高黏粘液型肺炎克雷伯菌临床分布、毒力基因检测及耐药分析  

Clinical distribution,virulence gene detection and drug resistanceanalysis of hypermucinous Klebsiella pneumoniae

作　　者：乔艳[1] 孙红[2] 应冲涛 陶赵宇 郭普[2] Qiao Yan;Sun Hong;Ying Chongtao;Tao Zhaoyu;Guo Pu(Department of Infectious Diseases,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China;Department of Clinical Laboratory,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China;Department of Blood Transfusion,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China)

机构地区：[1]蚌埠医学院第一附属医院感染性疾病科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院检验科,安徽蚌埠233004 [3]蚌埠医学院第一附属医院输血科,安徽蚌埠233004

出　　处：《右江民族医学院学报》2023年第4期630-634,共5页Journal of Youjiang Medical University for Nationalities

摘　　要：目的了解高黏粘液型肺炎克雷伯菌(hypermucoviscous Klebsiella Pneumonia,hmKP)临床分布、耐药性及毒力基因携带情况。方法收集蚌埠医学院第一附属医院2021年1月至12月临床分离的肺炎克雷伯菌,自动化仪器法进行鉴定和药敏实验,黏液拉丝试验筛选hmKP,PCR方法检测hmKP菌株的毒力基因和荚膜分型。结果2021年1月至12月临床共分离出554株肺炎克雷伯菌,其中hmKP 96株,占17.33%(96/554)。主要分离自脓液、血液标本及痰标本,分别占30.21%(29/96)、27.08%(26/96)和21.88%(21/96)。96株hmKP的荚膜分型,主要为K1和K2型,分别占60.42%(58/96)和16.67%(16/96),其中8株碳青霉烯耐药的hmKP荚膜血清型主要为K64型。96株hmKP主要携带的毒力基因为iutA、rmpA、aerobactin和magA基因,分别占95.83%(92/96)、94.79%(91/96)、89.58%(86/96)和60.42%(58/96)。hmKP对碳青霉烯类抗菌药物厄他培南和亚胺培南耐药率分别为8.33%和7.29%,低于普通型肺炎克雷伯菌,差异有统计学意义(P<0.05)。结论本院分离肺炎克雷伯菌高毒力株主要为K1、K2荚膜血清型,同时携带多种毒力基因,对常用抗菌药物较为敏感,碳青霉烯耐药的hmKP值得临床关注。Objective To investigate the clinical distribution,drug resistance and virulence genes carrying of hypermucoviscous Klebsiella Pneumoniae(hmKP).Methods Klebsiella Pneumoniae clinically isolated from The First Affiliated Hospital of Bengbu Medical College from January to December 2021 were collected.Identification and drug sensitivity test were carried out by automatic instrument method.hmKP was screened by mucus string test.Virulence gene and capsule typing of hmKP strain were detected by PCR.Results A total of 554 strains of Klebsiella pneumoniae were isolated from January to December 2021,including 96 strains of hmKP,accounting for 17.33%(96/554).They were mainly isolated from pus,blood and sputum,accounting for 30.21%(29/96),27.08%(26/96)and 21.88%(21/96)respectively.K1 and K2 were the major capsular serotypes in 96 strains of hmKP,accounting for 60.42%(58/96)and 16.67%(16/96)respectively.Among them,K64 was the major capsular serotype in 8 strains of carbapenem-resistant hmKP.The main virulence genes of 96 hmKP strains were iutA,rmpA,aerobactin and magA,accounting for 95.83%(92/96),94.79%(91/96),89.58%(86/96)and 60.42%(58/96),respectively.The resistance rates of hmKP to ertapenem and imipenem were 8.33%and 7.29%respectively,which were lower than those of K.pneumoniae(P<0.05).Conclusion The hmKP isolated from the hospital are mainly capsular serotypes K1 and K2,which carry multiple virulence genes and are sensitive to commonly used antimicrobial agents.Carbapenem-resistant hmKP deserves clinical attention.

关 键 词：高黏粘液型肺炎克雷伯菌 毒力基因 耐药 

分 类 号：R378.99[医药卫生—病原生物学]