肺炎克雷伯菌所致肝脓肿患者的临床特征及毒力基因检测

目的 分析肺炎克雷伯菌肝脓肿(KPLA)患者的临床特征,了解肺炎克雷伯菌毒力基因携带情况,为临床早期诊断和合理治疗提供参考.方法 回顾性分析江苏大学附属医院2017年7月—2019年8月收治的34例脓液培养阳性的细菌性肝脓肿患者的临床资料,分为KPLA组和非肺炎克雷伯菌肝脓肿(NKPLA)组.采用VITEK 2 Com...

Clinical characteristics and virulence genes of patients with liver abscess caused by Klebsiella pneumoniae

Objective To analyze the clinical characteristics of patients with Klebsiella pneumoniae liver abscess (KPLA), understand the carrying of virulence gene of Klebsiella pneumoniae (KP), and provide reference for clinical early diagnosis and rational treatment. Methods Clinical data of 34 patients with positive pus culture for bacte-rial liver abscess in the Affiliated Hospital of Jiangsu University from July 2017 to August 2019 were retrospectively analyzed, and were divided into KPLA group and non-KPLA (NKPLA) group. VITEK 2 Compact automatic microbial identification and antimicrobial susceptibility analyzer were used for bacterial identification and antimicrobial susceptibility testing, string test was conducted for hypermucoviscous KP, polymerase chain reaction (PCR) was used to detect antimicrobial resistance genes, capsular serotype and virulence genes, results were statistically analyzed. Results Among 34 cases of bacterial liver abscess cases, 22 patients were with KPLA. Most patients in KPLA group had underlying disease diabetes mellitus, while patients in NKPLA group had underlying disease biliary tract disease or malignant tumor. Only 2 (9.1%) of 22 KP strains were both resistant to ciprofloxacin, levofloxacin and compound sulfamethoxazole, 2 extended-spectrum β-lactamases (ESBLs) resistance genes were detected from 22 strains of KP, which were bla_TEM(36.4%)and bla_CTX-M-1(27.3%). 22 strains of KP were hypervirulent Klebsiella pneumoniae (hvKP), 5 kinds of hypervirulent capsular serotypes were detected, and K1 was the main serotype, accounting for 68.2%. 22 strains of KP all carried virulence genes rmpA, iucA, iroB and iutA. Conclusion KPLA is more common in middle-aged and old men, most are with underlying disease diabetes mellitus, all strains are hvKP, mainly K1 serotype, and carry a large number of virulence genes, resistance rate to commonly used antimicrobial agents is low, but it can carry resistance genes, which needs to be paid great attention by clinicians.