一株致多部位感染肺炎克雷伯菌耐药及毒力分析  

作　　者：王洁[1] 王敏敏[1] 陈琼[1] 

机构地区：[1]杭州市第一人民医院,310006

出　　处：《浙江临床医学》2018年第9期1562-1564,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省自然科学基金青年项目（LQ16H190002）

摘　　要：目的分析患者不同感染部位分离的肺炎克雷伯茵菌株特征，并检测毒力基因。方法采用MALDI—TOF对菌株进行鉴定，应用主成分分析系统（PCA）进行菌株聚类分析，采用VITEK—II COMPACT进行药敏试验，改良Hodge实验测定碳青霉烯酶表型，拉丝试验判断菌株是否为高黏性茵株，应用PCR检测分离菌株的毒力基因。结果4株肺炎克雷伯菌对亚胺培南和美罗培南均耐药，改良Hodge实验和拉丝试验阳性，PCA进化距离显示为同一克隆，携带rmpA、allS、iutA、kfu等毒力基因。结论该患者多部位分离到的肺炎克雷伯茵为碳青霉烯类耐药的相同克隆菌株，且携带相同的毒力基因，可能为高毒力菌株。Objective To analyze the characteristics and virulence factors of Klebsiella pneumoniae isolated from different sites of infection in same patient. Methods The strains were identified by MALDI-TOF, and the strains were clustered by principal component analysis （ PCA ） . The drug susceptibility test was carried out by VITEK-II COMPACT, and the phenotype of carbapenems was deterufined by modified Hodge test. The string test was used to determine whether the strain was a hypermucoviscous strain, the virulence gene were detected by PCR. Results 4 strains of Klebsiella pneumoniae were resistant to imipenem and meropenem, modified Hodge test and string test were all positive, PCA showed the same clone evolutionary distance. All isolates carried rmpA, allS , iut A, kfu and other virulence genes. Conclusion Klebsiella pneumoniae isolated from multiplc sites of the patient may be a hypervirulent isolate, all of which are carbapenem resistant and carry the same virulence.

关 键 词：肺炎克雷伯菌 碳青霉烯类耐药 毒力基因 

分 类 号：R978.11[医药卫生—药品]