Medicalpark Izmir Hospital, Department of Medical Microbiology, Izmir, Turkey.
Inonu University School of Medicine, Department of Medical Microbiology, Malatya, Turkey.
J Infect Public Health. 2018 Sep-Oct;11(5):640-642. doi: 10.1016/j.jiph.2018.04.003. Epub 2018 Apr 27.
Klebsiella pneumoniae is an important nosocomial pathogen that can lead to high morbidity and mortality. ESBL and carbapenamase producing strains may cause epidemic situations. The aim of our study was to investigate the molecular epidemiology and clonal relationship between carbapenem resistant K. pneumoniae strains isolated from our hospital during a three month period.
Fourteen carbapenem resistant K. pneumoniae strains isolated during April 1st-June 30th 2013 were included. The identification and the antibiotic susceptibility of the strains were studied by Vitek 2 Compact (Biomerieux, France) system. The carbapenemase production of the isolates were investigated by Modified Hodge assay. The bla of the strains was investigated by in house PCR. The clonal relationship between the isolates were studied by pulsed-field gel electrophoresis (PFGE) and automatized repetitive extragenic palindromic PCR (Rep-PCR, DiversiLab sistemi, Biomerieux, France) methods.
All the K. pneumoniae isolates were carbapenem resistant; they were all susceptible to gentamycin and colistin. All of them had bla. The genotyping analysis revealed that eight isolates were in the same cluster both by Rep-PCR (similarity border ≥95%) and PFGE (Tennover criteriae) analysis. The other isolates did not belong to any other clusters. The strains that are in the same cluster are isolated from the Anesthesiology Intensive Care Unit during a three month period. The cluster ration by both methods was 57%.
All K. pneumoniae strains possessed bla The clonal spreading was particularly detected in Anesthesiology Intensive Care Unit. Molecular epidemiological monitorization of nosocomial pathogens may prevent the spread of these multidrug resistant pathogens.
肺炎克雷伯菌是一种重要的医院获得性病原体，可导致高发病率和死亡率。产 ESBL 和碳青霉烯酶的菌株可能引起疫情。我们的研究目的是调查在三个月期间从我院分离的耐碳青霉烯类肺炎克雷伯菌菌株的分子流行病学和克隆关系。
纳入 2013 年 4 月 1 日至 6 月 30 日期间分离的 14 株耐碳青霉烯类肺炎克雷伯菌。采用 Vitek 2 Compact（法国生物梅里埃）系统对菌株进行鉴定和药敏试验。改良 Hodge 试验检测菌株产碳青霉烯酶情况。采用自制 PCR 检测 bla 基因。脉冲场凝胶电泳（PFGE）和自动重复回文外显子 PCR（Rep-PCR，法国生物梅里埃 DiversiLab 系统）分析方法研究分离株的克隆关系。
所有肺炎克雷伯菌分离株均为耐碳青霉烯类；对庆大霉素和黏菌素均敏感。均携带 bla。基因分型分析显示，8 株分离株通过 Rep-PCR（相似性边界≥95%）和 PFGE（Tennover 标准）分析均属于同一聚类。其他分离株不属于任何其他聚类。在三个月期间同一聚类的菌株均从麻醉科重症监护病房分离得到。两种方法的聚类率为 57%。
所有肺炎克雷伯菌均携带 bla 基因。克隆传播在麻醉科重症监护病房中尤为明显。对医院获得性病原体进行分子流行病学监测可能有助于预防这些多重耐药病原体的传播。
