title: Molecular epidemiology of clinical isolates of ampc producing Klebsiella pneumoniae.
abstract: OBJECTIVE
  AmpC producing K. pneumoniae have been increasingly reported from India but epidemiological studies are lacking. In the present study, molecular epidemiology of extended-spectrum AmpC beta-lactamases (ESACs) producing clinical isolates of K. pneumoniae prevalent in our hospital was studied.
  
  
  METHODS
  Fifty-one non-repeat, consecutive, clinical isolates of K. pneumoniae producing AmpC enzymes, were subjected to whole cell protein profile analysis (SDS-PAGE) and ribotyping. The antimicrobial susceptibility was determined using standard disk diffusion technique. The isolates showing decreased susceptibility to cefoxitin (< 18 mm) or cefotetan (< 16 mm) were subjected to modified three- dimensional test for detection of AmpC enzyme.
  
  
  RESULTS
  Six different types of protein profiles were observed. Ribotyping could further discriminate between the strains that were clustered by protein fingerprinting. Twelve different ribo-patterns were identified. Ribotyping was found to have a better Discriminatory Index (0.98) than that of SDS-PAGE (0.78). Of the 26 isolates that showed decreased susceptibility to cefoxitin and/or cefotetan 13 isolates were found to harbour AmpC enzyme.
  
  
  CONCLUSIONS
  The study demonstrated the usefulness of SDS-PAGE whole cell protein profile analysis and ribotyping to identify the clonality of the ESACs isolates, the latter having a higher discriminatory power. The presence of ESACs isolates in the community as well as in hospital settings emphasizes the need for regular monitoring of antimicrobial resistance.
authors.affiliation: Department of Microbiology, University College of Medical Sciences, New Delhi - 110 095, India. manchandavikas@hotmail.com
authors.forename: V
authors.initials: V
authors.lastname: Manchanda
authors.forename: N P
authors.initials: NP
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Shamweel
authors.forename: H K
authors.initials: HK
authors.lastname: Eideh
authors.forename: S S
authors.initials: SS
authors.lastname: Thukral
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000096:biosynthesis*; D015139:Blotting, Southern; D003428:Cross Infection / Q000382:microbiology*; D004275:DNA, Ribosomal / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D004591:Electrophoresis, Polyacrylamide Gel; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000737:chemistry / Q000145:classification / Q000201:enzymology* / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D021521:Ribotyping; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001426:Bacterial Proteins; D004275:DNA, Ribosomal; C048795:AmpC beta-lactamases; D001618:beta-Lactamases