不同病例来源肺炎克雷伯菌的致病性及其遗传进化关系分析  

Analysis of Pathogenicity and Genetic and Evolutionary Relationship of Klebsiella Pneumoniae from Different Cases

作　　者：孙弋雅 周方圆 周明玉 刘海月 王大为 刘英姿 Sun Yiya;Zhou Fangyuan;Zhou Mingyu;Liu Haiyue;Wang Dawei;Liu Yingzi(Jinzhou Medical University;Medical College of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学 [2]锦州医科大学医疗学院,辽宁锦州121000

出　　处：《锦州医科大学学报》2021年第4期25-30,34,共7页Journal of Jinzhou Medical University

基　　金：辽宁省自然科学基金资助项目,项目编号:2019-ZD-0817;2019-ZD-0836;2019-ZD-0613。

摘　　要：目的了解不同病例来源肺炎克雷伯菌致病特性及其遗传进化关系,深入探索该菌致病机制和传播途径奠定基础。方法分别采集锦州医科大学附属第一医院发热患者、硫化氢中毒患者、脑梗死患者、脑血管病患者及胆肠吻合口结石患者的血液或痰液样品,分离鉴定得到5株肺炎克雷伯菌,编号为KP1、KP2、KP3、KP4、KP5。对所分离的菌株通过16S rRNA序列进行基因测序和同源性比对分析;选取小鼠和雏鸡作为试验动物进行致病性试验,观察比较不同菌株所引起的病理变化特征、发病率和死亡率;应用纸片扩散法进行常用抗菌药物的耐药性检测分析。结果上述不同病例来源分离的肺炎克雷伯菌的亲缘关系有明显差异,KP1~KP4菌株同源性较高,为98.85%,而KP1~KP5整体同源性为93.42%,说明KP1~KP4与胆肠吻合口结石病例KP5亲缘关系较远;所分离菌株均可引起小鼠和雏鸡发病,发病率均为100%,而死亡率为50%~100%不等;其中脑梗死病例KP3致死率最高为100%,显著高于其它分离菌株,而胆肠吻合口结石病例KP5致死率最低,仅为50%;不同病例来源肺炎克雷伯菌对常用抗菌药物产生了耐药性,但耐药性差异显著。结论不同病例来源的肺炎克雷伯菌的亲缘关系远近不一,致病性差异显著,而亲缘关系远近与致病性及耐药性没有必然联系。由于该菌可感染小鼠和禽类,可以应用小鼠和禽类作为多种肺炎克雷伯菌研究的动物模型开展致病机制和药物开发等研究。同时提示在肺炎克雷伯菌防控过程中应重视对鼠类和禽类传播途径的控制。Objective To understand the pathogenic characteristics and genetic evolution of Klebsiella pneumoniae from different cases,in order to lay a foundation for further exploration of the pathogenic mechanism and transmission route of Klebsiella pneumoniae.Methods Blood or sputum samples were collected from the patients with fever,hydrogen sulfide poisoning,cerebral infarction,cerebrovascular disease,and biliary anastomotic stones admitted to the First Affiliated Hospital of Jinzhou Medical University.Five strains of Klebsiella pneumoniae,numbered KP1,KP2,KP3,KP4,KP5,were isolated and identified.Gene sequencing and homology analysis were performed on the isolated strains using 16S rRNA sequence.Mice and chickens were selected as experimental animals for pathogenicity tests,and the pathological changes,morbidity and mortality caused by different strains were observed and compared.The paper sheet diffusion method was used to detect and analyze the resistance of common antibacterial drugs.Results Klebsiella pneumoniae isolated from different cases above showed significant differences in genetic relationships.KP1~KP4 strains had a high homology which was 98.85%,while KP1~KP5 had an overall homology of 93.42%,indicating that KP1~KP4 had a distant genetic relationship with KP5 in the cases of biliary anastomotic stones.All the isolated strains caused disease in mice and chickens,with a morbidity rate of 100%and a mortality ranging from 50%to 100%.The mortality rate of KP3 in the patients with cerebral infarction was 100%,which was significantly higher than that of other isolates strains.The mortality rate of KP5 in the patients with biliary anastomotic stones was the lowest which was only 50%.Klebsiella pneumoniae from different cases developed resistance to commonly used antimicrobial agents,but there were significant differences in resistance.Conclusion The genetic relationship and the pathogenicity of Klebsiella pneumoniae from different cases are different,and the genetic relationship is not necessarily related to patho

关 键 词：肺炎克雷伯菌 致病性 进化关系 不同来源 

分 类 号：R378.966[医药卫生—病原生物学]