引起多部位感染的肺炎克雷伯菌毒力特征研究

发布时间：2018-04-23 11:25

本文选题：肺炎克雷伯菌 + 多部位感染　；参考：《中华医院感染学杂志》2016年21期

【摘要】：目的分析引起多部位感染的临床肺炎克雷伯菌的毒力特点,为后续相关工作提供帮助。方法收集2008年-2014年由肺炎克雷伯菌引起的血流感染合并其他部位感染(腹腔感染或泌尿系感染或呼吸道感染)病例80例。采用脉冲场凝胶电泳(PFGE)和多位点序列分型(MLST)对分离到的肺炎克雷伯菌进行同源性和分子流行病学分析;采用PCR方法分析肺炎克雷伯菌的荚膜血清型和毒力基因携带情况。结果 68例(85%)患者的多部位感染是由同一克隆的肺炎克雷伯菌引起;这些菌株间的同源性较小;仅有44.1%的菌株具有高粘液表型;仅有16.2%和13.2%的菌株属于克隆复合体23(CC23)和克隆复合体65(CC65);有32.4%的菌株为K1/K2荚膜血清型,而32.4%和35.3%的菌株分别属于K5/K20/K54/K57和其他血清型。结论引起多部位感染的肺炎克雷伯菌多数为非K1/K2血清型的菌株且不具有高粘液表型。因此,以此标准鉴定高毒力肺炎克雷伯菌株存在较大误差。除目前已知的毒力因子,其他的机制可能在肺炎克雷伯菌引起的多部位感染中起重要作用。
[Abstract]:Objective to analyze the virulence of Klebsiella pneumoniae caused by multi-site infection. Methods from 2008 to 2014, 80 cases of blood stream infection caused by Klebsiella pneumoniae combined with other infection (abdominal infection, urinary tract infection or respiratory tract infection) were collected. The homology and molecular epidemiology of isolated Klebsiella pneumoniae were analyzed by pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), and the capsule serotype and virulence gene carrying of Klebsiella pneumoniae were analyzed by PCR method. Results the multisite infection of 68 patients was caused by the same cloned Klebsiella pneumoniae, the homology among these strains was relatively small, only 44.1% of the strains had high mucus phenotype. Only 16. 2% and 13. 2% of the strains belonged to clone complex 23 (CC23) and clone complex 65 (CC65), while 32. 4% of the strains belonged to K1/K2 capsule serotype, while 32. 4% and 35. 3% belonged to K5/K20/K54/K57 and other serotypes, respectively. Conclusion Klebsiella pneumoniae which caused multiple site infection were non-K1/K2 serotype strains and had no high mucus phenotype. Therefore, there is a great error in the identification of Klebsiella pneumoniae by this standard. In addition to known virulence factors, other mechanisms may play an important role in multisite infection caused by Klebsiella pneumoniae.
【作者单位】：解放军总医院微生物科;
【基金】：国家自然科学基金资助项目(81572056)
【分类号】：R446.5

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