四川省中江县肺炎克雷伯菌毒力相关特征及耐药性分析  

Virulence associated characteristics and drug resistance of Klebsiella pneumoniae isolated from patients living in Zhongjiang county of Sichuan province

作　　者：曾海玲[1] 董立民 唐萍[1] 许娇娇 冷天 李玥 Zeng Hailing;Dong Limin;Tang Ping;Xu Jiaojiao;Leng Tian;Li Yue(Department of Laboratory Medicine,Zhongjiang County People's Hospital,Deyang 618100,Sichuan Province,China;MOE Key Laboratory of Major Diseases in Children,National Key Discipline of Pediatrics(Capital Medical University),National Clinical Research Center for Respiratory Diseases,Beijing Key Laboratory of Pediatric Respiratory Infection Diseases,Beijing Pediatric Research Institute,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]中江县人民医院检验科,德阳618100 [2]国家儿童医学中心,首都医科大学附属北京儿童医院,北京市儿科研究所,国家呼吸系统疾病临床医学研究中心,教育部儿科重大疾病研究重点实验室,儿童呼吸道感染性疾病研究北京市重点实验室,北京100045

出　　处：《中国基层医药》2023年第8期1220-1224,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：四川省德阳市科技计划(2019SZ055)。

摘　　要：目的探讨中江县肺炎克雷伯菌毒力相关表型/基因、荚膜血清型、耐药表型、序列分型(ST)的分布特征,提高临床认识,为细菌耐药防控和临床合理用药提供依据。方法回顾分析中江县人民医院2019年7-12月分离的肺炎克雷伯菌135株的资料。采用WalkAway-40Plus全自动分析系统进行菌种鉴定及药敏检测;采用拉丝实验鉴定菌株高黏液表型;采用聚合酶链式反应筛查高毒力荚膜血清型和毒力基因;采用多位点序列分析(MLST)鉴定菌株ST。结果135株菌中高黏液型菌株所占比例为50.4%。毒力基因iucA、iroN、rmpA阳性率分别为54.1%、54.8%、54.1%。荚膜血清K1、K2型菌株所占比例分别为11.9%、15.6%。共鉴定出65种ST型别,以ST23和ST37型最为常见,占比分别为11.1%和6.7%。菌株对16种抗菌药物的耐药率为0.0%~25.2%,对碳青霉烯类抗菌药物、阿米卡星、替加环素的耐药率均不足1%。高黏液型菌株的毒力基因阳性率显著高于非高黏液型菌株(P<0.001),其对头孢菌素类药物的耐药率显著低于非高黏液型菌株(P<0.001)。结论中江县肺炎克雷伯菌呈现“高毒力、低耐药”特征,应持续监测该地区肺炎克雷伯菌毒力及耐药性的变化,警惕高毒力菌株快速传播。Objective To investigate the distribution characteristics of virulence-related phenotypes/genotype,capsular serotype,drug resistance phenotypes,and sequence typing(ST)of Klebsiella pneumoniae in patients living in Zhongjiang county,improve clinical understanding,and provide evidence for the prevention and control of bacterial drug resistance and clinical rational drug use.Methods The data of 135 strains of Klebsiella pneumoniae isolated from patients who received treatment in Zhongjiang County People's Hospital from July to December 2019 were retrospectively analyzed.Bacterial identification and drug sensitivity testing were performed using the WalkAway-40Plus automated microbiology system.Strains with a high viscosity phenotype were identified using wire drawing experiments.Hypervirulence-associated capsular serotype and virulence genes were verified by polymerase chain reaction.ST of Klebsiella pneumoniae strain was identified using multilocus sequence typing.Results Strains with a high viscosity phenotype were identified in 50.4%of the 135 strains.54.1%,54.8%,and 54.1%of the strains were positive for virulence genes iucA,iroN,rmpA.The proportion of strains with capsular Serotype K1 or K2 was 11.9%and 15.6%,respectively.A total of 65 kinds of ST were identified,with ST23 and ST37 being the most common,accounting for 11.1%and 6.7%,respectively.The resistance rate of the strains to 16 kinds of antibiotics was 0.0%-25.2%,and the resistance rate to Carbapenem antibiotics,Amikacin,and Tigecycline was less than 1%.The positive rate of virulence gene of strains with a high viscosity phenotype was significantly higher than that of strains without a high viscosity phenotype(P<0.001),and its resistance rate to Cephalosporin was significantly lower in strains with a high viscosity phenotype than that in strains without a high viscosity phenotype(P<0.001).Conclusion Klebsiella pneumoniae in Zhongjiang County is characterized by"high virulence and low drug resistance".It is necessary to continuously monitor the changes in t

关 键 词：肺炎克雷伯菌 毒力因子类 细菌耐药监测 细菌荚膜血清型 高黏液表型 微生物敏感性试验 回顾性研究 

分 类 号：R515[医药卫生—内科学] R446.5[医药卫生—临床医学]