上海市医疗机构ST11型耐碳青霉烯类肺炎克雷伯菌分子流行病学特征与高毒力进化研究
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Molecular epidemiological characteristics and hypervirulence evolution of ST11 carbapenem-resistant Klebsiella pneumoniae in medical institutions in Shanghai
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    摘要:

    目的 了解上海市医疗机构分离的ST11型耐碳青霉烯类肺炎克雷伯菌(CRKP)的分子流行病学特征及高毒力进化趋势,为制定耐药菌的预防控制措施提供科学依据。方法 收集2021—2022年上海市12所医疗机构分离的201株CRKP,检测药敏结果并进行全基因组测序,拼接后的数据用于多位点序列分型(MLST)、血清分型(wzi分型),以及耐药基因和毒力基因分析。结果 201株CRKP均为多重耐药菌(MDROs)。对碳青霉烯类、头孢菌素类、喹诺酮类药物几乎全耐药;耐药基因分析显示,93.03%的CRKP菌株携带KPC基因。201株CRKP分为6种ST型和10种荚膜wzi分型,以ST11-KL64型(104株)为主,ST15-KL19型(54株)次之。52.24%(105株)的CRKP携带rpmA/rpmA2+iucA+iutA+iroN基因。结论 上海市医疗机构分离的CRKP以ST11-KL64型为主,多重耐药情况严重,且半数以上菌株为高毒力耐碳青霉烯类肺炎克雷伯菌(hv-CRKP),需持续加强对CRKP的分子特征监测,防止医院感染的暴发。

    Abstract:

    Objective To understand the molecular epidemiological characteristics and hypervirulence evolution trend of ST11 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from medical institutions in Shanghai, and provide scientific basis for formulating the prevention and control measures of drug-resistant organisms. Methods A total of 201 strains of CRKP isolated from 12 medical institutions in Shanghai from 2021 to 2022 were collected. Antimicrobial susceptibility testing and whole genome sequencing were performed. The concatenated data was used for multilocus sequencing typing (MLST), serum typing (wzi typing), as well as analysis of resistance and virulence genes. Results All 201 CRKP strains were multidrug-resistant organisms (MDROs). These strains were almost completely resistant to carbapenems, cephalosporins, and quinolones. Drug resistance gene analysis showed that 93.03% of CRKP strains carried KPC gene. 201 CRKP strains were divided into 6 ST types and 10 capsule wzi types, with ST11-KL64 (n=104) being the dominant type, followed by ST15-KL19 (n=54). 52.24% (n=105) of CRKP carried rpmA/rpmA2+iucA+iutA+iroN genes. Conclusion CRKP isolated from medical institutions in Shanghai is mainly ST11-KL64 type with severe multidrug resistance, and more than half of the strains are hypervirulent carbapenem-resistant Klebsiella pneumoniae (hv-CRKP). It is necessary to continuously strengthen the monitoring of the molecular characteristics of CRKP, so as to prevent outbreaks of healthcare-associated infection.

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毕菁,陈雯杰,田靓,等.上海市医疗机构ST11型耐碳青霉烯类肺炎克雷伯菌分子流行病学特征与高毒力进化研究[J]. 中国感染控制杂志,2025,24(8):1075-1082. DOI:10.12138/j. issn.1671-9638.20257205.
BI Jing, CHEN Wenjie, TIAN Liang, et al. Molecular epidemiological characteristics and hypervirulence evolution of ST11 carbapenem-resistant Klebsiella pneumoniae in medical institutions in Shanghai[J]. Chin J Infect Control, 2025,24(8):1075-1082. DOI:10.12138/j. issn.1671-9638.20257205.

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  • 收稿日期:2024-11-19
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  • 在线发布日期: 2025-08-19
  • 出版日期: 2025-08-28