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[哥伦比亚一家医院新生儿重症监护病房产CTX-M-12肺炎克雷伯菌引起的疫情的分子特征分析]

[Molecular characterization of an outbreak caused by CTX-M-12-producing Klebsiella pneumoniae in a Colombian hospital's neonatal intensive care unit].

作者信息

Mantilla José Ramón, Reguero María Teresa, González Elsa Beatriz, García Ibonne Ayde, Leal Aura Lucía, Espinal Paula Andrea, Alpuche Celia, Valderrama Ismael Alberto, Garzón Martha Isabel, Olarte Narda María

机构信息

Grupo de Epidemiología Molecular, Instituto de Biotecnología, Universidad Nacional de Colombia, Bogota D.C., Colombia.

出版信息

Biomedica. 2006 Sep;26(3):408-14.

Abstract

INTRODUCTION

Molecular characterisation of Klebsiella pneumoniae strains is a tool that assits in the reduction of the disemination of drug resistance and the control of nosocomial infections that are caused by this pathogen. Objective. Molecular description of an outbreak of nosocomial infection caused by Klebsiella pneumoniae in a neonatal intensive care unit in a tertiary level hospital in Bogotá.

METHODS

Eleven Klebsiella pneumoniae isolates were analysed. Production of Extended Spectrum Beta-Lactamases was verified by agar diffusion tests. Isoelectric points of the enzymes were determined by isoelectric focusing. The bla(CTX-M-12) gene was detected by PCR and pulsed field gel electrophoresis genotyping was done.

RESULTS

All the isolates were Extended Spectrum Beta-Lactamase producers. Pulsed field gel electrophoresis and BOX-PCR genotyping grouped two isolates from hospital objects and eight infection-causing isolates into a single epidemic clone. The isolate from a thermometer was not grouped into the epidemic clone and showed a different resistance pattern. Isoelectric focusing revealed simultaneous beta-lactamase production having different isoelectric points. PCR amplification revealed the presence of the bla(CTX-M-12) gene in the 11 isolates studied.

CONCLUSION

This is the first report of a molecularly characterised outbreak of CTX-M-12-producing Klebsiella pneumoniae from Colombia. The results of this study provide additional evidence of the global dissemination of CTX-M ESBL and the need for epidemiological follow-up in our hospitals.

摘要

引言

肺炎克雷伯菌菌株的分子特征分析是一种有助于减少耐药性传播和控制由该病原体引起的医院感染的工具。目的:对波哥大一家三级医院新生儿重症监护病房中由肺炎克雷伯菌引起的医院感染暴发进行分子描述。

方法

分析了11株肺炎克雷伯菌分离株。通过琼脂扩散试验验证超广谱β-内酰胺酶的产生。通过等电聚焦法测定酶的等电点。通过PCR检测bla(CTX-M-12)基因并进行脉冲场凝胶电泳基因分型。

结果

所有分离株均为超广谱β-内酰胺酶产生菌。脉冲场凝胶电泳和BOX-PCR基因分型将来自医院物品的2株分离株和8株引起感染的分离株归为一个单一的流行克隆。来自一支温度计的分离株未归入流行克隆,且显示出不同的耐药模式。等电聚焦显示同时产生具有不同等电点的β-内酰胺酶。PCR扩增显示在所研究的11株分离株中均存在bla(CTX-M-12)基因。

结论

这是来自哥伦比亚的产CTX-M-12肺炎克雷伯菌分子特征明确的暴发的首次报告。本研究结果为CTX-M超广谱β-内酰胺酶的全球传播以及我们医院进行流行病学随访的必要性提供了更多证据。

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