高毒力肺炎克雷伯菌(KP)是根据高粘膜粘度或各种毒力因子定义的,在临床上与社区获得性肝脓肿(CLA)相关。在这项研究中,我们调查了KP的临床和微生物学特征以及与高毒力相关的重要因素。临床特点,抗菌敏感性,高粘膜粘度,血清型,高毒力相关基因,根据CLA对2013年12月至2015年11月从基阳大学东山医院收集的414株KP分离株的生物膜形成进行分析.使用logistic回归分析研究了与CLA相关的高毒力KP(HvKP)的重要危险因素。值得注意的是,155株(37.4%)具有高粘膜粘性,170例(41.1%)含有氧气素。34例(8.2%)存在CLA。CLA和非CLA组之间的流行病学和治疗结果没有显着差异。CLA组对抗生素的敏感性明显较高,K1/K2,rmpA,maga,allS,kfu,IutA,字符串测试阳性结果,和生物膜质量。多因素logistic回归显示rmpA(OR,5.67;95%CI,2.09-15.33;p=0.001),maga(或,2.34;95%CI,1.01-5.40;p=0.047),生物膜质量>0.80(OR,2.13;95%CI,1.00-4.56;p=0.050)是CLA的显著危险因素。rmpA被确定为KP菌株中CLA的最重要风险因素,这意味着它是与HvKP相关的重要因素。
Hypervirulent Klebsiella pneumoniae (KP) is defined according to hypermucoviscosity or various virulence factors and is clinically associated with community-acquired liver abscess (CLA). In this study, we investigated the clinical and microbiological characteristics of KP and significant factors associated with
hypervirulence. The clinical characteristics, antimicrobial susceptibility, hypermucoviscosity, serotypes,
hypervirulence-related genes, and biofilm formation of 414 KP isolates collected from the Keimyung University Dongsan Hospital between December 2013 and November 2015 were analyzed according to CLA. Significant risk factors for hypervirulent KP (HvKP) associated with CLA were investigated using logistic regression analysis. Notably, 155 (37.4%) isolates were hypermucoviscous, and 170 (41.1%) harbored aerobactin. CLA was present in 34 cases (8.2%). Epidemiology and treatment outcomes did not differ significantly between the CLA and non-CLA groups. The CLA group had significantly higher antibiotic susceptibility, K1/K2, rmpA, magA, allS, kfu, iutA, string test-positive result, and biofilm mass. Multivariate logistic regression revealed rmpA (OR, 5.67; 95% CI, 2.09-15.33; p = 0.001), magA (OR, 2.34; 95% CI, 1.01-5.40; p = 0.047), and biofilm mass >0.80 (OR, 2.13; 95% CI, 1.00-4.56; p = 0.050) as significant risk factors for CLA. rmpA was identified as the most significant risk factor for CLA among KP strains, implying that it is an important factor associated with HvKP.