老年患者分离肺炎克雷伯菌常见高毒力血清型及blaKPC耐药基因的调查与分析  

Investigation and analysis of common hypervirulent serotypes and blakpc resistance genes of Klebsiella pneumoniae isolated from elderly patients

作　　者：赵燕 张婷 史继敏[2] 李刚 Zhao Yan;Zhang Ting;Shi Jimin;Li Gang(Department of Laboratory Medicine,Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China;Clinical Research Center of Jinshan Hospital Affiliated to Fudan University,Shanghai,201508,P.R.China)

机构地区：[1]复旦大学附属金山医院检验科,上海201508 [2]复旦大学附属金山医院临床研究中心,上海201508

出　　处：《老年医学与保健》2020年第5期780-783,共4页Geriatrics & Health Care

基　　金：上海市卫生健康委员会项目(201640130);金山区科学技术委员会项目(2016-3-03)。

摘　　要：目的调查并分析老年患者分离肺炎克雷伯菌中常见高毒力血清型分布及blaKPC耐药基因携带情况。方法以糖基转移酶WZY_K1、WZY_K2、WZY_K5、WZY_K54、WZY_K57、rmpA2及blaKPC基因为目标设计引物,建立多重PCR法并优化,收集感染老年患者的非重复肺炎克雷伯菌58株,运用多重PCR检测肺炎克雷伯菌高毒力血清型及blaKPC耐药基因。结果多重PCR法可准确鉴别6株参考菌株血清型及blaKPC基因。58株临床菌株中,以携带rmpA2基因为高毒力判断标准,共检出24株高毒力肺炎克雷伯菌(41.4%),其中K1血清型高毒力肺炎克雷伯菌7株(12.1%)、K2血清型型高毒力肺炎克雷伯菌4株(6.9%)、K5型血清型高毒力肺炎克雷伯菌2株(3.4%)、K54型血清型高毒力肺炎克雷伯菌2株(3.4%),单独携带rmpA2基因血清型未知高毒力肺炎克雷伯菌2株(3.4%),检出同时携带rmpA2及blaKPC基因的高毒力高耐药肺炎克雷伯菌7株(12.1%)。结论高毒力肺炎克雷伯菌是老年患者医院获得性感染重要病原菌之一,应加强感染老年患者的高毒力肺炎克雷伯菌监测,减少医院感染发生。Objective To investigate and analysis the distribution of hypervirulent serotypes and blakpc resistance gene of Klebsiella pneumoniae isolated from elderly patients.Methods The primers were designed based on glycosyltransferases WZY_K1,WZY_K2,WZY_K5,WZY_K54,WZY_K57,rmpA2 and blakpc genes,and multiplex PCR methods was established and optimized.Then 58 non-repetitive strains of Klebsiella pneumoniae were collected from clinical samples of elderly patients and the hypervirulent serotype and blakp resistance gene of Klebsiella pneumoniae were detected by multiplex PCR.Results Multiplex PCR method could accurately identify the serotype and blakpc gene of 6 reference strains.Taking the rmpA2 gene as the judgment criterion for high virulence,a total of 24 hypervirulent Klebsiella pneumoniae(41.4%)were detected in 58 clinical strains.Among them,there were 7 strains(12.1%)of K1 serotype hypervirulent Klebsiella pneumoniae,4 strains(6.%)of K2 serotype hypervirulent Klebsiella pneumoniae,2 strains(3.4%)of K54 serotype hypervirulent Klebsiella pneumoniae,2 strains(3.4%)of Klebsiella pneumoniae with unknown serotype of rmpA2 gene alone,7 strains of hypervirulent and high drug resistant Klebsiella pneumoniae carrying both rmpA2 and blakpc gene simultaneously.Conclusions Hypervirulent Klebsiella pneumoniae is one of the important pathogens of hospital-acquired infections in elderly patients.It is necessary to strengthen the surveillance of hypervirulent Klebsiella pneumoniae in elderly patients to reduce the incidence of nosocomial infections.

关 键 词：老年 碳青霉烯耐药 高毒力肺炎克雷伯菌 多重PCR 

分 类 号：R446.5[医药卫生—诊断学]