ﻦﯾا ﺮﺑ ناﺪﻨﻤﺸﻧاد رد ﻪﻠﺣﺮﻣ ﻦ
مﻮﯿﻠﺘﯿﭘاورﻮﯾ ﻪﺑ يﺮﺘﮐﺎﺑلﺎﺼﺗا ،يراردا هﺎﮕﺘﺳدﺖﻧﻮﻔﻋ دﺎﺠﯾا ﺪﺷﺎﺑﯽﻣ
.
ﻦﯾاﻪﻄﺳاوﻪﯾﺮﺒﻤﯿﻓﻪﮐﺪﺷهدادنﺎﺸﻧيدﺎﯾزدراﻮﻣرد
ﺖﺳا لﺎﺼﺗا
) 13 .(
دﻮﺟﻮﻣ لﻮﻤﻌﻣيﺎﻫ ﻦﯿﺴﻫدازا
د
ر UPEC
ﻪﺑ ناﻮﺘﯿﻣ P عﻮﻧ ﺎﯾﺮﺒﻤﯿﻓ،ﺎﯾﺮﺒﻤﯿﻓ
1
، S ،ﺎﯾﺮﺒﻤﯿﻓ F1C وﺎﯾﺮﺒﻤﯿﻓ
ﻦﯿﺴﻫدا هداﻮﻧﺎﺧ Dr
ﻪﮐ ﻦﯿﺴﻫدا ﻞﻣﺎﺷ Dr
يﺎﻫ ﻦﯿﺴﻫداو
دﺮﺑ مﺎﻧ ،ﺪﺷﺎﺒﯿﻣ لﺎﯾﺮﺒﻤﯿﻓا
) 19 .(
ﮏﯾ زا ﺎﻣ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد
ﺲﻧﻻوﺮﯾويﺎﻬﻧژ رﻮﻀﺣ ﻪﻌﻟﺎﻄﻣ ياﺮﺑ ﯽﭙﯿﺗﻮﻧژ شور E.coli
ﻢﯾدﺮﮐهدﺎﻔﺘﺳاﮏﯿﻧژﻮﺗﺎﭘورﻮﯾ
.
PCR ﯽﻠﯿﺧﯽﭙﯿﺗﻮﻧژشورﮏﯾ
يزﺎﺳرﺎﮑﺷآ ياﺮﺑﻪﮐﺪﺷﺎﺑ ﯽﻣﺮﺛﻮﻣو ﺪﻨﻤﺗرﺪﻗ،ﯽﺻﺎﺼﺘﺧا داهﺪﻨﻨﮐﺪﮐيﺎﻬﻧاﺮﭘا ﻪﮐﯽﺴﻧﻻوﺮﯾويﺎﻫرﻮﺘﮐﺎﻓﺮﮕﯾدوﻦﯿﺴﻫ
ﺲﻧﻻوﺮﯾويورﺪﻨﻧاﻮﺗﯽﻣ UTI
دﻮﺷﯽﻣهدﺎﻔﺘﺳا،ﺪﻧراﺬﮕﺑﺮﺛا
.
ﺎﯾﺮﺒﻤﯿﻓﺲﻧﻻوﺮﯾويﺎﻬﻧژعﻮﯿﺷﻪﮐﻢﯿﺘﻓﺎﯾردﻪﻌﻟﺎﻄﻣﻦﯾاردﺎﻣ
foc ,afa ,sfa ,pap ,fim
،ﺐﯿﺗﺮﺗ ﻪﺑ
94 %
،
5/ 35 %
،
31 %
،
5/ 26 %
،
17 %
ﺪﺷﺎﺑﯽﻣ
.
زا هﺪﻣآﺖﺳدﻪﺑﺞﯾﺎﺘﻧﺎﺑﺎﻫ ﻪﺘﻓﺎﯾﻦﯾا
لﺎﺳ ردﺶﻧارﺎﮑﻤﻫوﻮﯾﺮﺒﯾر
2008
درادﺖﻘﺑﺎﻄﻣ
.
ناﻮﻨﻋﺎﻬﻧآ
يﺎﻬﻧژعﻮﯿﺷﻪﮐﺪﻧدﺮﮐ fim
، pap ، sfa ، afa ﻦﯿﺑرد
162
،ﻪﻧﻮﻤﻧ
ﺐﯿﺗﺮﺗﻪﺑ
5/ 97 %
،
7/ 32 %
،
8/ 27 %
،
2/ 6 %
ﺪﺷﺎﺑﯽﻣ
.
ﻪﻌﻟﺎﻄﻣ رد
لﺎﺳ رد ﺶﻧارﺎﮑﻤﻫ و نﻻ ﻂﺳﻮﺗ ﻪﮐ يا
2007
هﺎﮕﺸﻧاد رد
عﻮﻧﻪﯾﺮﺒﻤﯿﻓﻪﮐﺪﯾدﺮﮔﺺﺨﺸﻣ،ﺪﺷمﺎﺠﻧانﺎﮕﯿﺸﯿﻣ I
راﺪﻘﻣﻪﺑ
ﻦﯾاﻪﮐددﺮﮔﯽﻣنﺎﯿﺑيرارداهﺎﮕﺘﺳدﺖﻧﻮﻔﻋلﻮﻃرديدﺎﯾز وددﺮﮔيﺮﺘﮐﺎﺑﻦﯾاردﺖﮐﺮﺣﺶﻫﺎﮐﻪﺑﺮﺠﻨﻣﺪﻧاﻮﺗﯽﻣنﺎﯿﺑ ردهﮋﯾﻮﺑ،ﺖﻧﻮﻔﻋردﻢﻬﻣﻞﻣﺎﻋﮏﯾناﻮﻨﻋﻪﺑعﻮﺿﻮﻣﻦﯾا
24
ﺎﺜﻣ رد نﻮﯿﺳاﺰﯿﻧﻮﻠﮐ نﺎﻣز زا ﺖﻋﺎﺳ ددﺮﮔ ﯽﻣ ﯽﻘﻠﺗ ،ﻪﻧ
) 25 .(
ﻪﮐ ﻢﯾدﺮﮐ هﺪﻫﺎﺸﻣ ﺎﻣ هوﻼﻌﺑ
90
ﻪﯾﻮﺳ fimH ياراد ،ﺖﺒﺜﻣ
يﺎﻬﻧژزاﯽﮑﯾ ﻞﻗاﺪﺣ pap,sfa,foc,afa
ﺪﻨﺷﺎﺑﯽﻣ
.
ﻪﺠﯿﺘﻧﻦﯾا
لﺎﺳردﺶﻧارﺎﮑﻤﻫونﻮﺴﻧﺎﺟﻂﺳﻮﺗهﺪﺷﻪﺋاراﻪﺠﯿﺘﻧﺎﺑ
2005
درادﺖﻘﺑﺎﻄﻣ
) 26 .(
ﻪﮐﺪﻧدﻮﺑهدﺮﮐناﻮﻨﻋﺎﻬﻧآ fimH
طﺎﺒﺗرارد
ﺎﺑ P
-ﻪﯾﺮﺒﻤﯿﻓ و S
-ﺪﺷﺎﺑﯽﻣﻪﯾﺮﺒﻤﯿﻓ
.
يﻮﺴﯾرآ
161
ﻪﯾﻮﺳ E.coli
ﻪﺑﻼﺘﺒﻣنﺎﮐدﻮﮐزاﻪﮐار UTI
ﻪﮐﺖﻓﺎﯾردودﺮﮐاﺪﺟ
4 / 58 %
ﺪﻨﺷﺎﺑﯽﻣﺲﻧﻻوﺮﯾويﺎﻬﻧژزاﯽﮑﯾيارادﻞﻗاﺪﺣﺎﻫﻪﯾﻮﺳزا
:
يﺎﻬﻧژعﻮﯿﺷﻪﮐﺪﺷﺺﺨﺸﻣ hly, sfa, cnf-I, pap
ﺐﯿﺗﺮﺗﻪﺑ
ﺎﺑﺖﺳاﺮﺑاﺮﺑ
98 / 22 %
،
94 /9 %
،
21 /6 %
،
24 /1 %
ﺟﻮﺗﺎﺑو ﻦﯾاﻪﺑﻪ
نژ عﻮﯿﺷ ﻪﮐ عﻮﺿﻮﻣ pap
يﺎﻫ ﻪﯾﻮﺳ ﻦﯿﺑ رد E.coli
دﺎﺠﯾا
ﻪﻌﻟﺎﻄﻣدرﻮﻣداﺮﻓاﺮﺜﮐاﻪﺠﯿﺘﻧردﺪﺷﺎﺑﯽﻣﻦﯿﯾﺎﭘﺲﯿﺘﺴﯿﺳهﺪﻨﻨﮐ ﺪﻧاهدﻮﺑﺲﯿﺘﺴﯿﺳﻪﺑﻼﺘﺒﻣﻖﯿﻘﺤﺗﻦﯾارد
) 7 .(
يﺎﻫﻪﯾﻮﺳردارﺎﻬﻧژﻦﯾادﻮﺟوﺖﯿﻤﻫاﻪﻌﻟﺎﻄﻣﻦﯾا UPEC
ﺪﻫد ﯽﻣ نﺎﺸﻧ
.
ﻧژ ﻦﯾا يﺪﯿﻠﮐ و ﻢﻬﻣ ﺶﻘﻧ ﻦﺘﺴﻧاد ﺎﺑ رد ﺎﻬ
دﻮﺟوﺎﺑويرارداهﺎﮕﺘﺳدهﺪﻨﻨﮐدﺎﺠﯾايﺎﻫ ﻪﯾﻮﺳﺲﻧﻻوﺮﯾو نﺎﻣرد ياﺮﺑ ﻪﻟﺎﺳ ﺮﻫﻪﮐ يدﺎﯾز يﺎﻫ ﻪﻨﯾﺰﻫ UTI
وﻪﻌﻣﺎﺟ ﺮﺑ
ﻪﯿﻠﻋﻦﺴﮐاوﯽﺣاﺮﻃﺮﮑﻓﻪﺑﻢﯿﻧاﻮﺗﯽﻣدﻮﺷﯽﻣﻞﯿﻤﺤﺗهداﻮﻧﺎﺧ ﻢﯿﺷﺎﺑ يرﺎﻤﯿﺑﻦﯾا
.
رﻮﻀﺣنﺎﻣﺰﻤﻫ رﻮﻄﺑﻖﯿﻘﺤﺗ ﻦﯾارد
5
نژ
ﺖﻓﺮﮔراﺮﻗﯽﺳرﺮﺑدرﻮﻣﻪﯾﺮﺒﻤﯿﻓ
.
ﻧآزا ﻪﻠﺣﺮﻣﻦﯿﻟواﻪﮐﯽﯾﺎﺠ
ﻢﻬﻣﺶﻘﻧﻪﯾﺮﺒﻤﯿﻓوﺪﺷﺎﺑﯽﻣيﺮﺘﮐﺎﺑلﺎﺼﺗاﺖﻧﻮﻔﻋدﺎﺠﯾاياﺮﺑ و ﺖﯿﻤﻫا ﻪﺠﯿﺘﻧ رد ﺪﻨﮐ ﯽﻣ ﻢﻫاﺮﻓ لﺎﺼﺗا ياﺮﺑ ار يﺪﯿﻠﮐ و دﻮﺷ ﯽﻣ ﺺﺨﺸﻣ ﻖﯿﻘﺤﺗ ﻦﯾا مﺎﺠﻧا تروﺮﺿ
.
ﻪﻌﻟﺎﻄﻣ ﻦﯾا رد
نژ ﻪﮐ ﺪﯾدﺮﮔ ﺺﺨﺸﻣ fim
و sfa ﻪﻌﻟﺎﻄﻣ درﻮﻣ داﺮﻓا ﻦﯿﺑ رد
دﻮﺧ ﻪﺑ اريرﺎﻣآ ﺪﺻرد ﻦﯾﺮﺘﺸﯿﺑ ﻦﯾا و ﺪﻨﻫدﯽﻣ صﺎﺼﺘﺧا
رد ﺎﺗ ﺪﺷﺎﺑ ﯽﻔﻄﻋ ﻪﻄﻘﻧ ﮏﯾ ناﻮﻨﻋ ﻪﺑ ﺪﻧاﻮﺗ ﯽﻣ عﻮﺿﻮﻣ ودﻦﯾا ﻪﯿﻠﻋ ﯽﺒﯿﮐﺮﺗ ﻦﺴﮐاو ﯽﺣاﺮﻃ ﺮﮑﻓ ﻪﺑ يﺪﻌﺑ تﺎﻌﻟﺎﻄﻣ ردﺖﻧﻮﻔﻋ ﻦﯾا دﺎﺠﯾازا ﻢﯿﻧاﻮﺘﺑ ﻖﯾﺮﻃ ﻦﯾﺪﺑﺎﺗ ﻢﯿﺷﺎﺑ ﻪﯾﺮﺒﻤﯿﻓ ﻢﯿﻨﮐ يﺮﯿﮕﺸﯿﭘ ﻪﻌﻣﺎﺟ
.
و ﻊﻣﺎﺟ تﺎﻋﻼﻃا ﻪﺑ ﯽﺑﺎﯿﺘﺳد ياﺮﺑ
ﺷﯽﻣدﺎﻬﻨﺸﯿﭘﺮﺘﻘﯿﻗدﯽﺑﺎﯾزرا رﻮﻀﺣﺮﮕﯾدتﺎﻘﯿﻘﺤﺗردﻪﮐدﻮ
ﻊﻤﺟ يﺎﻫ ﻢﺘﺴﯿﺳ ،ﺎﻫ ﻦﯿﺴﮐﻮﺗ ﻞﺜﻣ ﺲﻧﻻوﺮﯾو ﻞﻣاﻮﻋ ﺮﮕﯾد وﻦﻫآهﺪﻨﻨﮐ
...
ﺎﺗدﺮﯿﮕﺑراﺮﻗﯽﺳرﺮﺑدرﻮﻣﻪﯾﺮﺒﻤﯿﻓﺎﺑهاﺮﻤﻫﺰﯿﻧ
ﻦﯾاﻪﺑﻪﺟﻮﺗﺎﺑﺎﻣادادمﺎﺠﻧاﺎﻫرﻮﺘﮐﺎﻓﻦﯾاﻦﯿﺑياﻪﺴﯾﺎﻘﻣناﻮﺘﺑ ﺎﻣﺪﺷﺎﺑﯽﻣﺖﻧﻮﻔﻋدﺎﺠﯾاياﺮﺑﻪﻠﺣﺮﻣﻦﯿﻟوالﺎﺼﺗاﻪﮐعﻮﺿﻮﻣ د ارلﺎﺼﺗاردﻞﯿﺧديﺎﻬﻧژرﻮﻀﺣﻞﻣﺎﮐرﻮﻃﻪﺑدﻮﺧﻖﯿﻘﺤﺗر
ﻢﯾدادراﺮﻗﯽﺳرﺮﺑدرﻮﻣ
.
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