医院分离高毒力肺炎克雷伯菌的毒力基因检测及耐药性分析  

Virulence gene detection and drug resistance analysis of hypervirulent Klebsiella pneumoniae isolated from a hospital

作　　者：周浩泽 黎敏 鲁卫平 李进 ZHOU Hao-ze;LI Min;LU Wei-ping;LI Jin(Army Medical Center of PLA,Chongqing 400042;People's Hospital of Naxi District,China)

机构地区：[1]中国人民解放军陆军特色医学中心,重庆400042 [2]泸州市纳溪区人民医院

出　　处：《中国消毒学杂志》2023年第6期412-415,418,共5页Chinese Journal of Disinfection

基　　金：重庆市科卫联合医学科研项目(2022QNXM034)。

摘　　要：目的 研究医院分离高毒力肺炎克雷伯菌(Hvkp)的毒力基因及耐药性,为感染防控提供依据。方法采用基因检测和药敏试验方法,对某医院临床分离的肺炎克雷伯菌的毒力基因和耐药性情况进行检测与评价。结果 共检测肺炎克雷伯菌196株,有62株可判定为Hvkp,检出率为31.6%。62株Hvkp中毒力基因peg589、iroB、p-rmpA、p-rmpA2和irp2的检出率分别为88.7%、93.5%、96.7%、88.7%和66.1%,血清荚膜型K1和K2的检出率均为30.6%。Hvkp菌株对绝大多数临床常用抗菌药物的耐药率均低于10%,而经典的肺炎克雷伯菌株对绝大多数临床常用抗菌药物的耐药率均在15%以上。结论 临床分离的肺炎克雷伯菌中Hvkp构成比很高,其对常用抗菌药物的耐药率普遍低于经典菌株,提示应重视监测Hvkp菌株的耐药性,防止其在临床播散。Objective To study the virulence genes and drug resistance of hypervirulent Klebsiella pneumoniae(Hvkp)isolated from a hospital,and to provide evidence for infection prevention and control.Methods The virulence genes and drug resistance of Klebsiella pneumoniae isolated from a hospital were detected and evaluated by gene detection and drug sensitivity test.Results A total of 196 strains of Klebsiella pneumoniae were detected,62 of which could be identified as Hvkp,and the detection rate was 31.6%.The detection rates of virulence genes peg589,iro B,p-rmp A,p-rmp A2and irp2 in 62 strains of Hvkp were 88.7%,93.5%,96.7%,88.7% and 66.1%,respectively,and the detection rates of serum capsular types K1 and K2 were both 30.6%.The drug resistance rate of Hvkp strain to most clinical commonly used antibiotics was less than 10%,while that of classic Klebsiella pneumoniae was more than 15%.Conclusion The proportion of Hvkp in clinically isolated Klebsiella pneumoniae is very high,and its resistance rate to commonly used antibiotics is generally lower than that of classic strains,suggesting that attention should be paid to monitoring the drug resistance of Hvkp strains to prevent its clinical spread.

关 键 词：肺炎克雷伯菌 高毒力菌株 毒力基因 耐药率 

分 类 号：R378[医药卫生—病原生物学] R446.5[医药卫生—基础医学]