目的 探讨肺炎克雷伯菌肝脓肿患者的临床特征,以及肺炎克雷伯菌的微生物学特征和耐药情况.方法 收集110例肺炎克雷伯菌肝脓肿患者的临床资料,分为有其他肝胆疾病组和无其他肝胆疾病组进行研究,采用黏液丝试验确定肺炎克雷伯菌的高黏液性状,采用PCR扩增法进行毒力基因检测及荚膜分型,选用纸片扩散法进行药敏试验,并对结果进行统计学分析.结果 肺炎克雷伯菌肝脓肿常见于40~80岁的中老年男性,50.00%患者有糖尿病基础.110株肺炎克雷伯菌中,86.36%的菌株具有高黏液表型,荚膜分型以K1、K2血清型为主.无其他肝胆疾病组高黏液表型菌株、携毒力基因rmpA及气杆菌素的检出率明显高于有其他肝胆疾病组,差异有统计学意义(P<0.01).肺炎克雷伯菌对12种常见的抗菌药物的耐药率均较低.结论 肺炎克雷伯菌肝脓肿常见于中老年男性,高黏液、携带毒力基因rmpA和气杆菌素的高毒力肺炎克雷伯菌是肝脓肿的主要病原菌,对常见抗菌药物的耐药率较低.%Objective To analyzed the clinical characteristics of Klebsiella pneumoniae liver abscess as well as the characteristics and drug resistance situationof Klebsiella pneumoniae .Methods The clinical data in 110 cases of Klebsiella pneumoniae liver ab-scess were collected and divided into the other liver diseases group and non-other liver diseases group for conducting the study .The slime test was adopted to determine the high mucus character of Klebsiella pneumoniae .The PCR amplification was used to detect the virulence genes and capsular type and the drug susceptibility test was performed by using the disk diffusion method .Then the results were statistically analyzed .Results Klebsiella pneumoniae liver abscess was common in 40 -80 years old middle aged and elderly males .50 .00% patients had the diabetes base .In 110 strains of Klebsiella pneumoniae ,86 .36% strains had the high mucus phenotype ,the capsular types were dominated by serotype K1 and K2 .The detection rats of phenotype strains ,carrying virulence gene rmpA and aerocin in the non-other liver disease group were significantly higher than those in other liver diseases group ,the difference was statistically significant (P<0 .01) .The resistance rats of Klebsiella pneumoniae to 12 kinds of common antibacterials were lower .Conclusion Klebsiella pneumoniae liver abscess is common in middle aged and elderly males .High mucus and high vir-ulence Klebsiella pneumoniae carrying virulence gene empA and aerocin is main pathogenic bacterium of liver abscess ,w hich has lower resistance rate to common antibacterials .
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