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碳青霉烯类耐药且高毒力肺炎克雷伯菌的研究。

Investigations of carbapenem resistant and hypervirulent Klebsiella pneumoniae.

机构信息

1Research Team of Epidemiology and Bacterial Resistance, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco.

2Department of Clinical Bacteriology, Mohammed V Military Teaching Hospital, Rabat, Morocco.

出版信息

Acta Microbiol Immunol Hung. 2024 Jan 30;71(1):52-60. doi: 10.1556/030.2024.02207. Print 2024 Mar 26.

DOI:10.1556/030.2024.02207
PMID:38289372
Abstract

Hypervirulent Klebsiella pneumoniae is an emerging pathogen that has gained attention due to its increased ability to cause infections even in healthy individuals. The aim of this study is to investigate virulence factors in K. pneumoniae strains isolated from clinical specimens and their association with carbapenem resistance. The study was conducted on 260 isolates identified between 2018 and 2023 at the Mohammed V Military Teaching Hospital in Rabat, Morocco. The isolates were categorized based on their susceptibility to antibiotics. The hypermucoviscosity was determined by a string test, while the presence of capsular serotypes and virulence genes were identified by PCR. Among our strains, 6.2% (n = 16) exhibited hypervirulent characteristics, 56% were resistant to carbapenem. Notably, 5.7% (n = 6) of carbapenem-resistant isolates expressed the hypermucoviscous phenotype, while 1.5% (n = 2) of carbapenem-susceptible K. pneumoniae isolates exhibited the same trait. In our study, we found that a total of 10 isolates (3.8%) had virulent capsular serotypes, with K2 being the most prevalent 40% (n = 4) and K20 in 30% (n = 3). Furthermore, we detected the presence of the Aerobactin gene in 1.5% (n = 4) of the isolates examined. Based on our findings, it appears that there was no correlation between the presence of virulence factors and carbapenem resistance. In conclusion, identifying hypervirulent K. pneumoniae in clinical specimens and assessing their antibiotic resistance profiles are crucial to ensure effective therapy and to prevent outbreaks.

摘要

高毒力肺炎克雷伯菌是一种新兴的病原体,由于其能够增加对健康个体的感染能力而引起了关注。本研究旨在调查从临床标本中分离的肺炎克雷伯菌菌株的毒力因子及其与碳青霉烯类耐药的关系。该研究于 2018 年至 2023 年在摩洛哥拉巴特的穆罕默德五世军事教学医院进行,共涉及 260 株分离株。根据抗生素敏感性对分离株进行分类。超黏液性通过字符串试验确定,而荚膜血清型和毒力基因的存在则通过 PCR 确定。在我们的菌株中,6.2%(n=16)表现出高毒力特征,56%对碳青霉烯类耐药。值得注意的是,5.7%(n=6)的碳青霉烯类耐药分离株表现出高黏液表型,而 1.5%(n=2)的碳青霉烯类敏感肺炎克雷伯菌分离株也表现出相同的特征。在本研究中,我们发现共有 10 株(3.8%)具有毒力荚膜血清型,其中 K2 最为常见(n=4,占 40%),K20 占 30%(n=3)。此外,我们还检测到 1.5%(n=4)的分离株存在 Aerobactin 基因。根据我们的发现,毒力因子的存在与碳青霉烯类耐药之间似乎没有相关性。总之,在临床标本中识别高毒力肺炎克雷伯菌并评估其抗生素耐药谱对于确保有效治疗和预防暴发至关重要。

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