[1]吕承秀,王君君,李 庆.下呼吸道分离高毒力肺炎克雷伯菌和经典肺炎克雷伯菌常见耐药基因检测以及耐药性比较分析[J].现代检验医学杂志,2022,37(06):83-87.[doi:10.3969/j.issn.1671-7414.2022.06.015]
　L? Cheng-xiu,WANG Jun-jun,LI Qing.Detection of Common Drug Resistance Genes and Comparative Analysis of Drug Resistance between Hypervirulent Klebsiella Pneumoniae and Classical Klebsiella pneumoniae Isolated from Lower Respiratory Tract[J].Journal of Modern Laboratory Medicine,2022,37(06):83-87.[doi:10.3969/j.issn.1671-7414.2022.06.015]
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下呼吸道分离高毒力肺炎克雷伯菌和经典肺炎克雷伯菌常见耐药基因检测以及耐药性比较分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年06期
页码:
83-87
栏目:
论著
出版日期:
2022-11-15

文章信息/Info

Title:
Detection of Common Drug Resistance Genes and Comparative Analysis of Drug Resistance between Hypervirulent Klebsiella Pneumoniae and Classical Klebsiella pneumoniae Isolated from Lower Respiratory Tract
文章编号:
1671-7414(2022)06-083-05
作者:
吕承秀;  王君君;  李 庆
(淄博市第一医院检验科, 山东淄博 255200)
Author(s):
L? Cheng-xiu; WANG Jun-jun; LI Qing
(Department of Clinical Laboratory，the First Hospital of Zibo City, Shangdong Zibo 255200，China)
关键词:
高毒力肺炎克雷伯菌; 经典肺炎克雷伯菌; 耐药性; 耐药基因
分类号:
R378.996；R446.5
DOI:
10.3969/j.issn.1671-7414.2022.06.015
文献标志码:
A
摘要:
目的 分析下呼吸道分离高毒力肺炎克雷伯菌(hypervirulent Klebsiella pneumoniae，hvKP)和经典肺炎克雷伯菌(classical Klebsiella pneumoniae，cKP)常见耐药基因及耐药性比较分析，为临床抗感染治疗提供流行病学依据。方法 收集2019 年8 月～ 2021 年12 月下呼吸道分离的200 株非重复肺炎克雷伯菌菌株。用纸片扩散法(K-B 法)进行菌株抗生素敏感试验，聚合酶链反应(polymerase chain reaction，PCR)检测菌株的毒力基因、耐药基因。采用毒力基因iucA，rmpA 和peg-344 均阳性的菌株定义为hvKP，其余菌株定义为cKP，比较分析hvKP 和cKP 的耐药性。结果 200 株肺炎克雷伯菌中，hvKP 91 株，占比45.50%；cKP 109 株，占比54.50%。hvKP 和cKP 耐药菌株中的超广谱β- 内酰胺酶(extended spectrum β-Lactamases，ESBLs) 耐药基因均以blaSHV，blaTEM，blaCTX-1 group(1，3，15)为主要基因型，喹诺酮类耐药基因均以qnrS，acc(6’)- Ⅰ b，qnrB 为主要基因型。hvKP 对头孢唑林、头孢呋辛、头孢噻肟、阿莫西林/ 克拉维酸、左氧氟沙星、环丙沙星和复方新诺明的耐药率均低于cKP，差异有统计学意义(χ2=14.25，10.38，11.80，10.11，7.44，24.34，21.42，均P ＜ 0.05)；qnrS 基因在hvKP 中的阳性率低于cKP，差异有统计学意义(χ2=12.63，P=0.001)。结论 下呼吸道分离hvKP 与cKP 耐药菌株中耐药基因主要基因型一致，但是hvKP 对临床常用抗生素耐药率低于cKP，临床治疗应根据药敏结果合理应用抗生素。
Abstract:
Objective To analyze the common drug resistance genes and drug resistance comparison between hypervirulent Klebsiella pneumoniae(hvKP) and classical Klebsiella pneumoniae (cKP) isolated from lower respiratory tract, and provide epidemiological basis for clinical anti-infection treatment. Methods 200 strains of Klebsiella pneumoniae isolated from lower respiratory tract from August 2019 to December 2021 were collected. The antimicrobial susceptibility test was carried out by disk diffusion method (K-B method), and the virulence genes and drug resistance genes were detected by polymerase chain reaction (PCR). The strains with positive virulence genes iucA, rmpA and peg-344 were defined as hvKP, and the other strains were defined as cKP. The drug resistance of hvKP and cKP were compared and analyzed. Results Among the 200 strains of Klebsiella pneumoniae, 91 strains were hvKP, accounting for 45.50%, and cKP 109 strains, accounting for 54.50%. blaSHV， blaTEM and blaCTX-1group (1，3，15) were the main genotypes of extended spectrum β-Lactamases(ESBLs) resistance genes in hvKP and cKP, and qnrS, acc (6’) - Ⅰ b and qnrB were the main genotypes of quinolone resistance genes. The resistance rate of hvKP to Cefazolin，Cefuroxime，Cefotaxime，Amoxicillin/Clavulanic acid，Levofloxacin，Ciprofloxacin and Sulfamethoxazole were lower than that of cKP，and the differences were statistically significant(χ2=14.25，10.38，11.80， 10.11，7.44，24.34，21.42，all P ＜ 0.05).The positive rate of qnrS gene in hvKP was lower than that in cKP，the difference was statistically significant(χ2=12.63，P=0.001). Conclusion The main genotypes of drug resistance genes in hvKP and cKP strains isolated from lower respiratory tract were the same, but the resistance rate of hvKP to common clinical antibiotics was lower than that of cKP, and antibiotics should be used reasonably according to the results of drug sensitivity.

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相似文献/References:

[1]郑　茂a,陈宗耀a,鄂建飞a,等.高毒力肺炎克雷伯菌对碳青霉烯类耐药机制研究进展[J].现代检验医学杂志,2022,37(01):207.[doi:10.3969/j.issn.1671-7414.2022.01.043]
　ZHENG Maoa,CHEN Zong-yaoa,E Jian-feia,et al.Research Progress on the Mechanism of Hypervirulent Klebsiella Pneumoniae Resistance to Carbapenems[J].Journal of Modern Laboratory Medicine,2022,37(06):207.[doi:10.3969/j.issn.1671-7414.2022.01.043]

备注/Memo

备注/Memo:
基金项目：山东省医药卫生科技发展计划项目(2018WS008)。
作者简介：吕承秀(1987-)，男，硕士，主管检验师，研究方向：病原微生物学，E-mail：lvchengxiu870901@126.com。
通讯作者：李 庆(1975-)，男，硕士，主任技师，研究方向：病原微生物学，E-mail：zb ＿ lab@163.com。
更新日期/Last Update: 2022-11-15