Experimental Bacteriology Unit, Institut Pasteur Madagascar, Antananarivo, Madagascar.
Plague Unit, Institut Pasteur Madagascar, Antananarivo, Madagascar.
Sci Rep. 2022 Apr 27;12(1):6871. doi: 10.1038/s41598-022-10799-4.
Klebsiella pneumoniae can lead to a wide range of diseases including pneumonia, bloodstream and urinary tract infections. During a short period of a pulmonary plague epidemic in October 2017 in Madagascar, 12 K. pneumoniae isolates were identified in ten sputum and two buboes aspirate samples. These isolates were from 12 patients suspected of plague, without epidemiological relationships, but were negative for Yersinia pestis in culture. Data were collected from the plague national surveillance system. The isolates were characterized by antimicrobial susceptibility testing and whole-genome sequencing. Real-time PCR was performed to confirm the presence of K. pneumoniae DNA in buboes. All isolates were identified as K. pneumoniae sensu stricto. Five isolates were extended-spectrum β-lactamases producers; eleven different sequence types were identified. Five isolates belonged to known hypervirulent sequence types. Our results demonstrate community-acquired pneumonia caused by K. pneumoniae isolates in patients suspected of plague stressing the importance of bed-side differential diagnosis.
肺炎克雷伯菌可导致多种疾病，包括肺炎、血流感染和尿路感染。在马达加斯加 2017 年 10 月爆发肺鼠疫的短时间内，从 10 份痰和 2 份腹股沟脓肿抽吸样本中鉴定出 12 株肺炎克雷伯菌。这些分离株来自 12 名疑似鼠疫的患者，无流行病学关系，但培养物中均未检出鼠疫耶尔森菌。数据来自鼠疫国家监测系统。通过药敏试验和全基因组测序对分离株进行了特征描述。实时 PCR 用于确认腹股沟脓肿中肺炎克雷伯菌 DNA 的存在。所有分离株均被鉴定为肺炎克雷伯菌。其中 5 株为产超广谱β-内酰胺酶株，鉴定出 11 种不同的序列类型。其中 5 株属于已知的高毒力序列类型。我们的结果表明，疑似鼠疫患者社区获得性肺炎由肺炎克雷伯菌引起，这强调了床边鉴别诊断的重要性。
