Pan Wang-Kai, Chen Sui-Ning, Yang Mei-Juan, Tao Liang-Ping, Wang Mei-Qi, Zhang Xin-Wei, Xu Yin-Hai, Yan Jie, Qin Jiang-Feng, Sun Ai-Hua
School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, 310053, People's Republic of China.
The First Hospital of Putian City, Putian, Fujian, 351199, People's Republic of China.
Infect Drug Resist. 2025 Mar 13;18:1451-1464. doi: 10.2147/IDR.S502323. eCollection 2025.
is a common opportunistic pathogen. Predominant serotypes, virulence genes, and resistance characteristics of isolates from patients in different regions of China require further investigation.
isolates from patients and healthy individuals in middle and east China were identified using an auto-bacterial detector. Major serotypes and virulence genes in the isolates were detected by polymerase chain reaction, while drug resistance of the isolates was determined using broth microdilution assays.
Respiratory infection was observed in 70.0% of the patients. Of the isolates from patients, 42.3% were hypervirulent K (hvKp) serotypes, of which 30.1% and 37.0% belonged to K1 and K2 serotypes with 78.6-87.8% positive rates of and virulence genes. The isolates from healthy individuals had fewer hvKp serotypes and genes (7.2% and 22.9%/26.5%). Resistance rates (38.6-79.5%) of the isolates from healthy individuals against 14 antibiotics were higher than those from patients (16.4-40.8%). The isolates from patients were sensitive to amikacin (83.6%) and polymyxin-B (93.9%) but presented 20.3% and 26.6% resistance rates to imipenem and meropenem, respectively. The isolates from patients with urinary infections exhibited higher resistances (42.1-52%) to cefoxitin, cefuroxime, ceftriaxone, ciprofloxacin, and levofloxacin than those from patients with respiratory or blood infections (22.4-39.3%). In the isolates from patients, the K47 and K64 serotypes exhibited multiple drug resistance (65-90%) against 14 antibiotics but all the hvKp serotypes displayed much lower antibiotic resistance (1.9-26.0%).
K1/K2 were the major predominant hvKp serotypes with virulence genes and carbapenem-resistant strains were prevalent in patients from middle and east China. The hvKp serotypes have low antibiotic resistance, but isolates from patients with urinary infections resist the cephalosporin/quinolone antibiotics for treatment of bacterial urinary infections. Amikacin and polymyxin-B can be used to treat drug-resistant infections.
是一种常见的机会性病原体。中国不同地区患者分离株的主要血清型、毒力基因和耐药特征需要进一步研究。
使用自动细菌检测仪对中国中部和东部患者及健康个体的分离株进行鉴定。通过聚合酶链反应检测分离株中的主要血清型和毒力基因，同时使用肉汤微量稀释法测定分离株的耐药性。
70.0%的患者出现呼吸道感染。在患者分离株中，42.3%为高毒力K（hvKp）血清型，其中30.1%和37.0%属于K1和K2血清型，和毒力基因阳性率为78.6 - 87.8%。健康个体的分离株中hvKp血清型和基因较少（7.2%和22.9%/26.5%）。健康个体分离株对14种抗生素的耐药率（38.6 - 79.5%）高于患者分离株（16.4 - 40.8%）。患者分离株对阿米卡星（83.6%）和多粘菌素B（93.9%）敏感，但对亚胺培南和美罗培南的耐药率分别为20.3%和26.6%。泌尿系统感染患者的分离株对头孢西丁、头孢呋辛、头孢曲松、环丙沙星和左氧氟沙星的耐药性（42.1 - 52%）高于呼吸道或血液感染患者的分离株（22.4 - 39.3%）。在患者分离株中，K47和K64血清型对14种抗生素表现出多重耐药（65 - 90%），但所有hvKp血清型的抗生素耐药性都低得多（1.9 - 26.0%）。
K1/K2是主要的优势hvKp血清型，具有毒力基因，碳青霉烯耐药菌株在中国中部和东部患者中普遍存在。hvKp血清型抗生素耐药性低，但泌尿系统感染患者的分离株对头孢菌素/喹诺酮类抗生素耐药，可用于治疗细菌性泌尿系统感染。阿米卡星和多粘菌素B可用于治疗耐药感染。
