中国当代儿科杂志2026，Vol.28Issue(3)：269-276,8.DOI:10.7499/j.issn.1008-8830.2507029
新生儿肺炎克雷伯菌败血症的临床与菌株分子特征研究
Clinical and molecular characteristics of neonatal Klebsiella pneumoniae sepsis
摘要
Abstract
Objective To characterize the molecular profiles of Klebsiella pneumoniae isolates causing neonatal sepsis and assess their clinical implications.Methods Clinical data and bloodstream isolates from neonates with Klebsiella pneumoniae sepsis admitted to four hospitals in Hebei Province from 2020 to 2024 were collected.Whole-genome sequencing was performed to analyze molecular characteristics of the pathogenic strains.Clinical features were compared between virulence gene-carrying and non-carrying groups.A phylogenetic tree based on sequencing data was constructed to explore potential transmission routes.Results A total of 37 infants and their clinical bloodstream isolates were included.Thirty-three(89%)had late-onset infection,and 32(86%)were hospital-acquired.Preterm infants accounted for 95%.Twenty-eight(76%)underwent invasive procedures,and 13(35%)had prior exposure to broad-spectrum antimicrobials.All infants were cured after treatment.Resistance rates to third-generation cephalosporins and carbapenems were 89%and 27%,respectively.ST45 was the most common sequence type.The carriage rates of extended-spectrum β-lactamase and carbapenemase genes were 84%and 24%,respectively.Concordance between resistance genes and phenotypic resistance was 86%.Clinical antimicrobial use was not fully consistent with resistance phenotypes or gene carriage.Among virulence genes,ybt had the highest carriage rate(54%).The proportion of concurrent infections at other sites did not differ significantly between the virulence gene-carrying and non-carrying groups(50%vs 29%,P=0.315).Phylogenetic analysis revealed intra-hospital and inter-hospital transmission of Klebsiella pneumoniae strains causing neonatal sepsis.Conclusions Detection of antimicrobial resistance and virulence genes facilitates deeper understanding of bacterial pathogenesis and provides a basis for optimizing regional infection control and antimicrobial treatment strategies.关键词
新生儿败血症/肺炎克雷伯菌/全基因组测序/多重耐药Key words
Neonatal sepsis/Klebsiella pneumoniae/Whole-genome sequencing/Multidrug resistance引用本文复制引用
河北省新生儿败血症研究协作组,马莉..新生儿肺炎克雷伯菌败血症的临床与菌株分子特征研究[J].中国当代儿科杂志,2026,28(3):269-276,8.基金项目
河北省省级科技计划资助(21377709D). （21377709D）
