The use of a fluorescence typing method in an epidemiological study of Klebsiella infection in a London hospital.

The fluorescent antibody technique was used to investigate an epidemic of Klebsiella infection in a urological ward and to trace the probable source to a contaminated sink in the treatment room. It was also shown that cross infections by particular capsular types were very common within each ward. Certain types of Klebsiella occurred in cut flower water but could not be associated with the types infecting the patients. Antibiotic resistance patterns within one capsular type were found to vary whether the type was from different sources in one patient or from different patients in the same ward. One capsular type was observed to develop resistance to increasing numbers of antibiotics over a 3-year period. This was probably due to the acquisition of R-plasmids. There also appeared to be a relation between capsular type and the site of infection. The frequency of Klebsiella infections in the urological wards dropped significantly after up-grading the treatment room, improving catheter storage and reducing ampicillin use.