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《Chinese Journal of Disease Control & Prevention》 2017-06
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The prevalence,multidrug resistance and hypervirulence of klebsiella pneumoniae in feces from children with acute diarrhea in Guangzhou

GE Jing;ZHONG Xue-shan;XIAO Gang;CHEN You-ming;CHEN Qing;Department of Epidemiology,School of Public Health,Southern Medical University;Department of Vector Biological Control,Yuexiu District Center for Disease Control and Prevention,Guangzhou;Laboratory Department of the Third Affiliated Hospital of Southern Medical University;  
Objective The aim of this study was to understand the prevalence,multidrug resistance and hypervirulence of Klebsiella pneumoniae( KP) in feces from children with acute diarrhea in Guangzhou City. Methods Fresh fecal samples from children with acute diarrhea were collected between May and September in 2015. Colonies of KP were isolated and identified. Antimicrobial susceptibility of KP isolates was conducted. Screening and phenotypic confirmatory tests for extended-spectrum β-lactamases( ESBLs) in KP were conducted for ESBLs-producing isolates. To investigate the prevalence of ESBL type of KP,three resistance genes including blaTEM,blaSHVand blaCTX-Mamong ESBLs-producing isolates were detected by using polymerase chain reaction( PCR). Six common capsular serotypes of hypervirulent KP( hv KP) among all KP isolates were screened by using PCR. Results A total of 87 fecal specimens were collected from out-patient children with acute diarrhea. The prevalence of KP was 66. 7%. There were high resistance rates of KP isolates to penicillins,first-generation cephalosporins and nitrofurantoin,while the resistance rates to quinolones,aminoglycosides,second-,third-,and fourth-generation cephalosporins were lower. Carbapenem resistant KP was not detected in this study. The prevalence of ESBLs-producing isolates was 12. 1%( 7/58). Among all ESBLs-producing isolates,4 isolates were TEM and 2isolates were CTX-M types. However,no SHV type isolates were identified. The proportion of multidrug resistance was27. 6%( 16/58). In addition,three hv KP isolates were detected,of which the capsular serotypes were proved to be K2,K20 and K54,respectively. The type of K1,K5 and K57 isolates were not detected. Conclusions There was high prevalence rate of KP isolated from children with acute diarrhea. The serious multidrug resistance of KP and the hv KP with multidrug resistance should be taken into consideration.
【Fund】: 国家自然科学基金(81573210)
【CateGory Index】: R725.7
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