2016年海南省高毒力肺炎克雷伯菌的临床分布、毒力基因和分子流行病学特点
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吴华

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R181.3+2

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海南省自然科学基金(20158266)


Clinical distribution, virulence factors, and molecular epidemiology of hypervirulent Klebsiella pneumoniae in Hainan Province in 2016
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    摘要:

    目的分析2016年海南省某医院高毒力肺炎克雷伯菌(hvKP)的临床分布、荚膜分型、分子分型、毒力基因携带及药敏情况。方法回顾性分析2016年1—12月该院临床分离的肺炎克雷伯菌,通过黏液拉丝试验选取hvKP,对菌株进行药敏试验,与普通肺炎克雷伯菌(cKP)比较;采用聚合酶链反应(PCR)法对菌株进行荚膜分型、毒力基因和耐药基因检测,采用脉冲场凝胶电泳(PFGE)和多位点序列分型(MLST)方法对菌株进行分子分型。结果共分离hvKP 84株,其中主要标本来源为痰(45株);K1和K2是hvKP的主要荚膜型,ST23、ST65和ST86是hvKP的主要ST型;rmpA、aerobatin、allS、kfuBC和cf29a在hvKP中的携带率分别为90.48%、96.43%、42.86%、66.67%和53.57%,均高于cKP,PFGE发现allS基因仅存在于K1型;hvKP对抗菌药物的耐药率普遍低于cKP。结论痰是hvKP菌株,尤其是K1型hvKP的主要标本来源;超过90%的hvKP菌株携带rmpA和aerobatin基因,allS基因仅存在于K1型hvKP中。

    Abstract:

    ObjectiveTo investigate clinical distribution, capsular serotyping, molecular typing, virulence gene carriage, and antimicrobial susceptibility of hypervirulent Klebsiella pneumoniae (hvKP) strains isolated from a hospital in Hainan Province in 2016.MethodsKlebsiella pneumoniae(K. pneumoniae) isolated from the hospital between January and December 2016 were analyzed retrospectively, hvKP strains were selected through string test, antimicrobial susceptibility testing was performed and compared with classic K. pneumoniae(cKP); capsular serotyping, virulence genes, and drug resistance genes of hvKP strains were detected with polymerase chain reaction, molecular typing was performed with pulsedfield gel electrophoresis (PFGE) and multilocus sequence typing.ResultsA total of 84 hvKP strains were isolated, the main specimen source was sputum(45 strains); K1 and K2 were the major capsular serotypes of hvKP, while ST23, ST65, and ST86 were the main sequence types of hvKP. The carriage rates of rmpA, aerobatin, allS, kfuBC, and cf29a in hvKP were 90.48%, 96.43%, 42.86%, 66.67%, and 53.57% respectively, all of them were statistically higher than those of cKP strains, PFGE found that allS was positive only among K1 strains; most antimicrobial resistance rates of hvKP were lower than those of the cKP.ConclusionSputum is the main specimen source of hvKP, especially K1 serotype; more than 90% of hvKP strains carry rmpA and aerobatin genes, allS gene only exists in K1 type hvKP.

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吴华,周晓君,李天娇,等.2016年海南省高毒力肺炎克雷伯菌的临床分布、毒力基因和分子流行病学特点[J]. 中国感染控制杂志,2018,17(1):10-15. DOI:10.3969/j. issn.1671-9638.2018.01.003.
WU Hua, ZHOU Xiaojun, LI Tianjiao, et al. Clinical distribution, virulence factors, and molecular epidemiology of hypervirulent Klebsiella pneumoniae in Hainan Province in 2016[J]. Chin J Infect Control, 2018,17(1):10-15. DOI:10.3969/j. issn.1671-9638.2018.01.003.

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  • 收稿日期:2017-04-16
  • 最后修改日期:2017-06-12
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  • 在线发布日期: 2017-12-29
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