首页|基于全基因组测序的外科重症监护室患者定植与感染碳青霉烯类耐药肺炎克雷伯菌分析

基于全基因组测序的外科重症监护室患者定植与感染碳青霉烯类耐药肺炎克雷伯菌分析

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目的 基于全基因组测序分析外科重症监护室患者定植与感染碳青霉烯类耐药肺炎克雷伯菌(carbapenem-resistant Klebsiella pneumoniae，CRKP)的耐药基因、毒力基因及同源性。方法 对2021年3月复旦大学附属中山医院大外科重症监护室和肝外科重症监护室分离的CRKP感染菌株和2021年1月-3月上述科室分离的CRKP定植菌株进行全基因组测序分析。对菌株携带的耐药基因、毒力基因及同源性进行分析。结果 共纳入16株CRKP菌株，其中10株为定植株，6株为感染株。除β。内酰胺酶类耐药基因CTX外(16。7％vs。100。0％，P＜0。05)，CRKP感染株与定植株的其他耐药基因检出率差异均无统计学意义(P＞0。05)。部分菌株的耐药基因聚类分析较为接近。全基因组测序分析显示，CRKP菌株均携带多种毒力基因，entB、irp2、iroN、rmpA基因的检出率分别为100。0％、87。5％、37。5％和62。5％。CRKP感染株与定植株的毒力基因检出率差异均无统计学意义(P＞0。05)。同源性分析显示部分菌株同源关系较接近，存在交叉传播的可能。结论 外科重症监护室患者CRKP感染株与定植株的部分菌株有交叉传播的风险，今后应加强医院感染防控以降低感染的发生。
Analysis of colonization and infection of carbapenem-resistant Klebsiella pneumoniae in surgical intensive care unit patients based on whole genome sequencing
Objective To analyze the drug resistance genes,virulence genes and homologies of carbapenem-resistant Klebsiella pneumoniae(CRKP)colonized and infected patients in surgical intensive care unit based on whole genome sequencing.Methods Whole genome sequencing analysis was performed on CRKP infected strains isolated from the Department of General Surgery Intensive Care Unit and the Department of Liver Surgery Intensive Care Unit of Zhongshan Hospital,Fudan University in March 2021 and CRKP colonized strains isolated from the above departments between January and March 2021.The drug resistance genes,virulence genes and homologies of the strains were analyzed.Results A total of 16 CRKP strains were included,including 10 colonized strains and 6 infected strains.Except for theβ-lactamase drug resistance gene CTX(16.7％vs.100.0％,P＜0.05),there was no significant difference in the detection rate of other drug resistance genes between CRKP infected strains and colonized strains(P＞0.05).The cluster analysis of drug resistance genes of some strains was relatively close.Whole genome sequencing analysis showed that CRKP strains carried a variety of virulence genes,and the detection rates of entB,irp2,iroN,and rmpA genes were 100.0％,87.5％,37.5％,and 62.5％,respectively.There was no significant difference in the detection rate of virulence genes between CRKP infected strains and colonized strains(P＞0.05).Homology analysis showed that some strains had close homologous relationships,and there was the possibility of cross transmission.Conclusions Some of CRKP infection strains and colonization strains in surgical intensive care unit patients have the risk of cross transmission.In the future,we should strengthen the prevention and control of nosocomial infection to reduce the incidence of infection.

Active screeningcarbapenem-resistant Klebsiella pneumoniaewhole genome sequencinghomologous analysis

陈翔、高晓东、周春妹、黄声雷、潘文彦、刘霄、梅静骅、史庆丰

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复旦大学附属中山医院感染管理科(上海 200032)

复旦大学附属中山医院检验科(上海 200032)

复旦大学附属中山医院护理部(上海 200032)

主动筛查 碳青霉烯类耐药肺炎克雷伯菌 全基因组测序分析 同源性分析

美国中华医学基金会项目复旦大学附属中山医院发展基金上海申康医院发展中心市级医院临床科技创新项目上海申康医院发展中心诊疗技术推广项目(第三批)

23-5132021ZSFZ14SHDC22021315SHDC22022220

2024

10.7507/1002-0179.202312181

华西医学
四川大学华西医院

华西医学

CSTPCD
影响因子：0.744
ISSN：1002-0179
年,卷(期)：2024.39(3)
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