尿液分离高黏液表型肺炎克雷伯菌的毒力基因检测及生物膜形成测定

Virulence genes in hypermucoviscosity phenotype Klebsiella pneumoniae strains isolated from urine and formation of biofilm

  • 摘要: 目的 检测尿液分离肺炎克雷伯菌的高黏液(HM)表型、荚膜血清型及主要毒力基因,并测定其生物膜形成情况。方法 收集尿路感染患者分离的肺炎克雷伯菌89株,黏液丝试验检测HM表型。PCR筛查6种常见高毒力荚膜血清型(K1, K2, K5, K20, K54, K57)和10种常见毒力基因(magA,rmpA, rmpA2,aerobactin,wcaG, mrkD,iroN, fimH,uge和ureA ),利用微孔板法检测生物膜的形成情况。结果 89株尿源性肺炎克雷伯菌中,除K5型外,其他5种常见高毒力荚膜血清型均有检出,共检出14株黏液丝试验阳性菌株,占15.73%; HM表型与非HM表型菌株中高毒力荚膜血清型的检出率分别为85.71%(12/14)和6.67%(5/75),差异有统计学意义(χ2= 42.730, P<0.001); 毒力基因以fimH、uge、ureA和mrkD的流行最为广泛,且在HM表型与非HM表型菌株中分布一致,差异无统计学意义,另外6种毒力基因在HM表型菌株的检出率均大于非HM表型菌株(P<0.05); HM表型菌株对常用抗菌药物的耐药率均低于非高黏菌株,差异有统计学意义(P<0.05),共发现2株产超广谱β内酰胺酶(ESBLs)的HM表型菌株,且其中1株对碳青霉烯类耐药; 89株肺炎克雷伯菌株有55株形成生物膜,阳性率为61.80%,HM表型菌株和非HM表型菌株形成生物膜的阳性率分别为35.71%(5/14)和66.67%(50/75),两者比较差异有统计学意义(χ2=4.790,P=0.029)。结论 致尿路感染的高黏表型肺炎克雷伯菌存在强毒力和(或)生物膜阳性菌株,必须高度重视,避免广泛流行。

     

    Abstract: OBJECTIVE To detect the hypermucoviscosity (HM) phenotypes, capsular serotypes and major virulence gene in Klebsiella pneumoniae strains isolated from urine and observe the formation of biofilms. METHODS Totally 89 strains of K.pneumoniae were isolated from patients with urinary tract infection, the HM phenotype was determined by string test and all isolates were assessed for six common types of hypervirulent capsular serotypes (K1, K2, K5, K20, K54, K57) and ten common types of virulence genes (magA,rmpA, rmpA2,aerobactin,wcaG, mrkD,iroN, fimH,uge and ureA) by PCR.The formation of biofilm was determined by using microtiter dish biofilm formation assay. RESULTS Among the 89 strains of K.pneumoniae, all of the common types of high virulence genes were detected except K5.Totally 14 strains showed positive for the string test, accounting for 15.73%.The detection rate of the hypervirulent capsular serotype was 85.71%(12/14) in the HM phenotype strains, 6.67%(5/75) in the non-HM phenotype strains, and there was significant difference (χ2= 42.730, P<0.001). FimH, uge, urea and mrkD were most prevalent among the virulence genes and distributed consistently in the HM phenotype strains and the non-HM phenotype strains, and there were no significant differences.The detection rates of other 6 types of virulence genes were significantly higher in the HM phenotype strains than in the non-HM phenotype strains (P<0.05).The drug resistance rates of the HM phenotype strains to the commonly used antibiotics were significantly lower than those of the non-HM phenotype strains(P<0.05).Totally 2 strains of extended-spectrum -lactamses (ESBLs)-producing HM phenotypes K.pneumoniae were identified, 1 of which was resistant to carbapenems.Totally 55 of 89 strains of K.pneumoniae formed the biofilms, with the positive rate 61.80%; the positive rate of formation of biofilms was 35.71%(5/14) in the HM phenotype strains, 66.67%(50/75) in the non-HM phenotype strains, and there was significant difference between the two groups (χ2=4.790,P=0.029). CONCLUSION It is necessary to attach great importance to the HM phenotype K.pneumoniae strains that result in urinary tract infection and are highly virulent and (or) positive for biofilms so as to prevent the wide spread.

     

/

返回文章
返回