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目的了解泰安市感染性腹泻病患者肺炎克雷伯菌的携带状况、血清分型及耐药性特点,为泰安市腹泻病的预警及防控和临床治疗提供科学依据。方法对分离自泰安市腹泻患者粪便标本中的31株肺炎克雷伯菌进行生化鉴定,合成特异性引物对肺炎克雷伯菌株进行荚膜血清型(K1、K2、K3、K5、K20、K54、K57)相关基因检测分型,采用微量肉汤稀释法对其进行16种抗生素敏感试验。结果泰安市2013年-2015年共发现445例腹泻患者,共检出肺炎克雷伯菌31株,总检出率为6.97%,2岁以下占64.5%。K57、K54型菌株为优势血清型,分别占22.58%、12.9%。药敏结果对氨苄西林和阿奇霉素的耐药率均高达96.77%,有5株菌对11种药物耐药。结论泰安市腹泻病患者携带肺炎克雷伯菌存在较为严重的多重耐药性。血清分型显示存在流行侵入性肝脓肿综合征的风险,应加强人群特别是婴幼儿腹泻及耐药监测,做好肺炎克雷伯菌肠道传染病的早期预警及防控。
Objective To understand the carrying status, serotyping and drug resistance of Klebsiella pneumoniae in patients with infectious diarrhea in Tai’an City, and to provide scientific basis for early warning, prevention and control and clinical treatment of diarrhea in Tai’an City. Methods 31 strains of Klebsiella pneumoniae in stool samples from patients with diarrhea in Tai’an City were biochemically identified. Specific primers were used to detect the serotypes of Klebsiella pneumoniae (K1, K2, K3, K5, K20, K54 , K57) related gene detection typing, using micro broth dilution method for its 16 kinds of antibiotic susceptibility testing. Results A total of 445 cases of diarrhea were found in Tai’an from 2013 to 2015. Of the 31 strains of Klebsiella pneumoniae detected, the total detection rate was 6.97% and 64.5% under 2 years old. K57, K54 strains for the dominant serotypes, accounting for 22.58%, 12.9%. The susceptibility rate to ampicillin and azithromycin was as high as 96.77%. Five strains were resistant to 11 drugs. Conclusion There is more serious multi-drug resistance in carrying Klebsiella pneumoniae in patients with diarrhea in Taian City. Serological typing indicates the presence of a risk of invasive invasive liver abscess syndrome. Diarrhea and drug resistance monitoring should be strengthened in the population, especially in infants and young children. Early detection and prevention of enteric-borne diseases of Klebsiella pneumoniae should be done.