摘要目的:探讨中江县肺炎克雷伯菌毒力相关表型/基因、荚膜血清型、耐药表型、序列分型（ST）的分布特征，提高临床认识，为细菌耐药防控和临床合理用药提供依据。方法:回顾分析中江县人民医院2019年7-12月分离的肺炎克雷伯菌135株的资料。采用WalkAway-40Plus全自动分析系统进行菌种鉴定及药敏检测；采用拉丝实验鉴定菌株高黏液表型；采用聚合酶链式反应筛查高毒力荚膜血清型和毒力基因；采用多位点序列分析（MLST）鉴定菌株ST。结果:135株菌中高黏液型菌株所占比例为50.4%。毒力基因 iucA、 iroN、 rmpA阳性率分别为54.1%、54.8%、54.1%。荚膜血清K1、K2型菌株所占比例分别为11.9%、15.6%。共鉴定出65种ST型别，以ST23和ST37型最为常见，占比分别为11.1%和6.7%。菌株对16种抗菌药物的耐药率为0.0%~25.2%，对碳青霉烯类抗菌药物、阿米卡星、替加环素的耐药率均不足1%。高黏液型菌株的毒力基因阳性率显著高于非高黏液型菌株（ P < 0.001），其对头孢菌素类药物的耐药率显著低于非高黏液型菌株（ P < 0.001）。 结论:中江县肺炎克雷伯菌呈现“高毒力、低耐药”特征，应持续监测该地区肺炎克雷伯菌毒力及耐药性的变化，警惕高毒力菌株快速传播。

abstractsObjective:To investigate the distribution characteristics of virulence-related phenotypes/genotype, capsular serotype, drug resistance phenotypes, and sequence typing (ST) of Klebsiella pneumoniae in patients living in Zhongjiang county, improve clinical understanding, and provide evidence for the prevention and control of bacterial drug resistance and clinical rational drug use. Methods:The data of 135 strains of Klebsiella pneumoniae isolated from patients who received treatment in Zhongjiang County People's Hospital from July to December 2019 were retrospectively analyzed. Bacterial identification and drug sensitivity testing were performed using the WalkAway-40Plus automated microbiology system. Strains with a high viscosity phenotype were identified using wire drawing experiments. Hypervirulence-associated capsular serotype and virulence genes were verified by polymerase chain reaction. ST of Klebsiella pneumoniae strain was identified using multilocus sequence typing. Results:Strains with a high viscosity phenotype were identified in 50.4% of the 135 strains. 54.1%, 54.8%, and 54.1% of the strains were positive for virulence genes iucA, iroN, rmpA. The proportion of strains with capsular Serotype K1 or K2 was 11.9% and 15.6%, respectively. A total of 65 kinds of ST were identified, with ST23 and ST37 being the most common, accounting for 11.1% and 6.7%, respectively. The resistance rate of the strains to 16 kinds of antibiotics was 0.0%-25.2%, and the resistance rate to Carbapenem antibiotics, Amikacin, and Tigecycline was less than 1%. The positive rate of virulence gene of strains with a high viscosity phenotype was significantly higher than that of strains without a high viscosity phenotype ( P < 0.001), and its resistance rate to Cephalosporin was significantly lower in strains with a high viscosity phenotype than that in strains without a high viscosity phenotype ( P < 0.001). Conclusion:Klebsiella pneumoniae in Zhongjiang County is characterized by "high virulence and low drug resistance". It is necessary to continuously monitor the changes in the virulence and drug resistance of Klebsiella pneumoniae in Zhongjiang County, Sichuan Province, and be alert to the rapid dissemination of highly virulent strains.