摘要
目的分析上海地区某医院血流感染患儿肺炎克雷伯菌(KP)的耐药性及分子流行病学特征。方法收集上海市儿童医院2021年1月至2022年11月接受治疗的血流感染患儿血液样本,分离培养鉴定PK菌株,采用纸片扩散法(K-B)测定耐药性,检测耐药基因;采通过全基因组测序分期荚膜型、毒力基因以及多位点序列分型(MLST)分析。结果收集120份血液样本中,共检出KP菌株74株,总检出率为61.67%(74/120)。74株KP菌株对氨苄西林/舒巴坦耐药率最高,耐药率为35.14%;其次为哌拉西林/他唑巴坦、亚胺培南、左氧氟沙星,耐药率分别为20.27%、21.62%、22.97%。耐药基因检测显示,肺炎克雷伯菌blaKPC基因携带率最高21.62%(16/74);黏膜血液型与毒力基因检测显示,K64型KP检出最多28株(37.84%)。ST型分型结果显示,74株KP菌株公共检出32种ST型;其中ST23型9.46%(7/74),其次为ST29、ST111、ST412、ST36、ST20、ST37型各2株。结论引起血流感染患儿KP的耐药性还处于相对较低的水平,但仍存在一定的KP抗菌药物耐药菌株和多重耐药菌株,且耐药基因与毒性基因携带率较高,应予以关注。
Objective To investigate the antimicrobial resistance and molecular epidemiological characteristics of Klebsiella pneumoniae(KP)in children with bloodstream infection in a hospital in Shanghai.Methods Blood samples were collected from children with bloodstream infections who received treatment at Shanghai Children's Hospital from January 2021 to November 2022.PK strains were isolated,cultured and identified.Drug resistance was determined using the paper diffusion(K⁃B)method,and drug resistance genes were detected.Capsular serotype,virulence genes and multi⁃locus sequence typing(MLST)were analyzed through whole genome sequencing.Results A total of 74 KP strains were detected in 120 blood samples,re⁃sulting in a total detection rate of 61.67%(74/120).The highest resistance rate among the 74 KP strains was to ampicillin/sulbactam at 35.14%.The drug resistance rates to piperacillin/tazobactam,imipenem and levofloxa⁃cin were 20.27%,21.62%and 22.97%,respectively.Drug resistance gene detection showed that the blaKPC gene carrying rate in Klebsiella pneumoniae was the highest at 21.62%(16/74).Mucosal blood type and viru⁃lence gene detection showed that K64 KP was the most prevalent with 28 strains(37.84%).ST typing results showed that 32 ST types were identified among the 74 KP strains,with ST23 being the most common at 9.46%(7/74),followed by ST29,ST111,ST412,ST36,ST20 and ST37.Conclusion The drug resistance of KP in children with bloodstream infections is still relatively low.However,there are still some antimicrobial resis⁃tant strains and multiple drug⁃resistant strains of KP.Additionally,the carrying rate of drug⁃resistant genes and toxic genes is high,which should be a cause for concern.
作者
韩碧芸
张泓
王春
HAN Biyun;ZHANG Hong;WANG Chun(Department of Clinical Laboratory,Shanghai Children's Hospital,Shanghai,China,200040)
出处
《分子诊断与治疗杂志》
2024年第5期899-903,共5页
Journal of Molecular Diagnostics and Therapy
关键词
血流感染
肺炎克雷伯菌
耐药性
分子流行病学
Bloodstream infection
Klebsiella pneumoniae
Drug resistance
Molecular epidemi⁃ology
