嘉兴地区ST15型耐碳青霉烯肺炎克雷伯菌分子流行病学研究  

Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae ST15 in Jiaxing

作　　者：吴晓燕 李小四 李红胜 范陈良 WU Xiaoyan;LI Xiaosi;LI Hongsheng;FAN Chenliang(Department of Clinical Laboratory,the Second Hospital of Jiaxing,Jiaxing 314000,China)

机构地区：[1]嘉兴市第二医院检验科,314000

出　　处：《浙江医学》2024年第21期2292-2296,2305,共6页Zhejiang Medical Journal

基　　金：嘉兴市科技计划项目(2021AD30104)。

摘　　要：目的探讨嘉兴地区ST15型碳青霉烯耐药肺炎克雷伯菌(CRKP)分子流行病学特征。方法收集嘉兴市第二医院2021年1月至2023年6月非重复且表型检测为bla_(OXA-48)like的CRKP 22株,采用微量肉汤稀释法进行药敏试验,采用全基因组测序分析耐药基因、毒力基因;并对菌株进行K、O两种荚膜抗原的血清型预测、核心基因组多位点序列分型(cgMLST)聚类分析和菌株溯源分析。结果22株CRKP均为ST15型,对多数抗生素耐药,对亚胺培南低耐药(最低抑菌浓度2~16 mg/L)。22株ST15型CRKP共检测到37种耐药基因,均携带bla_(OXA-232)、bla_(CTX-M-15)、bla_(SHV-28)及获得性16s rRNA甲基转移酶基因rmtF;2株携带bla_(TEM-1)、APH_6-Id、sul2。所有菌株携带7类105种毒力基因,以分泌系统类毒力基因最多(4类39种);均检测到荚膜多糖调节蛋白rmpA2;2株(9.1%)携带黏附类毒力基因mrkH。血清型均为KL112、O1/02V1。22株ST15型CRKP分为2种cgMLST,与上海、杭州分离菌株高度同源。结论嘉兴地区ST15型肺炎克雷伯菌携带bla_(OXA-232)、bla_(CTX-M-15)、bla_(SHV-28)及rmtF等多种耐药基因及rmpA2等高毒力基因,且与周边城市菌株具有高度同源性。Objective To investigate the molecular epidemiological characteristics of ST15 type of carbapenem resistant Klebsiella pneumoniae(CRKP)in Jiaxing.Methods A total of 22 non-repetitive blaOXA 48 like CRKP strains were collected from the Second Hospital of Jiaxing from January 2021 to June 2023,and their drug susceptibility were analyzed by the microbroth dilution method.The resistance genes and virulence genes were analyzed by whole genome sequencing;Serotype prediction of K and O capsular antigens,core genome multilocus sequence typing(cgMLST)cluster analysis and strain traceability analysis were performed.Results All 22 strains of CRKP belong to ST15 type,which exhibited resistance to most antibiotics and low-level resistance to imipenem(minimum inhibitory concentration:2-16 mg/L).The sequencing results revealed 37 kinds of drug resistance genes in the 22 CRKP ST 15 strains,among which,bla_(OXA-232)、bla_(CTX-M-15),bla_(SHV-28) and acquired 16s rRNA methyltransferase gene rmfF were identified in all 22 strains,while sul2,bla_(TEM-1) and APH_6-Id were carried in two strains.A total of 105 virulence genes of 7 classes,including capsular polysaccharide regulatory protein rmpA2,were detected in all strains,most of which were secretory system virulence genes(39 kinds of 4 classes).Two strains(9.1%)carried the adhesion virulence gene mrkH.The serum types were all KL112 and O1/02V1.The 22 CRKP ST 15 strains were categorized into two kinds of cgMLST,which were highly homologous with the strains isolated from Shanghai and Hangzhou.Conclusion Klebsiella pneumoniae ST15 in Jiaxing carries several drug resistance genes such as bla_(OXA-232),bla_(CTX-M-15),bla_(SHV-28) and rmtF,as well as high virulence genes such as rmpA2.They are highly homologous with the strains in surrounding cities.

关 键 词：肺炎克雷伯菌 ST15型 全基因组测序 耐药基因 毒力基因 

分 类 号：R446.5[医药卫生—诊断学]