摘要
目的了解骨科患者创面感染肺炎克雷伯菌的耐药特性和毒力特性。方法收集从2017年2月至2019年10月于郑州市第七人民医院骨科住院的创面感染患者的感染创面分离的肺炎克雷伯菌32株,应用肉汤稀释法测定肺炎克雷伯菌对13种常用抗菌药物的耐药性,荚膜染色和拉丝试验确定肺炎克雷伯菌的荚膜和黏液性毒力表型,结晶紫染色法测定肺炎克雷伯菌体外生物膜形成能力,聚合酶链反应法检测肺炎克雷伯菌的耐药基因和毒力基因。结果32株肺炎克雷伯菌对13种抗菌药物的耐药率为6.25%~81.25%,其中对氨苄西林耐药率最高,为81.25%;其次是头孢曲松和头孢哌酮,分别为75.00%和62.50%;对亚胺培南的耐药率最低,为6.25%。32株肺炎克雷伯菌均有荚膜,其中12株(37.50%)表现为高黏液性,21株(65.63%)形成生物膜。32株肺炎克雷伯菌携带的毒力基因主要为fimH-1[100.00%(32/32)]、entB[96.88%(31/32)]、markD[93.75%(30/32)],21.88%(7/32)的菌株携带rmpA,18.75%(6/32)的菌株携带iroNB,magA基因的携带率最低[9.38%(3/32)];携带的耐药基因主要为blaCTX-M、blaSHV、blaKPC、gyrA、qnrA,且表现为多药耐药。结论骨科患者创面感染的肺炎克雷伯菌耐药较严重,其耐药性与毒力特性相关,高毒力菌株多表现为多重耐药。
Objective To investigate the drug resistance and virulence characteristics of Klebsiella pneumoniae isolated from infected wounds of patients in department of orthopedics.Methods A total of 32 Klebsiella pneumoniae strains were collected from infected wounds of inpatients admitted to Department of Orthopedics,the Seventh People′s Hospital of Zhengzhou from February 2017 to October 2019.The drug resistance of Klebsiella pneumoniae against 13 antimicrobials commonly used in clinic were determined by the agar dilution method.The capacity of producing capsule and hypermucoviscosity of Klebsiella pneumoniae were determined by capsules staining and wire drawing test,respectively.The capacity of biofilm formation was determined by crystal violet staining assay.The polymerase chain reaction technology was used to detect the drug resistant gene and virulence gene.Results The drug resistance rates of 32 Klebsiella pneumoniae against to 13 antimicrobials were 6.25%-81.25%.The drug resistance rate to ampicillin was the highest,which was 81.25%;the drug resistance rate to ceftriaxone and cefoperazone were 75.00%and 62.50%,respectively;the drug resistance rate to imipenem was the lowest,which was 6.25%.All of the 32 strains had capsule,12 strains(37.50%)could produce hypermucoviscosity and 21 strains(65.63%)could form biofilm.The main virulence factor genes were fimH-1[100.00%(32/32)],entB[96.88%(31/32)]and mrkD[93.75%(30/32)],and followed by rmpA[21.88%(7/32)]and iroNB[18.75%(6/32)];the carrying rate of magA gene was the lowest,accounted for 9.38%(3/32).Most strains carried multiple drug-resistant genes,including blaCTX-M,blaSHV,blaKPC,gyrA,qnrA,and their showed multidrug resistance.Conclusion The situation of drug resistance of Klebsiella pneumonia isolated from infected wounds of patients in department of orthopaedics is more serious,the drug resistance is related to the virulence factors,and the high-virulence strains mostly show multidrug resistance.
作者
邹鹏
涂继军
陈治权
杨永超
陈新锋
ZOU Peng;TU Jijun;CHEN Zhiquan;YANG Yongchao;CHEN Xinfeng(Department of Orthopedics,the Seventh People′s Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China;Department of Clinical Laboratory,the Seventh People′s Hospital of Zhengzhou,Zhengzhou 450000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2021年第6期534-539,共6页
Journal of Xinxiang Medical University
基金
河南省医学科技攻关资助项目(编号:LHGJ20191104)。
关键词
肺炎克雷伯菌
耐药性
毒力表型
毒力因子
Klebsiella pneumoniae
drug resistance
virulence phenotype
virulence factor
