某三甲医院高黏液表型肺炎克雷伯菌临床分离株的耐药基因与毒力基因和同源性分析

Drug resistance genes, virulence genes and homology of clinical hypermucoviscous Klebsiella pneumoniae isolates in a three-A hospital

    摘要
  • 摘要:
    目的 了解某院高黏液表型肺炎克雷伯菌(HMKP)耐药基因、毒力基因、荚膜血清型情况，为临床的抗感染治疗提供参考。
    方法 收集滁州市第一人民医院2023年7-12月临床分离的并鉴定非重复HMKP 46株，进行药敏试验，耐药基因、毒力基因及荚膜血清型，采用聚合酶链反应(PCR)法进行扩增，产物进行基因测序比对确定。采用多位点序列分型(MLST)进行分子流行病学分型，eBURST分析菌株同源性。
    结果 46株HMKP主要分离自ICU(28.26%，13株)和呼吸科(23.91%，11株)；标本类型主要为呼吸道标本(91.30%，42株)；HMKP对所监测抗菌药物的耐药率均＜10%。PCR结果显示，仅1株携带CTX-M1耐药基因。荚膜血清型以K2型(16株，34.78%)、K1型(7株，15.22%)和K57(7株，15.22%)为主。五种毒力基因的检出率分别为aerobactin(46株，100.00%)、kfu(46株，100.00%)、rmpA(43株，93.48%)、iroNB(42株，91.30%)、rmpA2(37株，80.43%)、magA(31株，67.39%)。46株HMKP共22种ST型别，以ST86(9株，19.56%)、ST25(8株，17.39%)、ST23(5株，10.87%)、ST412(5株，10.87%)和ST65(2株，4.35%)为主。eBURST软件同源性分析结果显示，18个ST型别具有较近的亲缘关系。
    结论 临床分离的HMKP仅1株携带CTX-M1基因，荚膜血清型以K2、K1和K57为主，毒力基因aerobactin和kfu的检出率为100.00%，K2血清型携带多种毒力基因模式，ST分型以ST86、ST25、ST23和ST412为主，HMKP菌株间存在明显的进化关系。

     

    Abstract:
    OBJECTIVE To investigate the drug resistance genes, virulence genes and capsule serotypes of hypermucoviscous Klebsiella pneumoniae (HMKP) from a hospital, providing a reference for clinical anti-infective treatment.
    METHODS A total of 46 non-repetitive HMKP strains, isolated and identified from clinical samples in the First People′s Hospital of Chuzhou from Jul. to Dec. 2023, were collected. Drug susceptibility testing was performed, and drug resistance genes, virulence genes and capsule serotypes were amplified by polymerase chain reaction (PCR). The PCR products were determined by genetic sequencing and comparison. Multilocus sequence typing (MLST) was used for molecular epidemiological typing, and eBURST was used to analyze strain homology.
    RESULTS The 46 HMKP strains were mainly isolated from ICU (28.26%, 13 strains) and respiratory departments (23.91%, 11 strains). The primary specimen type was respiratory specimens (91.30%, 42 strains). The drug resistance rates of HMKP to the monitored antibacterial drugs were all < 10%. PCR results showed that only 1 strain carried the CTX-M1 drug resistance gene. The predominant capsule serotypes were K2 (16 strains, 34.78%), K1 (7 strains, 15.22%) and K57 (7 strains, 15.22%). The detection rates of the five virulence genes were as follows: aerobactin (46 strains, 100.00%), kfu (46 strains, 100.00%), rmpA (43 strains, 93.48%), iroNB (42 strains, 91.30%), rmpA2 (37 strains, 80.43%) and magA (31 strains, 67.39%). Among the 46 HMKP strains, 22 sequence types (STs) were identified, with ST86 (9 strains, 19.56%), ST25 (8 strains, 17.39%), ST23 (5 strains, 10.87%), ST412 (5 strains, 10.87%) and ST65 (2 strains, 4.35%) being the most prevalent. Homology analysis conducted by eBURST software revealed that 18 STs had relatively close genetic relationships.
    CONCLUSIONS Only 1 strain of clinically isolated HMKP carries the CTX-M1 gene, with the predominant capsule serotypes being K2, K1 and K57. The detection rates of virulence genes aerobactin and kfu are 100.00%. The K2 serotype carries multiple virulence gene patterns, and the STs are mainly ST86, ST25, ST23 and ST412. There is a clear evolutionary relationship among HMKP strains.

     

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