产气克雷伯菌引起新生儿感染的临床分布特征及质谱同源性分析  

Clinical distribution characteristics and mass spectrometry-based homology analysis of neonatal infections caused by Klebsiella aerogenes

作　　者：苏宁 李文静[1] 张国栋[1] SU Ning;LI Wenjing;ZHANG Guodong(Department of Clinical Laboratory,Suzhou Municipal Hospital,Suzhou 215002,China)

机构地区：[1]苏州市立医院医学检验科,苏州215002

出　　处：《国际免疫学杂志》2024年第3期277-282,共6页International Journal of Immunology

摘　　要：目的分析产气克雷伯菌引起新生儿感染的临床分布特征及质谱同源性,为防控新生儿感染提供依据。方法回顾性收集2021年4月至2023年4月苏州市立医院新生儿科收集的58株非重复的产气克雷伯菌分离物。利用基质辅助激光解析电离飞行时间质谱(matrix assisted laser desorption/ionization time of flight mass spectrometry,MALDI-TOF MS)技术进行蛋白水平的同源性分析建库。使用MALDI Biotyper 3.1生成主成分分析(principal component analysis,PCA)和主谱图(main spectrum profile,MSP)树状图,以获得蛋白水平的同源性。结果51例感染患儿中以重症监护室、早产患儿及低体重感染患儿为主,分别占84.31%(43/51)、86.27%(44/51)和84.31%(43/51)。重症监护室内早产患儿气管插管患儿42例,占97.67%,低出生体重患儿气管插管患儿32例,占74.44%。51例产气克雷伯菌感染患儿绝大多数住院时间较长,住院时长>60 d的占25.49%。58株产气克雷伯菌临床标本主要从血、导管头、痰液、胃液、眼分泌物和尿液中分离出。6例患儿在不同样本类型中同时检出产气克雷伯菌。MSP聚类分析显示,58株产气克雷伯菌分为3个群,其中KA群14株,KB群6株,KC 38株。KC群主要与重症监护室有关,多伴有气管插管和血流感染。KB群主要与早产低体重患儿相关,而KA群主要与普通病房患儿相关。结论产气克雷伯菌具有高侵袭力,MALDI-TOF MS质谱快速同源性分析对产气克雷伯菌感染快速筛查具有一定的临床意义。Objective Analyzing the clinical distribution characteristics and mass spectrometry homology of neonatal infections caused by Klebsiella aerogenes,aiming to provide insights for the prevention and control of neonatal infections.Methods Total of 58 non-duplicate isolates of Klebsiella aerogenes from the Neonatal Department of Suzhou Municipal Hospital between April 2021 and April 2023 were collected.Matrix assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF MS)was utilized for protein-level homology analysis and library construction.Principal component analysis(PCA)and main spectrum profile(MSP)dendrograms were generated using MALDI Biotyper 3.1 to assess protein-level homology.Results Among the 51 infected children,the majority of them were in the intensive care unit,premature infants,and low birth weight infants,accounting for 84.31%(43/51),86.27%(44/51)and 84.31%(43/51)respectively.There were 42 premature infants in the intensive care unit who underwent tracheal intubation,accounting for 97.67%,and 32 low birth weight infants who underwent tracheal intubation,accounting for 74.44%.The majority of the 51 children with Klebsiella pneumoniae infection had longer hospital stays,and 25.49%of patients with hospital stays>60 days.Clinical specimens of the 58 strains of Klebsiella aerogenes were primarily isolated from blood,catheter tips,sputum,gastric fluid,ocular secretions,and urine.Six pediatric patients were simultaneously detected with Klebsiella aerogenes in different sample types.MSP clustering analysis showed that the 58 strains of Klebsiella aerogenes were categorized into 3 groups,comprising 14 strains in the KA group,6 strains in the KB group,and 38 strains in the KC group.The KC group was mainly related to the intensive care unit,often accompanied by tracheal intubation and bloodstream infections.The KB group was mainly related to premature birth and low birth weight children,while the KA group was mainly related to children in general wards.Conclusion Klebsiella aerogenes exhi

关 键 词：产气克雷伯菌 新生儿 感染 基质辅助激光解析电离飞行时间质谱 同源性分析 

分 类 号：R722.13[医药卫生—儿科]