ABSTRACT
Objective To collecct clinical isolates of Klebsiella pneumonia ,detect the sensitivity of antibiotics,determine the characterization of ESBLs-producing strains,type the isolates by PFGE and investingate the clinical data for analysis. Methods ESBLs-producing strains were tested by inhibitor potentiated disk diffusion rcommended by CLSI2015. The susceptibility to 26 different kinds of antibiotics were testd by CLSI2015 disk diffusion method. The typing of the gene of strains by PFGE was analyzed. Results Sixty ESBLs strains produced in 115 strains of Klebsiellapneumoniae ,which was 100% sensitive to imipenem and meropenem in antimicrobial susceptibility ,and were basically resistant to Amoxacillin ,ampicillin ,piperacillin and the first to the fourth generation of cephalosporins. The 60 ESBLs-producing Klebsiellapneumoniae gene was divided into 14 types (A ~ N)by PFGE,of which type A was the epidemic strain(35%,21/60). Conclusion The incidence rate of ESBLs-producing strains is high in respiratory ward in severe resistant multiantibioticsThe epidemic caused by homologusKlebsiella pneumonia can happen. PFGE is a stable and reliable method in searching the source of noso-comial infecton and is suitable for surveillance in the homologus nosocomial infecton.
ABSTRACT
Objective To collecct clinical isolates of Klebsiella pneumonia ,detect the sensitivity of antibiotics,determine the characterization of ESBLs-producing strains,type the isolates by PFGE and investingate the clinical data for analysis. Methods ESBLs-producing strains were tested by inhibitor potentiated disk diffusion rcommended by CLSI2015. The susceptibility to 26 different kinds of antibiotics were testd by CLSI2015 disk diffusion method. The typing of the gene of strains by PFGE was analyzed. Results Sixty ESBLs strains produced in 115 strains of Klebsiellapneumoniae ,which was 100% sensitive to imipenem and meropenem in antimicrobial susceptibility ,and were basically resistant to Amoxacillin ,ampicillin ,piperacillin and the first to the fourth generation of cephalosporins. The 60 ESBLs-producing Klebsiellapneumoniae gene was divided into 14 types (A ~ N)by PFGE,of which type A was the epidemic strain(35%,21/60). Conclusion The incidence rate of ESBLs-producing strains is high in respiratory ward in severe resistant multiantibioticsThe epidemic caused by homologusKlebsiella pneumonia can happen. PFGE is a stable and reliable method in searching the source of noso-comial infecton and is suitable for surveillance in the homologus nosocomial infecton.
ABSTRACT
La rápida emergencia de la resistencia antimicrobiana debida a las betalactamasas de espectro extendido (BLEE) tiene un impacto clínico significativo, lo cual se considera un problema de salud pública. El objetivo de este estudio fue determinar si existe diseminación clonal de K. pneumoniae productora de BLEE, en pacientes adultos hospitalizados en el Complejo Hospitalario Ruiz y Páez (CHRP), Ciudad Bolívar, Venezuela. Se evaluaron 13 cepas de K. pneumoniae aisladas de pacientes adultos con infección intrahospitalaria. La confirmación fenotípica de la producción de BLEE, fue realizada por los métodos de sinergia de doble disco y del disco combinado. Se realizó la tipificación molecular de los aislados mediante electroforesis de campo pulsante (ECP). Todas las cepas presentaron resistencia asociada a las fluoroquinolonas y 9 fueron resistentes a los aminoglucósidos. Se encontraron 12 fenotipos de susceptibilidad; el fenotipo I prevaleció en dos cepas. La ECP reveló que la mayoría de las cepas presentaron pulsotipos distintos, descartando una posible relación clonal entre ellas, a excepción de dos aislados que presentaron pulsotipos indistinguibles entre sí, ambos del mismo servicio de hospitalización. Se puede concluir que en el CHRP para el período marzo-junio de 2011, no hubo diseminación clonal de K. pneumoniae productoras de BLEE.
The rapid emergence of antimicrobial resistance to extended spectrum ß-lactamases (ESBL) has a significant clinical impact, and is considered a public health problem. The purpose of this study was to determine if there is clonal dissemination of ESBL producer K. pneumonia in adult patients hospitalized at the Complejo Hospitalario Ruiz y Paez (CHRP) of Ciudad Bolivar, Venezuela. Thirteen K. pneumoniae strains isolated from adult patients with intra-hospital infections were evaluated. The phenotypic confirmation of ESBL production was done with the double disk synergy and combined disk methods. The molecular typing of the isolates was done through pulse field electrophoresis (PFE). All the strains presented fluoroquinolone-associated resistance and 9 were aminoglucoside resistant. Twelve susceptibility phenotypes were found; phenotype I prevailed in 2 strains. PFE revealed that most of the strains presented different pulsetypes, discarding a possible clonal relationship among them, except for 2 isolates which presented undistinguishable pulsetypes, both from the same hospitalization service. It can be concluded that at the CHRP there was no clonal dissemination of ESBL producer K. pneumoniae during the March-June 2011 period.