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      Distribution and molecular epidemiology of 56 strains of hypervirulent Klebsiella pneumoniae in Dongguan, Guangdong

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          Abstract

          Objective To study the clinical infection distribution and homology between strains of hypervirulent Klebsiella pneumoniae, analyze its molecular epidemiological characteristics, and we provide a laboratory basis for preventing and control⁃ ling the clonal spread of hypervirulent Klebsiella pneumoniae.

          Methods Clinically isolated 56 non-repetitive strains of hyper⁃ virulent Klebsiella pneumoniae from Dongguan People’s Hospital were used to detect and sequence their capsular serotypes us⁃ ing PCR amplification techniques. Multi-locus sequence typing (MLST) and Enterobacteriaceae were used, in order to under⁃ stand the molecular epidemiological characteristics of homologous, repeat sequence PCR (ERIC-PCR) for homology analysis.

          Results The majority of the 56 hypervirulent Klebsiella pneumoniae specimens were from respiratory specimens, 22 strains (39.3%); 14 blood samples (25.0%); 9 liver drainage fluids (16.1%); 5 urine samples (8.9%); and 6 other specimens (10.7%). The departments were mainly distributed in ICU, general surgery area 3,neurosurgery area 2 and general departments. The cap⁃ sular serotypes were mainly Kl, K2, and K57, and K1 and K57 each accounted for 25.0% (14/56), and the K2 was slightly high⁃ er, accounting for 26.8% (15/56); among different specimen types, K1 had the highest proportion in blood specimens, which was 35.7% (5/14); K2, K57 types were mainly found in respiratory specimens. ERIC-PCR products were divided into 22 types: 10 strains of type I, 9 strains of type II, 7 strains of type III, 5 strains of type IV, 4 strains of type V, each 2 strains of Ⅵ- Ⅶ, each 2 strains of Ⅷ- Ⅸ, the remaining 13 types was each one strain; MLST of multi-site sequence analysis showed 16 types of ST, mainly three types of ST23, ST86, and ST218, of which ST23 was all K1 (100.0%) hypervirulent Klebsiella pneumoniae; The homology analysis of HvKP in different patients of different departments found that I / ST23 K1 type was predominant, of which ICU was predominantly Ⅳ/ST23 K1 type and Ⅶ/ ST11 K54 type; the general surgery area 3 were mainly prevalent Ⅰ/ST23 K1 type and II/ST218 K57 Type; Respiratory department was mainly prevalent Ⅰ/ST23 K1 type, MLST and ERIC-PCR analysis results were different.

          Conclusion Hypervirulent Klebsiella pneumoniae in this area is mainly cloned with Ⅰ/ST23 K1 clones. The laboratory conducted molecular epidemiological investigation on hypervirulent Klebsiella pneumoniae to understand the risk factors of high-risk areas, high incidence areas, and susceptible populations, and promptly inform the clinical feedback. It can effectively prevent and control the clonal spread of hypervirulent Klebsiella pneumoniae.

          Abstract

          摘要: 目的 研究高毒力肺炎克雷伯菌( hypervirulent Klebsiella pneumoniae, HvKP ) 临床感染分布及菌株间的同源 性,分析其分子流行病学特征,为预防和控制高毒力肺炎克雷伯菌的克隆传播提供实验依据。 方法 收集东莞市人民 医院临床分离非重复的 56 株 HvKP,应用 PCR 扩增技术检测其荚膜血清型并测序,运用多位点序列分型(MLST)和肠杆 菌科基因间一致重复序列 PCR(ERIC—PCR)进行同源性分析,了解其分子流行病学特征。 结果 56 株 HvKP 标本来源 以呼吸道标本为主,为 22 株(39.3%);其次为血液 14 株(25.0%);肝脓肿引流液 9 株(16.1%),尿液 5 株(8.9%),其他标本 6 株(10.7%)。科室主要分布 ICU、普外三区、神经外科二区、综合科;荚膜血清型以 Kl、K2、K57 型为主,K1、K57 型各占25.0%(14/56),K2 型略高,占 26.8%(15/56);不同标本类型中,K1 在血液标本占比最高,为 35.7%(5/14);K2、K57 型主要 见于呼吸道标本。ERIC-PCR 产物分为 22 个型别:Ⅰ型 10 株、Ⅱ 型 9 株、Ⅲ型 7 株、Ⅳ型 5 株、Ⅴ型 4 株、Ⅵ~Ⅶ各 2 株、Ⅷ~Ⅸ各 2 株,其余 13 个型别各 1 株;多位点序列分析 MLST 显示 16 种 ST 型,主要以 ST23、ST86、ST218 这 3 种型别为主, 其中 ST23 全部是 K1 型(100.0%)HvKP;不同科室的不同患者高毒力肺炎克雷伯菌进行同源性分析发现,Ⅰ/ST23 K1 型居多,其中 ICU 主要流行Ⅳ/ST23 K1 型和Ⅶ/ST11 K54 型;普外三区主要流行Ⅰ/ST23 K1 型和Ⅱ/ST218 K57 型;呼吸科 主要流行Ⅰ/ST23 K1 型,MLST 与 ERIC-PCR 分析结果有所差别。 结论 东莞市 HvKP 以Ⅰ/ST23 K1 型 和以痰液、血液 和肝脓肿引流液标本来源为主,应对高毒力肺炎克雷伯菌进行分子流行病学调查,以有效预防和控制 HvKP 传播。

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          Author and article information

          Journal
          CTM
          China Tropical Medicine
          China Tropical Medicine (China )
          1009-9727
          01 October 2020
          01 October 2020
          : 20
          : 10
          : 967-971
          Affiliations
          1Clinical Laboratory, Dongguan People's Hospital, Dongguan, Guangdong 523000, China
          Author notes
          *Corresponding author: ZHANG Bashan, E-mail: zbsdgry@ 123456163.com
          Article
          j.cnki.46-1064/r.2020.10.12
          10.13604/j.cnki.46-1064/r.2020.10.12
          © 2020 Editorial Department of China Tropical Medicine

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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