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目的了解1例高黏液表型(HMV)产酸克雷伯菌致白血病患者的死亡原因。方法采用Vitek 2Compact全自动微生物仪进行菌株鉴定及药敏试验,黏液丝试验检测HMV表型,PCR方法及基因测序检测主要的高毒力荚膜血清型基因(K1、K2、K5、K20、K54、K57)和毒力基因(rmpA、wcaG、allS、kfu、aerobactin、mrkD、fimH、uge、wabG、cf29a),多位点序列分析(MLST)对该菌株进行分子分型。结果白血病患者血液及肺组织分离株均为产酸克雷伯菌,MLST分型为同一型ST19,该菌株对所测药物均敏感,具有高黏液表型,只检测到wcaG毒力基因,其他毒力基因和所测荚膜血清型基因均阴性。结论携带wcaG毒力基因是ST19产酸克雷伯菌致白血病患者死亡的主要原因,应引起临床关注。
Objective To understand the cause of death in one case of Leukemia caused by Klebsiella oxytoca producing in one case of high mucus phenotype (HMV). Methods Vitek 2Compact automatic microbiological analyzer was used to identify strains and drug susceptibility test. The muco-silk test was used to detect the phenotype of HMV. The major virulent capsular serotypes (K1, K2, K5, K20, K54 , K57) and virulence genes (rmpA, wcaG, allS, kfu, aerobactin, mrkD, fimH, uge, wabG, cf29a) and multilocus sequence analysis (MLST). Results The blood and lung tissue of patients with leukemia were Klebsiella oxytoca. MLST was classified into the same type of ST19. The strain was sensitive to the tested drugs and had a high mucoid phenotype. Only the wcaG virulence gene was detected and the other Virulence genes and measured capsular serotypes were negative. Conclusion The wcaG virulence gene is the main cause of death of leukemia caused by ST19 acidogenic Klebsiella pneumoniae, which should cause clinical concern.