Sharma Akshika, Vats Nisha, Rati Ruchi, Sharma Lalit, Chatterjee Nirupama, Jaggi Namita
Education and Research, Artemis Hospitals, Sector-51, Gurugram, Haryana, India.
Department of Microbiology, Artemis Hospitals, Sector-51, Gurugram, Haryana, India.
BMC Infect Dis. 2024 Dec 28;24(1):1477. doi: 10.1186/s12879-024-10012-z.
Klebsiella pneumoniae, a pathogen of concern worldwide can be classified as classical K. pneumoniae (cKp) and Hypervirulent K. pneumoniae (HvKp). In health care settings, genotyping and identification of hypervirulent strains enables better clinical management. The present study was conducted in a north Indian tertiary care hospital which receives both Indian and foreign patients. During the study period (September -December 2022), 29 isolates of K. pneumoniae were collected from Out Patients department (OPD), Intensive Care Unit (ICU) and wards. Genotypic profiling was based on Multi Locus Sequence Typing (MLST) and wzi type. Virulence was determined by PCR based screening of genes (RmpA, iucB, ybts, iroN) as well as phenotypic tests: string test, biofilm formation and serum neutralization assay. We identified 17 Sequence Type and 14 wzi strain. The most common Sequence Type was ST231 (6/29) followed by ST 6260 (3/29)0.15 (51.7%) isolates were carbapenem resistant (CR). Eleven isolates carried the aerobactin gene iucB and/or rmpA genes. The results of the study show the presence of diverse genotypes and virulence genes of K. pneumoniae, stressing the need for stricter surveillance. We also observed a significantly higher average length of stay in patients carrying hypervirulent or carbapenem resistant strains (p < 0.05).
肺炎克雷伯菌是一种全球关注的病原体,可分为经典肺炎克雷伯菌(cKp)和高毒力肺炎克雷伯菌(HvKp)。在医疗环境中,对高毒力菌株进行基因分型和鉴定有助于更好地进行临床管理。本研究在一家接收印度和外国患者的印度北部三级医院进行。在研究期间(2022年9月至12月),从门诊部(OPD)、重症监护病房(ICU)和病房收集了29株肺炎克雷伯菌分离株。基因分型基于多位点序列分型(MLST)和wzi型。通过基于PCR的基因(RmpA、iucB、ybts、iroN)筛查以及表型试验(拉丝试验、生物膜形成和血清中和试验)来确定毒力。我们鉴定出17种序列型和14种wzi菌株。最常见的序列型是ST231(6/29),其次是ST6260(3/29)。0.15(51.7%)的分离株对碳青霉烯类耐药(CR)。11株分离株携带气杆菌素基因iucB和/或rmpA基因。研究结果表明肺炎克雷伯菌存在多种基因型和毒力基因,强调了更严格监测的必要性。我们还观察到携带高毒力或碳青霉烯类耐药菌株的患者平均住院时间明显更长(p<0.05)。