高黏液表型肺炎克雷伯菌的荚膜分型与毒力基因的检测  

Detection of capsular serotype and virulence gene of Klebsiella pneumonia with hypermucoviscosityphenotype

作　　者：沈定霞[1] 李东冬[1] 郭玲[1] 刘晓峰[1] 

机构地区：[1]解放军总医院微生物科,北京100853

出　　处：《中华检验医学杂志》2014年第5期374-377,共4页Chinese Journal of Laboratory Medicine

摘　　要：目的检测肺炎克雷伯菌的高黏液表型、荚膜型及主要毒力基因，了解不同感染来源肺炎克雷伯菌的特点。方法回顾性研究。收集解放军总医院2010年1月至2012年12月静脉血、痰液、肺泡灌洗液、尿液、正常无菌部位穿刺液、肝脓肿和其他脓肿穿刺液等来源的肺炎克雷伯菌178株，利用黏液丝试验检测高黏液表型，PCR方法检测主要荚膜型和毒力基因。将检测结果结合菌株来源进行列联表分析和X^2检验。结果178株肺炎克雷伯菌中，黏液丝试验阳性共83株，占46．6％。高黏液表型肺炎克雷伯菌中毒力基因rmpA阳性牢为92．8％（77/83）。肝脓肿及其他脓肿脓液来源中肺炎克雷伯菌荚膜分型以K1/K2/K57为主，占75．0％（27/36），高于静脉血组32．4％（12/37）、痰及肺泡灌洗液组50．0％（22/44）、尿液组21．7％（5/23）、无菌部位穿刺液组25．0％（5/20），X^2=21．19，P〈0．01；黏液丝试验结果中，肝脓肿及其他脓肿脓液组肺炎克雷伯菌的阳性率77．8％（28/36）显著高于静脉血组29．7％（11/37）、尿液组30．4％（7/23）和无菌部位穿刺液组25．0％（5/20），X^2=27．90，P〈0．01。结论高黏液表型肺炎克雷伯菌存在于临床多种标本特别是肝脓肿和其他脓肿的脓液标本中。K57型肺炎克雷伯菌是我国除Kl和K2型外的又一型具有高黏液性状、高毒力的肺炎克雷伯菌。（手华捡验医学杂志，2014，37：374-377）Objective To detect the hypermucoviscosity phenotype, capsular serotype and virulence gene of Klebsiella pneumonia （ K. pneumonia） from various kinds of clinical specimens and understand the characteristics of different K. pneumonia causing infections. Methods A retrospective study was conducted through collection of 178 K. pneumonia isolates from blood, sputum, bronchoalveolar lavage fluid, urine, normally sterilized fluid, puncture fluid from liver abscess and other abscesses between January 2010 and December 2012 in General Hospital of Chinese PLA. String test was carried out for detection of hypermucoviscosity phenotype. Capsular serotype and virulence gene （rmpA） were checked by polymerase chain reaction. Analysis was made according to the hypermucoviscosity, capsular serotype, rmpA gene, as well as the sources of K. pneumoniae. Statistic data was analyzed by contingency table analysis and X^2 test. Results Eighty-three out of 178 （46. 6% ） strains of K. pneumonia were hypermucoviscous with positive string test, the positive rate of virulence gene rmpA was 92. 8% （77/83）. K1/K2/K57 capsular serotypes were the predominant serotypes in the group of puncture fluid from liver abscess and other abscesses （75.0% ,27/36） than the group of blood （ 32. 4%, 12/37 ）, urine （ 21.7%, 5/23 ） and normally sterilized fluid （ 25.0%, 5/20） , and also more than in the group of sputum, bronchoalveolar lavage fluid （ 50. 0% , 22/ 44） ,X^2 =21.19,P 〈0. 01. The positive rate of string test in the group of puncture fluid from liver abscess and other abscesses （77.8%, 28/36） was significantly higher than the group of blood （ 29.7%, 11/37 ）, urine （30. 4%, 7/23 ）, or normally sterilized fluid （ 25.0%, 5/20）, X^2 = 27.90, P 〈 0. 01. The positive rate of rmpA gene in the isolates from puncture fluid of liver abscess and other abscesses was higher than other groups. Conclusions As the pathogens of various kinds of infections, mainly abscess and respiratory infection, hypermucovisco

关 键 词：克雷伯菌 肺炎 毒力 多糖类 细菌 表型 细菌蛋白质类 

分 类 号：R378.996[医药卫生—病原生物学]