[Molecular epidemiology of nosocomial infection by extended-spectrum beta-lactamases-producing Klebsiella pneumoniae].
Molecular epidemiology applied to the study of nosocomial infection has been fundamental in formulating and evaluating control methods. From patients in a level 3 Bogota hospital, Klebsiella pneumoniae samples were isolated that produced extended-spectrum beta-lactamases (ESBL). Each of 15 isolates was characterized microbiologically and by molecular characters realized by pulsed field gel electrophoresis (PFGE) and by repetitive-DNA sequences amplification (REP-PCR). Antimicrobial susceptibility and ESBL production was determined in accordance with NCCLS guidelines. The beta-lactamases were evaluated by isoelectric-focusing and PCR. Twelve (80%) of the isolates were associated with nosocomial infection; 11 of them were from intensive care units. The antibiotic susceptibility displayed 13 resistance patterns--87% presented co-resistance to amikacin, 53% to gentamicin, 33% to ciprofloxacin, 40% to cefepime, 67% to piperacillin/tazobactam, 60% to trimethoprim/sulfamethoxazole and 47% to chloranphenicol. All were sensitive to imipenem. Production of TEM and SHV beta-lactamases was detected simultaneously in most isolates by isoelectric focusing and 93.3% produced a ceftazidimase of pl 8.2 of the SHV-5 type. The 15 isolates were grouped into 11 and 12 electrophoretic patterns by PFGE and REP-PCR, respectively. The degree of genetic variability indicated an endogenous origin of the nosocomial infections.
Espinal
Paula Andrea
PA
Posgrado Interfacultades de Microbiología, Universidad Nacional de Colombia, Bogotá, DC, Colombia.
Mantilla
José Ramón
JR
Saavedra
Carlos H
CH
Leal
Aura Lucía
AL
Alpuche
Celia
C
Valenzuela
Emilia María
EM
D000293:Adolescent; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000235:genetics; D004269:DNA, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics*; D007711:Klebsiella pneumoniae / Q000235:genetics* / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases