一株多药耐药肺炎克雷伯菌全基因组测序及耐药组学分析  

Whole genome sequencing and pharmacogenomic analysis of a multidrug-resistant strain of Klebsiella pneumoniae

作　　者：刘轶 匡慧慧 郭素琴 程萌 张悦[2] 孙娜娜 胡红焱 LIU Yi;KUANG Hui-hui;GUO Su-qin;CHENG Meng;ZHANG Yue;SUN Na-na;HU Hong-yan(Zhujiang Hospital,Guangzhou,Guangdongg 510515,China;不详)

机构地区：[1]南方医科大学珠江医院(第二临床医学院),广东广州510515 [2]解放军总医院海南医院检验科,海南三亚572022

出　　处：《中华医院感染学杂志》2024年第20期3041-3045,共5页Chinese Journal of Nosocomiology

基　　金：军队后勤重点课题基金资助项目(AWS21J005)。

摘　　要：目的对一株多药耐药肺炎克雷伯菌进行全基因组测序并对全部耐药基因进行分析。方法2023年10月从一名脑梗死患者的尿液中常规方法分离肺炎克雷伯菌,进行鉴定和药敏试验,并通过16sRNA测序进行菌株确认,采用三代测序技术进行全基因组测序,通过生物信息学相关软件进行质量控制及组装,通过综合抗菌药物耐药性数据库对全部耐药基因进行分析。结果从一位脑梗死男性患者尿液中分离出肺炎克雷伯菌,编号为hnyy23-147,对临床常用的内酰胺类、喹诺酮类、四环素类、氨基糖苷类、磺胺类抗菌药物均耐药,对多黏菌素敏感;全基因组测序显示菌株含有1个染色体和3个质粒,全部耐药基因分布于染色体2号、3号质粒上,耐药基因包括aadA2b、blaSHV-159、fosA6、qnrS1、sul1、sul2、dfrA14、rmtB、blaKPC-2、blaSHV-12,染色体突变导致的耐药包括acrR突变、ompK35突变、ompK36突变和gyrB突变。结论通过全基因组测序的方法可及时了解多药耐药肺炎克雷伯菌全部耐药基因和分子流行病学规律,有助于加强医院感染控制和抗菌药物合理使用,对防止多药耐药菌传播具有重要意义。OBJECTIVE To sequence the whole genome of a multi-drug resistant strain of Klebsiella pneumoniae and analyze all drug resistance genes.METHODS In Oct.2023,a strain of Klebsiella pneumoniae was isolated from the urine of a patient with cerebral infarction by routine methods,identified and tested for drug sensitivity,then identified by VITEK-2 and confirmed by 16sRNA sequencing.The third-generation sequencing technology was used for whole genome sequencing.The quality control and assembly of the drug resistance genes were per-formed by bioinformatics related software,and the drug resistance function annotation platform was used to ana-lyze all resistance genes.RESULTS Klebsiella pneumoniae,No.hnyy23-147,was isolated from the urine of a male patient with cerebral infarction,and was resistant to clinically used antimicrobial drugs such as lactams,quinolones,tetracyclines,aminoglycosides,and sulfonamides,while was sensitive to polymyxin.Whole genome sequencing showed that the strain contained one chromosome and three plasmids,and all the drug resistance genes were distributed on chromosome and plasmids 2 and 3.Resistance genes included aad A2b,blasHv-159,fosA6,qnrS1,sull,sul2,dfrA14,rmtB,bla_(KPC)-2,bla_(SHV)-12.Resistance caused by chromosomal mutations included acrR,ompK35,ompK36 and g yrB mutations.CONCLUSION The whole genome sequencing method can provide a timely understanding of all drug resistance genes and molecular epidemiology of multidrug-resistant Klebsiella pneumoniae,which can help to strengthen the control of nosocomial infection and the rational use of antibiotics,and is of great significance to preventing the spread of multidrug-resistant bacteria.

关 键 词：细菌耐药 肺炎克雷伯菌 全基因组测序 多药耐药菌 生物信息学 

分 类 号：R378[医药卫生—病原生物学]