title: Genotypic analysis of Klebsiella pneumoniae isolates in a Beijing Hospital reveals high genetic diversity and clonal population structure of drug-resistant isolates.
abstract: BACKGROUND
  The genetic diversity and the clinical relevance of the drug-resistant Klebsiella pneumoniae isolates from hospital settings are largely unknown. We thus conducted this prospective study to analyze the molecular epidemiology of K. pneumoniae isolates from patients being treated in the 306 Hospital in Beijing, China for the period of November 1, 2010-October 31, 2011.
  
  
  RESULTS
  Antibiotic susceptibility testing, PCR amplification and sequencing of the drug resistance-associated genes, and multilocus sequence typing (MLST) were conducted. A total of 163 isolates were analyzed. The percentage of MDR, XDR and PDR isolates were 63.8% (104), 20.9 (34), and 1.8% (3), respectively. MLST results showed that 60 sequence types (STs) were identified, which were further separated by eBURST into 13 clonal complexes and 18 singletons. The most dominant ST was ST15 (10.4%). Seven new alleles and 24 new STs were first identified in this study. Multiple logistic regression analysis revealed that certain clinical characteristics were associated with those prevalent STs such as: from ICU, from medical ward, from community acquired infection, from patients without heart disease, from patients with treatment success, susceptible to extended spectrum cephalosporin, susceptible to cephamycins, susceptible to fluoroquinolones, and with MDR.
  
  
  CONCLUSIONS
  Our data indicate that certain drug-resistant K. pneumoniae clones are highly prevalent and are associated with certain clinical characteristics in hospital settings. Our study provides evidence demonstrating that intensive nosocomial infection control measures are urgently needed.
authors: CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China.
authors: Qi
authors: Q
authors: Wang
authors: Bin
authors: B
authors: Li
authors: Alan K L
authors: AK
authors: Tsang
authors: Yong
authors: Y
authors: Yi
authors: Patrick C Y
authors: PC
authors: Woo
authors: Cui Hua
authors: CH
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D005798:Genes, Bacterial; D020043:Genes, Essential; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D007223:Infant; D007710:Klebsiella Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D012641:Selection, Genetic; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents