بررسي شيوع سروتيپ هاي كپسولي K1 و K2 در بين سويه هاي كلبسيلا پنومونيه (Klebsiella pneumoniae)جدا شده از عفونت هاي مجاري ادراري و زخم ها

Investigation of the K1 and K2 capsular serotypes prevalence of Klebsiella pneumonia isolated from Urinary tracts and wounds infections

ﻣﻘﺪﻣﻪ: ﺑﺎﮐﺘﺮي ﮐﻠﺒﺴﯿﻼ ﭘﻨﻮﻣﻮﻧﯿﻪ)Klebsiella pneumoniae( ، ﯾﮏ ﺑﺎﮐﺘﺮي ﮔﺮم ﻣﻨﻔﯽ و ﯾﮑﯽ از ﻋﻠﻞ ﻋﻤﺪه ﻋﻔﻮﻧﺖﻫﺎي ﺑﯿﻤﺎرﺳﺘﺎﻧﯽ ﺑﻪ وﯾﮋه ﻋﻔﻮﻧﺖﻫﺎي ﻣﺮﺗﺒﻂ ﺑﺎ ﻣﺠﺎري ادراري ﻣﯽﺑﺎﺷﺪ. ﻫﺪف از اﯾﻦ ﭘﮋوﻫﺶ ﺗﻌﯿﯿﻦ ﺳﺮوﺗﯿﭗﻫﺎي ﮐﭙﺴﻮل دار K1 و K2 در ﻧﻤﻮﻧﻪﻫﺎي ﺟﻤﻊ آوري ﺷﺪه از ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎي ﺷﻬﺮ ﮐﺮﻣﺎﻧﺸﺎه اﺳﺖ. روش ﮐﺎر: ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﯾﮏ ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﯽ- ﺗﻮﺻﯿﻔﯽ اﺳﺖ. ﻧﻤﻮﻧﻪﻫﺎ از ﺑﯿﻤﺎراﻧﯽ ﺑﺎ ﻋﻔﻮﻧﺖ ادراري و ﯾﺎ زﺧﻢﻫﺎي اﯾﺠﺎد ﺷﺪه از ﺳﻮﺧﺘﮕﯽ ﺟﻤﻊ آوري ﺷﺪ. ﺳﺮوﺗﯿﭗ ﻧﻤﻮﻧﻪﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از روش ﻣﺒﺘﻨﯽ ﺑﺮ ﺗﮑﺜﯿﺮ زﻧﺠﯿﺮه ﭘﻠﯽ ﻣﺮازي )PCR( ﺑﺎ ﭘﺮاﯾﻤﺮﻫﺎي ﺑﺮاي ژنﻫﺎي magAو wzy از ﺧﻮﺷﻪ ژﻧﯽ CPS ﮐﻪ ﺑﻪ ﺗﺮﺗﯿﺐ ﺑﺮاي ﺑﯿﻮﺳﻨﺘﺰ ﮐﭙﺴﻮلﻫﺎي ﭘﻠﯽ ﺳﺎﮐﺎرﯾﺪي K1 وK2 ﺿﺮوري اﺳﺖ، ﺑﻌﺪ از اﺛﺒﺎت ﺑﺎﮐﺘﺮي ﺑﺎ روش ﻓﻨﻮﺗﯿﭙﯿﮏ، ﺗﻌﯿﯿﻦ ﮔﺮدﯾﺪ. ﻧﺘﺎﯾﺞ: ﯾﺎﻓﺘﻪﻫﺎ ﻧﺸﺎن داد ﮐﻪ از 60 ﻧﻤﻮﻧﻪ ﺗﺎﯾﯿﺪ ﺷﺪه در ﺑﺮرﺳﯽﻫﺎي ﻓﻨﻮﺗﯿﭙﯿﮏ ﺑﺎ ﻧﺴﺒﺖ ﻣﺴﺎوي 1 ﺑﻪ 1 از ﻧﻤﻮﻧﻪﻫﺎي ادرار و زﺧﻢ، 37 ﻧﻤﻮﻧﻪ)61/67%( ﻣﺘﻌﻠﻖ ﺑﻪ ﺳﺮوﺗﯿﭗ K1 و 23 ﻧﻤﻮﻧﻪ)38/33 %( ﻣﺘﻌﻠﻖ ﺑﻪ ﺳﺮوﺗﯿﭗ K2 ﺑﻮد. ﻫﻤﭽﻨﯿﻦ در ﻣﯿﺎن ﻧﻤﻮﻧﻪﻫﺎي ادرار ﺑﯿﻤﺎران ،22ﻧﻤﻮﻧﻪ)73/33%(ﺳﺮوﺗﯿﭗ K1 داﺷﺘﻨﺪ و در ﻣﯿﺎن ﻧﻤﻮﻧﻪﻫﺎي ﻣﺘﻌﻠﻖ ﺑﻪ زﺧﻢﻫﺎي اﯾﺠﺎد ﺷﺪه ﻧﺎﺷﯽ از ﺳﻮﺧﺘﮕﯽ 21 ﻧﻤﻮﻧﻪ )70%(ﺳﺮوﺗﯿﭗ K1 و9 ﻧﻤﻮﻧﻪ )30%( ﺳﺮوﺗﯿﭗ K2 را داﺷﺘﻨﺪ ﻧﺘﯿﺠﻪ ﮔﯿﺮي: ﺷﯿﻮع ﺳﺮوﺗﯿﭗ K1 در ﺟﻤﻌﯿﺖ ﻣﻮرد ﻣﻄﺎﻟﻌﻪ در ﻫﺮ دو ﻧﻤﻮﻧﻪ ادرار و ﺳﻮﺧﺘﮕﯽ ﺑﯿﺸﺘﺮ ﺑﻮد.

ntroduction: Klebsiella pneumonia, a gram-negative bacterium, is one of the main causes of nosocomial infections. The purpose of this study is to determine K1 and K2 capsule serotypes in samples collected from hospitals in Kermanshah. Materials & methods: This study was a Cross-Sectional – Descriptive research. The Samples were collected of patients with urinary tract infections or wounds caused by burns between the first 4 months of 2016. The serotype of samples was determined by using of PCR method for wzy and magA genes belong to CPS cluster which are necessary for biosynthesis of polysaccharide capsule K1 and K2, respectively, after approving bacteria by phenotypic method. Results: The findings showed that out of 60 samples approved in phenotypic studies with a 1: 1 ratio of urine and wound samples, 37 samples (61.67%) was belonged to K1 and 23 samples (38.33%) to K2 serotype. Also, among the urine samples of patients, 22 samples (73.33%) had K1 serotype and about of the samples belonging to wounds caused by burns, 21(70%) and 9(30%) samples had K1 and K2 serotype, respectively.