Investigate the biofilm-forming ability and drug resistance of Hypervirulent Klebsiella pneumoniae (HvKP) to provide scientific basis for the treatment of HvKP-infection. A total of 96 Klebsiella pneumoniae strains isolated from clinical infection specimens in Changsha Central Hospital from January to December in 2021 were retrospectively collected, and the clinical data of patients were collected. The string test preliminarily distinguished between HvKP and classic Klebsiella pneumoniae (CKP). The biofilm-forming ability of clinical strains of Klebsiella pneumoniae (KP) was determined by microplate method. The Vitek 2 Compact automatic microbial identification/drug sensitivity analysis system was used for bacterial identification and drug sensitivity test. The clinical data of patients, biofilm forming ability and drug resistance in the HvKP group and those in the CKP group were compared and analyzed. The results showed that a total of 20 strains of HvKP were isolated from 96 non-repetitive KP, and the detection rate was 20.8%. HvKP mainly come from respiratory specimens, up to 75.0%.The prevalence of hepatobiliary diseases and the infection rate of multiple sites in patients with HvKP infection were higher than those in patients with CKP infection, and the difference was statistically significant(χ2=5.184,7.488;P=0.023,0.006).There was no significant difference between the two groups in terms of gender, age, ICU admission, hypertension, diabetes, coronary heart disease, lung disease, urinary system disease, central nervous system disease and laboratory test indexes (all P>0.05).17 (85.0%) strains of HvKP can form biofilm, including 2 strains with weak biofilm-forming ability (10.0%), 10 strains with moderate biofilm-forming ability (50.0%) and 5 strains with strong biofilm-forming ability (25.0%). Among the 76 CKP, 71 (93.4%) could form biofilm, including 13 (17.1%) with weak biofilm-forming ability, 30(39.5%) with moderate biofilm-forming ability and 28 (36.8%) with strong biofilm-forming ability. There was no significant difference in biofilm-forming ability between HvKP and CKP (χ2=1.470,P=0.225).The overall resistance rate of HvKP was not high, but a multi-resistant HvKP resistant to carbapenems was found. The detection rate of multi-resistant HvKP (5.0%) was lower than that of multi-resistant CKP (28.9%), and the difference was statistically significant (χ2=4.984, P=0.026).The resistance rate of HvKP to piperacillin/tazobactam, aztreonam, ciprofloxacin, levofloxacin, ceftazidime, cefepime, tobramycin, minocycline, doxycycline, and compound sulfamethoxazole was lower than that of CKP, and the difference was statistically significant (all P<0.05). In conclusion, most of hypervirulent Klebsiella pneumoniae can form biofilm in this study, but the difference of biofilm-forming ability is not obvious compared with classic Klebsiella pneumoniae. HvKP maintains high sensitivity to commonly used antibacterial drugs, but the drug resistance monitoring of the bacteria cannot be ignored.
探讨高毒力肺炎克雷伯菌（Hypervirulent Klebsiella pneumoniae，HvKP）生物被膜形成能力及耐药性，为HvKP感染治疗提供科学依据。回顾性收集2021年1至12月长沙市中心医院临床感染标本所分离的非重复肺炎克雷伯菌96株，同时收集患者临床资料。黏液拉丝试验初步区分HvKP和普通肺炎克雷伯菌（Classic Klebsiella pneumoniae，CKP），微孔板法测定肺炎克雷伯菌（Klebsiella pneumoniae，KP）临床菌株的生物被膜形成能力，Vitek 2 Compact全自动微生物鉴定/药敏分析系统进行细菌鉴定及药敏试验，比较分析HvKP组患者和CKP组患者临床资料、菌株生物被膜形成能力以及耐药性。结果显示，96株非重复KP中共分离出20株HvKP，检出率为20.8%，HvKP中呼吸道标本占比最高，达75.0%。HvKP感染患者肝胆疾病患病率以及多部位感染率高于CKP感染患者，差异具有统计学意义（χ2=5.184、7.488，P=0.023、0.006）。两组患者从性别、年龄、是否入住ICU、高血压、糖尿病、冠心病、肺部疾病、泌尿系统疾病、中枢神经系统疾病、实验室检测指标比较，差异无统计学意义（P均>0.05）。HvKP中有17株（85.0%）能形成生物被膜，其中弱成膜2株（10.0%）、中等成膜10株（50.0%）、强成膜5株（25.0%）；而76株CKP有71株（93.4%）能形成生物被膜，其中弱成膜13株（17.1%）、中等成膜30株（39.5%）、强成膜28株（36.8%），HvKP生物被膜形成率与CKP比较，差异无统计学意义（χ2=1.470，P=0.225）。HvKP整体耐药率不高，但发现1株耐碳青霉烯类抗生素的多重耐药HvKP，多重耐药HvKP检出率（5.0%）低于多重耐药CKP（28.9%），差异具有统计学意义（χ2=4.984，P=0.026）。HvKP对哌拉西林/他唑巴坦、氨曲南、环丙沙星、左氧氟沙星、头孢他啶、头孢比肟、妥布霉素、米诺环素、多西环素、复方磺胺甲噁唑的耐药率低于CKP，差异具有统计学意义（P均<0.05）。综上，本研究高毒力肺炎克雷伯菌大多能够形成生物被膜，但与普通肺炎克雷伯菌比较成膜能力差异不明显，HvKP对常用抗菌药物保持较高的敏感性，但不能忽视该菌的耐药性监测。.