2017-2019年我院高毒力肺炎克雷伯菌毒力基因的分子流行特征  

Epidemic characteristics of virulence genes of hypervirulence Klebsiella pneumoniae in our hospital from 2017 to 2019

作　　者：李小丽 邱世洁 范晓怡 刘菊珍[1] 黄云祖[1] 余广超[1] LI Xiaoli;QIU Shijie;FAN Xiaoyi;LIU Juzhen;HUANG Yunzu;YU Guangchao(The Center of Clinical Laboratories,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China;The Center of Clinical Laboratories,Foshan Maternal and Child Health Care Hospital,Foshan 528000,China)

机构地区：[1]暨南大学附属第一医院临床检验中心,广东广州510630 [2]佛山市妇幼保健院临床检验中心,广东佛山528000

出　　处：《暨南大学学报（自然科学与医学版）》2021年第4期397-405,共9页Journal of Jinan University(Natural Science & Medicine Edition)

摘　　要：目的:探讨广州暨南大学附属第一医院2017至2019年高毒力肺炎克雷伯菌毒力基因的分子流行特征,为高毒力肺炎克雷伯菌所致临床感染的防治提供实验室依据.方法:通过拉丝试验初步筛选出高粘液肺炎克雷伯菌(hmKP),利用PCR技术对所有hmKP进行黏液表型调节基因A(RmpA)和气杆菌素(aerobactin)基因扩增,两毒力基因均表达则即判定该菌株为高毒力肺炎克雷伯菌(hvKP),再采用PCR技术对hvKP中常见的血清荚膜型K和多个毒力基因进行特异性扩增.结果:2017年9月至2019年9月间我院通过拉丝试验初筛出hmKP共51株,同时扩增出两毒力基因(RmpA,aerobactin)即判定为hvKP者有43株,其中25株分离自侵袭性肺炎克雷伯菌感染,18株分离自非侵袭性肺炎克雷伯菌感染.K1、K2型为其主要的血清荚膜分型,分别占41.86%(18/43)、23.26%(10/43);毒力基因检出率排名前4的分别是:ycfM 100.00%(43/43),entB 100.00%(43/43),ureA 93.02%(40/43),wabG 93.02%(40/43).结论:2017至2019年我院分离的高毒力肺炎克雷伯菌血清荚膜型以K1、K2为主,毒力基因检出率较高的是ycfM、entB、ureA和wabG毒力基因.Objective:To explore the molecular epidemiological characteristics of the virulence genes in hypervirulence Klebsiella pneumoniae(hvKP)from 2017 to 2019 in the First Affiliated Hospital of Jinan University,and so as to provide laboratory evidence for the prevention and treatment of clinical infections caused by hvKP.Methods:Hypermucoviscosity Klebsiella pneumoniae(hmKP)was preliminarily screened through String Test(ST).Then the mucoid phenotype regulatory gene A(RmpA)and aerobactin gene were detected in all hmKPs using PCR technology.The strain was judged to be hvKP when both virulence genes were positive.The common serum capsule K types and multiple virulence genes of hvKP were amplified by PCR.Results:During 2017-2019,a total of 51 hmKP strains were initially screened in our hospital through the String Test.Both two virulence genes(RmpA and aerobactin)were amplified at the same time,which was used to judge hvKP,and 43 hvKP strains were identified.There were 25 strains were isolated from invasive Klebsiella pneumoniae infection,while 18 strains were isolated from non-invasive Klebsiella pneumoniae infection.K1 and K2 were the main serum capsule types,which account for 41.86%(18/43)and 23.26%(10/43)respectively.The top four virulence gene detection rates were:ycfM 100.00%(43/43),entB 100.00%(49/51),ureA 93.02%(40/43)and wabG 93.02%(40/43).Conclusion:The main serum capsule types of hvKP isolated in our hospital from 2017 to 2019 are K1 and K2,and the virulence genes with high detection rates are ycfM,entB,ureA and wabG.

关 键 词：肺炎克雷伯菌 高毒力 毒力基因 

分 类 号：R378.2[医药卫生—病原生物学]