title: [Molecular epidemiology of nosocomial infection by extended-spectrum beta-lactamases-producing Klebsiella pneumoniae].
abstract: 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.
authors.affiliation: Posgrado Interfacultades de Microbiología, Universidad Nacional de Colombia, Bogotá, DC, Colombia.
authors.forename: Paula Andrea
authors.initials: PA
authors.lastname: Espinal
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Mantilla
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Saavedra
authors.forename: Aura Lucía
authors.initials: AL
authors.lastname: Leal
authors.forename: Celia
authors.initials: C
authors.lastname: Alpuche
authors.forename: Emilia María
authors.initials: EM
authors.lastname: Valenzuela
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases