腹腔感染耐碳青霉烯类肺炎克雷伯菌的毒力特征

doi:10.3969/j.issn.1006-7795.2021.05.007

首都医科大学学报 ›› 2021, Vol. 42 ›› Issue (5): 733-738.doi: 10.3969/j.issn.1006-7795.2021.05.007

腹腔感染耐碳青霉烯类肺炎克雷伯菌的毒力特征

马立艳¹, 孙伟¹, 夏帅², 苏建荣^1*

1.首都医科大学附属北京友谊医院检验科,北京 100050;
2.首都医科大学研究生院,北京 100069

收稿日期:2021-08-24 发布日期:2021-10-29
通讯作者: 首都卫生发展科研专项项目重点攻关(2018-1-4081)。

Study on the virulence features of carbapenem-resistant Klebsiella pneumoniae from invasive abdomen infections

Ma Liyan¹, Sun Wei¹, Xia Shuai², Su Jianrong^1*

1. Clinical Laboratory Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
2. Graduate School of Capital Medical University, Beijing 100069, China

Received:2021-08-24 Published:2021-10-29
Contact: Capital Health Research and Development of Special (2018-1-4081).

摘要/Abstract

摘要： 目的研究耐碳青霉烯类肺炎克雷伯菌(carbapenem-resistant klebsiella pneumoniae, CRKP)的毒力特征。方法收集首都医科大学附属北京友谊医院侵袭性腹腔感染部位分离的CRKP菌株38株,采用PCR方法检测碳青霉烯酶耐药基因bla_KPC-2、bla_NDM-1、bla_IMP-4、bla_VIM-1和bla_OXA-48,检测毒力基因rmpA2和铁载体iucA基因,采用多位点序列分型(multilocus sequence typing, MLST)方法进行菌株的基因分型,采用结晶紫法、铬天青S法分别定量检测生物膜形成能力和铁载体生成能力。结果 38株CRKP中,ST11为主要克隆株,占比78.1%(25/38)。88.0%(22/25)的ST11型菌株中只检测到bla_KPC-2,高于非ST11组,两组之间差异有统计学意义。60.0%(15/25)的ST11型菌株同时携带rmpA2和iucA,高于非ST11组,两组之间差异无统计学意义。生物膜形成能力在非ST11组和KPC+rmpA2+iucA组较弱,差异无统计学意义。ST11组铁载体生成能力高于非ST11组、KPC+rmpA2+iucA组高于KPC组,两组之间的差异均有统计学意义。结论同时携带KPC-2型耐药基因、rmpA2和iucA毒力基因的ST11型CRKP菌株的出现,需要采取更为严格的医院感染控制措施防止播散。

关键词: 肺炎克雷伯菌, 耐碳青霉烯类, 毒力, 生物膜, 铁载体

Abstract: Objective To investigate the virulence features of carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods A total of 38 CRKP clinical strains isolated from invasive abdomen infections were collected. The polymerase chain reaction (PCR) were performed to detect carbapenemase genes (blaKPC-2、blaNDM-1、blaIMP-4、blaVIM-1 and bla_OXA-48), virulence gene (rmpA2) and siderophore gen e(iucA). The CRKP strains were characterized wtih their multilocus sequence typing (MLST) . The capacity of biofilm formation and siderophore production of the isolates were quantitatively tested by crystal violet method and chrome azurol S (CAS) assay, respectively. Results Among 38 CRKPs, 25 strains (25/38, 78.1%) belonged to ST11, which was the predominate clone. Twenty-two strains(22/25, 88.0%)in ST11 group carried bla_KPC-2 only, with the percentage significant higher than that in non-ST11 group. Fifteen ST11 CRKPs (15/25, 60.0%) simultaneously possessed rmpA2 and iucA, and there had no statistical difference between ST11 group and non-ST11 group. Biofilm formation capacity were weaker in non-ST11 group and KPC+rmpA2+iucA group, without statistical differences. The CAS assay showed that the capacity of siderophore production in ST11 group and KPC+rmpA2+iucA group were significantly stronger than that in non-ST11 group and KPC group, respectively. Conclusion The coexistence of bla_KPC-2, rmpA2, and iucA in ST11 CRKPs indicated that strict control measures should be taken to prevent further dissemination.

Key words: Klebsiella pneumoniae, carbapenem-resistant, virulence, biofilm, siderophore

中图分类号:

R446.5

马立艳, 孙伟, 夏帅, 苏建荣. 腹腔感染耐碳青霉烯类肺炎克雷伯菌的毒力特征[J]. 首都医科大学学报, 2021, 42(5): 733-738.

Ma Liyan, Sun Wei, Xia Shuai, Su Jianrong. Study on the virulence features of carbapenem-resistant Klebsiella pneumoniae from invasive abdomen infections[J]. Journal of Capital Medical University, 2021, 42(5): 733-738.

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腹腔感染耐碳青霉烯类肺炎克雷伯菌的毒力特征

Study on the virulence features of carbapenem-resistant Klebsiella pneumoniae from invasive abdomen infections

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