四川大学学报（医学版）2024，Vol.55Issue(2)：391-396,6.DOI:10.12182/20240360202
血流感染碳青霉烯耐药肺炎克雷伯菌的耐药基因和毒力基因及分子流行病学研究
Carbapenemase Genes,Virulence Genes,and Molecular Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Derived From Bloodstream Infections
廖全凤 1袁余 1张为利 1邓劲 1康梅1
作者信息
- 1. 四川大学华西医院 实验医学科 (成都 610041)
- 折叠
摘要
Abstract
Objective To investigate the clinical characteristics and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from patients with bloodstream infections in a large tertiary-care general hospital in Southwest China.Methods A total of 131 strains of non-repeating CRKP were collected from the blood cultures of patients who had bloodstream infections in 2015-2019.The strains were identified by VITEK-2,a fully automated microbial analyzer,and matrix-assisted laser desorption ionization-time of flight(MALDI-TOF)mass spectrometry.The minimum inhibitory concentration(MIC)was determined by microbroth dilution method.The common carbapenemase resistant genes and virulence factors were identified by PCR.Homology analysis was performed by multilocus sequencing typing.Whole genome sequencing was performed to analyze the genomic characteristics of CRKP without carbapenemase.Results The 131 strains of CRKP showed resistance to common antibiotics,except for polymyxin B(1.6%resistance rate)and tigacycline(8.0%resistance rate).A total of 105(80.2%)CRKP strains carried the Klebsiella pneumoniae carbapenemase(KPC)resistance gene,15(11.4%)strains carried the New Delhi Metallo-β-lactamase(NDM)gene,and 4(3.1%)isolates carried both KPC and NDM genes.Sequence typing(ST)11(74.0%)was the dominant sequence type.High detection rates for mrkD(96.2%),fimH(98.5%),entB(100%),and other virulence genes were reported.One hypervirulent CRKP strain was detected.The seven strains of CRKP that did not produce carbapenemase were shown to carry ESBL or AmpC genes and had anomalies in membrane porins OMPK35 and OMPK36,according to whole genome sequencing.Conclusion In a large-scale tertiary-care general hospital,CRKP mainly carries the KPC gene,has a high drug resistance rate to a variety of antibiotics,and possesses multiple virulence genes.Attention should be paid to CRKP strains with high virulence.关键词
碳青霉烯耐药肺炎克雷伯菌/碳青霉烯酶基因/毒力基因/MLST分型/血流感染Key words
Carbapenem-resistant Klebsiella pneumoniae/Carbapenemase genes/Virulence genes/Multilocus sequence typing/Bloodstream infection引用本文复制引用
廖全凤,袁余,张为利,邓劲,康梅..血流感染碳青霉烯耐药肺炎克雷伯菌的耐药基因和毒力基因及分子流行病学研究[J].四川大学学报（医学版）,2024,55(2):391-396,6.
