■在临床环境中,高粘膜粘性和高毒力肺炎克雷伯菌(hm-hvKp)分离株的发生和传播是世界上一个严重的公共卫生问题。然而,社区人群中这些分离株的数据有限.本研究旨在了解上海地区社区患者hm-hvKp分离株的流行情况和分子特征。中国。
■2018年,浦东新区实施了以社区腹泻病例hm-hvKp为重点的主动监测系统,上海,中国,涉及12个哨点医院.测试了粪便样品中hm-hvKp分离株的抗菌敏感性,和全基因组测序(WGS)进行预测血清型和序列类型,并确定抗菌素耐药性决定因素,毒力决定因素,和系统发育集群。
■肺炎克雷伯菌分离株的总体患病率为2.48%(31/1252),hm-hvKp的比例为1.76%(22/1252),hm非hv肺炎克雷伯菌的比例为0.72%(9/1252)。hm-hvKp分离株在不同年龄组和不同月份中的患病率有统计学意义。所有22hm-hvKp分离株对20种抗菌药物敏感,仅携带blaSHV基因,KL1和KL2分别占8例(36.36%)和7例(31.82%),分别。八个ST23/KL1分离株属于主要的CG23-I进化枝,通常具有rmpA/rmpA2-iro-iuc-ybt-irp-clb的毒力决定子谱。五个ST86/KL2分离株被分配到ST86/KL2-1的全局簇(n=2),ST86/KL2-2(n=2),ST86/KL2-3(n=1),都缺乏CLB基因.上海ST23/KL1和ST86/KL2分离株与全球肝脓肿分离株密切相关,血,还有尿液.
■Hm-hvKp由上海社区人口携带,以ST23/KL1和ST86/KL2分离株为主。不同大陆的Hm-HvKp分离株,不同的来源,不同毒力水平密切相关。有必要对社区人群中的hm-hvKp分离株进行持续监测。
UNASSIGNED: The occurrence and dissemination of hypermucoviscous and hypervirulent Klebsiella pneumoniae (hm-hvKp) isolates in clinical settings are a critical public health problem in the world. However, the data on these isolates in community populations are limited. This study aims to understand the prevalence and molecular characteristics of hm-hvKp isolates in community patients in Shanghai, China.
UNASSIGNED: In 2018, an active surveillance system focused on hm-hvKp in community diarrhoeal cases was implemented in Pudong New Area, Shanghai, China, involving 12 sentinel hospitals. The antimicrobial susceptibility of hm-hvKp isolates from fecal samples was tested, and whole-genome sequencing (WGS) was performed to predict the serotypes and sequence types and to identify antimicrobial resistance determinants, virulence determinants, and phylogenetic clusters.
UNASSIGNED: The overall prevalence of hm K. pneumoniae isolates was 2.48% (31/1252), with the proportions of 1.76% (22/1252) for hm-hvKp and 0.72% (9/1252) for hm not hv K. pneumoniae. The prevalence of hm-hvKp isolates among different age groups and different months was statistically significant. All the 22 hm-hvKp isolates were susceptible to 20 antimicrobial agents and only carried bla SHV gene, and KL1 and KL2 accounted for eight (36.36%) cases and seven (31.82%) cases, respectively. The eight ST23/KL1 isolates belonged to the predominant CG23-I clade, which typically possessed the virulence determinants profile of rmpA/rmpA2-iro-iuc-ybt-irp-clb. The five ST86/KL2 isolates were assigned to the global clusters ST86/KL2-1 (n=2), ST86/KL2-2 (n=2), ST86/KL2-3 (n=1), all lack of the clb gene. Shanghai ST23/KL1 and ST86/KL2 isolates were closely related to the global isolates from liver abscesses, blood, and urine.
UNASSIGNED: Hm-hvKp is carried by the community population of Shanghai, with ST23/KL1 and ST86/KL2 isolates predominant. Hm-hvKp isolates of different continents, different sources, and different virulence levels were closely related. Ongoing surveillance of hm-hvKp isolates in the community population is warranted.