宁波地区重症感染患儿肺炎克雷伯菌临床分离株耐药性和毒力特征  

Drug resistance and virulence characteristics of clinical isolates of Klebsiella pneumoniae from children with severe infection in Ningbo

作　　者：张杰[1] 吴军华[1] 陈杨福[1] ZHANG Jie;WU Jun-hua;CHEN Yang-fu(Ningbo Women&Children's Hospital,Ningbo,Zhejiang 315000,China)

机构地区：[1]宁波市妇女儿童医院,浙江宁波315000

出　　处：《中华医院感染学杂志》2023年第17期2707-2710,共4页Chinese Journal of Nosocomiology

基　　金：宁波市自然科学基金项目(2018A610252);宁波市儿童健康与疾病临床医学研究中心(2019A21002)。

摘　　要：目的探讨宁波地区重症感染患儿肺炎克雷伯菌临床分离株耐药和毒力特征,为临床治疗提供实验依据.方法收集2020年1月-2022年1月宁波市妇女儿童医院重症监护病房收治的重症感染患儿肺炎克雷伯菌临床分离株98株,聚合酶链反应(PCR)法检测菌株血清型及毒力基因分布,产超广谱β-内酰胺酶(ESBLs)筛查采用药敏纸片法.结果98株肺炎克雷伯菌分型包括K1、K2、K3、K20、K54、K57型,占比分别为36.73%、19.39%、7.14%、5.10%、13.27%、14.29%,未分型4株,占4.08%;96株拉丝实验结果为阳性,阳性率为97.96%;K1型菌株携带rmpA、wcaG、aerobactin、kfu和allS毒力基因,K2、K3、K20、K54和K57型携带rmpA、aerobactin基因,K2型还携带wcaG、kfu、allS基因;98株肺炎克雷伯菌中产ESBLs菌株46株,检出率为46.94%.结论宁波地区重症感染患儿肺炎克雷伯菌临床分离株血清分型主要有K1、K2、K3、K20、K54、K57型,毒力基因有rmpA、wcaG、aerobactin、kfu和allS,ESBLs肺炎克雷伯菌的检出率较高.OBJECTIVE To explore the drug resistance and virulence characteristics of clinical isolates of Klebsiella pneumoniae from children with severe infection in Ningbo so as to provide experimental data for clinical treatment.METHODS Totally 98 clinical isolates of K.pneumoniae were collected from the children with severe infection who were treated in intensive care unit(ICU)of Ningbo Women&Children's Hospital from Jan 2020 to Jan 2022.The serotypes and virulence genes of the strains were detected by polymerase chain reaction(PCR),and extended spectrumβ-lactamases(ESBLs)were screened by means of drug susceptibility disk method.RESULTS Among the serotypes of the 98 strains of K.pneumoniae,K1 accounted for 36.73%,K219.39%,K37.14%,K205.10%,K5413.27%,K5714.29%;4 strains were not classified,accounting for 4.08%.Totally 96 strains were positive for wire drawing test,with the positive rate 97.96%.The K1 type strains carried with rmpA,wcaG,aerobactin,kfu and allS virulence genes.The K2,K3,K20,K54 and K57 types carried with rmpA and aerobactin genes;the K2 type also carried with wcaG,kfu and allS genes.Totally 46 strains of ESBLs-producing K.pneumoniae were detected among the 98 strains of K.pneumoniae.CONCLUSION The major serotypes of the clinical isolates of K.pneumoniae from the children with severe infection in Ningbo include Kl,K2,K3,K20,K54 and K57 types;the strains carry with the virulence genes rmpA,caG,aerobactin,kfu and allS;the isolated rate of ESBLs-producing K.pneumoniae strains is high.

关 键 词：儿童 肺炎克雷伯菌 血清分型 毒力 超广谱β-内酰胺酶 耐药性 宁波 

分 类 号：R378.996[医药卫生—病原生物学]