CAJ | 학술논문

目的：研究肺炎克雷伯菌的耐药率与分子流行病学规律，明确其遗传背景，为临床抗菌药物的合理选择提供依据。方法收集临床分离肺炎克雷伯菌138株，采用K-B纸片扩散法进行10种常用抗菌药物的体外药物敏感性试验，对所有菌株进行多位点序列分型（MLST）。结果 MLST方案中选取的7个管家基因GC含量均分布于55.02％～65.06％。各等位基因数分布于3～6范围内，其中infB的等位基因数只有3个，而tonB的等位基因数有6个。tonB的多态性位点最多，为79个；体外药物敏感性试验结果表明，138株肺炎克雷伯菌对10种抗菌药物耐药率分布于9.42％～50.00％；MLST结果显示，全部菌株共形成9个ST型，其中ST11有78株、ST258有16株、ST340有10株、ST379有8株，上述4个ST型均属于克隆复合体CC258。此外，本次研究还发现1个新ST型。结论肺炎克雷伯菌对临床常用抗菌药物的耐药率较高，呈现多重耐药趋势；肺炎克雷伯菌的传播趋势相对集中，在院内抗生素选择压的作用下易形成典型的克隆复合体。
목적：연구폐염극뢰백균적내약솔여분자류행병학규률，명학기유전배경，위림상항균약물적합리선택제공의거。방법수집림상분리폐염극뢰백균138주，채용K-B지편확산법진행10충상용항균약물적체외약물민감성시험，대소유균주진행다위점서렬분형（MLST）。결과 MLST방안중선취적7개관가기인GC함량균분포우55.02％～65.06％。각등위기인수분포우3～6범위내，기중infB적등위기인수지유3개，이tonB적등위기인수유6개。tonB적다태성위점최다，위79개；체외약물민감성시험결과표명，138주폐염극뢰백균대10충항균약물내약솔분포우9.42％～50.00％；MLST결과현시，전부균주공형성9개ST형，기중ST11유78주、ST258유16주、ST340유10주、ST379유8주，상술4개ST형균속우극륭복합체CC258。차외，본차연구환발현1개신ST형。결론폐염극뢰백균대림상상용항균약물적내약솔교고，정현다중내약추세；폐염극뢰백균적전파추세상대집중，재원내항생소선택압적작용하역형성전형적극륭복합체。
Objective To research the resistant rate and molecular epidemiology of Klebsiella pneumonia and clarify the genetic backgrounds, thus to provide basis for clinical use of antibiotics. Methods A total of 138 strains isolated Kleb-siella pneumoniae were collected to detect antibiotics susceptibility testing by K-B disk diffusion and multilocus sequence typing (MLST). The eBURST and START2 software were used to analyze MLST data. Results The GC content of seven housekeeping genes included in MLST scheme were from 55.02%to 65.06%. The number of alleles was range from three to six. The infB only had three alleles while six in tonB. tonB possessed the most polymorphism sites which had seventy-nine. The antibiotics susceptibility testing showed that the resistant rate of 138 strains isolated Klebsiella pneumoniae to ten an-tibiotics were from 9.42%to 50.00%. MLST research indicated that all isolates clustered into 9 ST types, of which were 78 strains in ST11, 16 strains in ST258, 10 strains in ST340, 8 strains in ST379. They were all clustered into one clonal complex CC258. Moreover, there was one novel ST observed in this study. Conclusion The resistant rates of Klebsiella pneumoniae to clinical antimicrobial are relatively high, and emerging multiple-drug resistance tendency. Besides, the dis-semination pattern of Klebsiella pneumoniae is relatively concentrated and could form a typical clone complex easily under the nosocomial antibiotic selection pressure.