Li Hong-Fu, Zhang Li-Xia, Zhang Wen-Lan, Li Jing, Li Ya-Qian, Hu Tong-Ping
Department of Clinical Laboratory, Zhuhai Third People's Hospital, Zhuhai, People's Republic of China.
Department of Clinical laboratory, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Inner Mongolia, People's Republic of China.
Infect Drug Resist. 2023 Feb 23;16:1133-1144. doi: 10.2147/IDR.S391468. eCollection 2023.
The purpose of this study was to analyse the clinical, microbiological and molecular epidemiological characteristics of patients with pyogenic liver abscess (PLA) caused by (KPN) in Inner Mongolia, China.
The KPN isolates from 78 KPN-PLA cases admitted to a tertiary teaching hospital in Baotou, Inner Mongolia, from 2016 to 2019 were studied systematically and described comprehensively. The virulence factors, drug resistance and sequence types of KPN in different samples were identified by a wire-drawing test, polymerase chain reaction, a drug susceptibility test and multi-site sequence typing.
There were more male than female KPN-PLA patients (<0.05). The mortality rate was 2.5%, and KPN-PLA was significantly associated with diabetes mellitus (<0.05). Most of the KPN isolates in the puncture fluid of patients with KPN-PLA were hypervirulent KPN (HvKP). The positive rate of the KPN-PLA specimens was higher than that of the blood and urine specimens. The KPN isolates of the urine specimens had higher drug resistance than the other two (<0.05). The hypermucoviscous KPN, () (+), K1 and K2 serotypes accounted for 80.8%, 89.7%, 56.4% and 26.9%, respectively. In addition to (3.8%), the detection rates of virulence factors and were higher (69.2%-100.0%). The positive rate of KPN isolates of the KPN-PLA puncture fluid was higher than that of the blood and urine samples (<0.05). In addition, ST23 was found to be the dominant ST (32.1%) of KPN-PLA in the Baotou region.
In the KPN-PLA specimens, the KPN isolates were more virulent than those in the blood and urine specimens, and a carbapenem-resistant HvKP strain emerged. This research will help improve the understanding of HvKP and provide useful suggestions for KPN-PLA treatments.
本研究旨在分析中国内蒙古地区由肺炎克雷伯菌（KPN）引起的化脓性肝脓肿（PLA）患者的临床、微生物学及分子流行病学特征。
对2016年至2019年内蒙古包头某三级教学医院收治的78例KPN-PLA患者的KPN分离株进行系统研究并全面描述。通过拉丝试验、聚合酶链反应、药敏试验和多位点序列分型鉴定不同样本中KPN的毒力因子、耐药性及序列类型。
KPN-PLA患者中男性多于女性（<0.05）。死亡率为2.5%，KPN-PLA与糖尿病显著相关（<0.05）。KPN-PLA患者穿刺液中的大多数KPN分离株为高毒力KPN（HvKP）。KPN-PLA标本的阳性率高于血液和尿液标本。尿液标本的KPN分离株耐药性高于其他两者（<0.05）。高黏液型KPN、（）（+）、K1和K2血清型分别占80.8%、89.7%、56.4%和26.9%。除（3.8%）外，毒力因子和的检出率较高（69.2%-100.0%）。KPN-PLA穿刺液KPN分离株的阳性率高于血液和尿液样本（<0.05）。此外，发现ST23是包头地区KPN-PLA的主要ST（32.1%）。
在KPN-PLA标本中，KPN分离株的毒力高于血液和尿液标本中的分离株，且出现了耐碳青霉烯类的HvKP菌株。本研究将有助于提高对HvKP的认识，并为KPN-PLA的治疗提供有益建议。
