泛耐药肺炎克雷伯菌的致病力研究  

Pathogenicity study of pandrug-resistant Klebsiella pneumoniae

作　　者：周郑[1] 任建安[2] 张长乐[1] 刘海燕[3] 顾国胜[2] 黎介寿[2] 

机构地区：[1]安徽医科大学第一附属医院普通外科,安徽合肥230022 [2]南京军区南京总医院解放军普通外科研究所 [3]安徽医科大学第一附属医院重症医学科,安徽合肥230022

出　　处：《中国感染与化疗杂志》2012年第1期42-45,共4页Chinese Journal of Infection and Chemotherapy

基　　金：国家自然科学基金(30872456)

摘　　要：目的通过菌血症的动物实验,研究不同耐药程度细菌毒力的差异性。方法用30只家兔为实验动物,随机分为3组,通过中心静脉分别注入3种肺炎克雷伯菌的细菌株:菌株A(敏感菌株);菌株B(多重耐药菌株);菌株C(泛耐药菌株),建立菌血症模型。结果 A,B,C3组家兔的平均生存时间分别为(10.5±3.6)d、(12.7±2.3)d和(13.9±0.3)d(A与C比较,P<0.004);C组的中性粒细胞计数明显低于A组(A与C比较,P=0.027);A组的CD4/CD8变化幅度显著大于C组(A与C比较,P=0.036);A组的细胞因子肿瘤坏死因子α(TNF-α)的表达更高(A与B比较,P<0.01;A与C比较,P<0.01);且A组家兔组织中的细菌负荷更多。结论泛耐药菌导致的菌血症对机体的损害小于敏感菌感染所带来的危害。相比敏感菌感染动物,泛耐药菌感染动物存活时间较长,炎症反应的程度较低。Objective This study was designed to examine the pathogenicity of bacterial pathogens with different level of resistance in an animal model. Methods Thirty rabbits were randomized into 3 groups. Rabbit model of experimental bacteremia was established by challenge with K. pneumoniae, including one susceptible （A）, one multidrug-resistant （B） and one pandrug-resistant （C） strain intravenously via central vein to assess the effect of resistance level on the outcomes. Results The mean survival time of the animal after challenge with strain A, B or C was 10.5 ＋ 3.63, 12.7 ＋ 2.31 and 13.9 ＋ 0.32 days, respectively （A vs. C, P〈0. 004）. The neutrophil count after challenge with strain C was lower compared with that challenge with strain A （A vs. C, P = 0. 027）. CD4/CD8 ratio in group A was higher than that in group C （A vs. C, P = 0. 036）. TNF-a level was higher in group A compared with B or C （A vs. B, P〈 0. 001 ; A vs. C, P〈 0. 001）. Tissue bacterial load after animal euthanasia was significantly higher in group A. Conclusions The outcome of rabbit bacteremia induced by pandrug-resistant K. pneumoniae is less serious than that induced by susceptible strain. Rabbits infected with pandrug-resistant strain of K. Pneumoniae survived longer with a lower level of inflammatory response compared with the animals infected with a susceptible strain.

关 键 词：菌血症 肺炎克雷伯菌 泛耐药 多重耐药 敏感 

分 类 号：R446.5[医药卫生—诊断学]