CIBIACI and Department of Evolutionary Biology, University of Florence, Via Romana 17/19, 50125, Florence, Italy.
Eur J Clin Microbiol Infect Dis. 2012 Mar;31(3):371-8. doi: 10.1007/s10096-011-1319-6. Epub 2011 Jul 9.
We report the results of a three-year surveillance program of Klebsiella spp. in six hospitals in Florence (Italy). A total of 172 Klebsiella isolates were identified and typed by AFLP: 122 were K. pneumoniae and 50 were K. oxytoca. Most K. pneumoniae (80%) and K. oxytoca (93%) showed unrelated AFLP profiles. Beside this heterogeneous population structure, we found five small epidemic clonal groups of K. pneumoniae. Four of these groups were involved in outbreak events, three of which occurred in neonatal ICUs. The fifth clonal group spread in three different wards of two hospitals. Only one non-epidemic clonal group of K. oxytoca was detected. The frequencies of isolates with multiple antibiotic resistances increased with time; at the end of the study period, most K. pneumoniae were resistant to all the antibiotics tested. A PCR analysis of seven ertapenem resistant isolates was unable to detect any of the major genes known to underlie carbapenem resistance in K. pneumoniae.
我们报告了在意大利佛罗伦萨的六家医院进行的为期三年的 Klebsiella 属监测计划的结果。通过 AFLP 鉴定和分型，共分离出 172 株 Klebsiella 分离株：122 株为肺炎克雷伯菌，50 株为产酸克雷伯菌。大多数肺炎克雷伯菌（80%）和产酸克雷伯菌（93%）显示出无关的 AFLP 图谱。除了这种异质的种群结构外，我们还发现了 5 个小的肺炎克雷伯菌流行克隆群。其中 4 个群与暴发事件有关，其中 3 个发生在新生儿 ICU。第 5 个克隆群在两家医院的三个不同病房中传播。仅检测到 1 个产酸克雷伯菌非流行克隆群。具有多种抗生素耐药性的分离株的频率随时间增加；在研究结束时，大多数肺炎克雷伯菌对所有测试的抗生素均有耐药性。对 7 株厄他培南耐药分离株的 PCR 分析未能检测到肺炎克雷伯菌中已知的任何主要碳青霉烯类耐药基因。
