Liao C H, Huang Y T, Chang C Y, Hsu H S, Hsueh P R
Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Eur J Clin Microbiol Infect Dis. 2014 Mar;33(3):365-9. doi: 10.1007/s10096-013-1964-z. Epub 2013 Sep 9.
We investigated the epidemiology of different serotypes of Klebsiella pneumoniae isolates causing bacteremic liver abscess (LA) using multilocus sequence typing (MLST). MLST and molecular typing were performed for 41 K1 (19 LA), 37 K2 (5 LA), and 33 non-K1/K2 (6 LA) isolates that were derived from a previous one-year K. pneumoniae bacteremia cohort. Capsular serotypes and rmpA of these isolates were determined by polymerase chain reaction (PCR) methods. Among the 41 K1 isolates, 39 were ST23 and the remaining two isolates were ST23 single-locus variant. There were 11 STs among K2 isolates. ST65 was the most common (n = 10), followed by ST86, ST373, and ST375. Only ST65 (n = 3), ST373 (n = 1), and ST375 (n = 1) caused LA, and ST65 was a three-locus variant of ST23. For non-K1/K2 isolates, the ST types varied widely. ST218 (K57) was the most common type (n = 6, 18 %), and it was a single-locus variant of ST23 and caused two cases of LA. The existences of rmpA among serotypes varied (100 % for K1, 89 % for K2, and 55 % for non-K1/K2). For isolates causing LA, all of them were positive for rmpA. For non-K1/K2 isolates causing infections other than LA, the positivity of rmpA ranged from 0 % (biliary tree infection) to 67 % (pneumonia). In this one-year cohort, all K1 isolates were ST23 or its single-locus variants, but the composition of ST types among K2 isolates was quite variable. ST23 and its one- (ST1005 and ST218) and three-locus (ST65) variants comprised 80 % of isolates causing LA.
我们使用多位点序列分型（MLST）方法研究了导致菌血症性肝脓肿（LA）的不同血清型肺炎克雷伯菌分离株的流行病学特征。对来自先前为期一年的肺炎克雷伯菌菌血症队列的41株K1（19例LA）、37株K2（5例LA）和33株非K1/K2（6例LA）分离株进行了MLST和分子分型。通过聚合酶链反应（PCR）方法测定这些分离株的荚膜血清型和rmpA。在41株K1分离株中，39株为ST23，其余两株为ST23单一位点变异株。K2分离株中有11种ST型。ST65最为常见（n = 10），其次是ST86、ST373和ST375。只有ST65（n = 3）、ST373（n = 1）和ST375（n = 1）导致了LA，且ST65是ST23的三位点变异株。对于非K1/K2分离株，ST型差异很大。ST218（K57）是最常见的类型（n = 6，18%），它是ST23的单一位点变异株，导致了两例LA。血清型中rmpA的存在情况各不相同（K1为100%，K2为89%，非K1/K2为55%）。对于导致LA的分离株，所有分离株的rmpA均为阳性。对于导致除LA以外感染的非K1/K2分离株，rmpA的阳性率范围为0%（胆道感染）至67%（肺炎）。在这个为期一年的队列中，所有K1分离株均为ST23或其单一位点变异株，但K2分离株中ST型的组成差异很大。ST23及其单一位点（ST1005和ST218）和三位点（ST65）变异株占导致LA分离株的80%。
