Study On The Tying For Klebsiella Pneumonia Of Nosocomail Infection By PFGE

The nosocomail infection has increased sharply with the modern medicine improvement. Klebsiella pneumonia has become one of the most prevalent pathogens of nosocomial infection and the Extend-spectrum & -lactamases (ESBLs) -producing strain, ESBLs can hydrolyze the third generation of cephalosporins and monobactams, ESBLs-producing strain can resistant mulantibiotic , and cause the epidemic outbreak of the infection .To control the epidemic of the nosocomail effectively and find out the source of infection, analysis on homogeneity of bacterial and typing for bacterial have been recognized in the world at current, but there is no uniform standard on the typing for bacterial, pulse field gel electrophoresis (PFGE) was recommended by the CDC for the typing of bacterial, the research on tying for the nosocomail infection caused by Klebsiella pneumonia with PFGE is relatively scare in clinical, We have conducted the following research rcollecting 30 clinical isolates of Klebsiella pneumonia, from ICU of the First Affiliated Hospital, College of Medicine , ZheJiang University; detecting the sensitive for antibiotic, determining the characterization of ESBLs-producing strains, typing theisolates by PFGE and investigating the clinical data for analysis .1. The analysis of the sensitive for antibiotic:The susceptibility to 14 different kinds of antibiotic were tested by NCCLS disk diffusion method , the result showed 30 strains collected from ICU was susceptible to Cefoxitine ?Cefoperazone-Sulbactam and Imipenem-Cilastatin whereas resisted to others antibiotic, to some degree.2. The detection of ESBLs-producing strains, ESBLs-producing strains were tested by inhibitorpotentiated disk diffusion recommended by NCCLS (1999), twenty-nine of 30 strains were ESBLs-producing strains only one was not ESBLs-producing strain.3. The typing for the gene of strains by PFGEThe gene of 30 strains digested by Xbal produced 31 various fragments in different size, 9 patterns was obtained by PFGE, 16 strains in the A group could be further divided intoAK A2 > A3 > A4 and A5 subtypes. 12 strains were included in Al, other strains belonged to A2 > A3 > A 4 and A5 respectively, 6 stains in B pattern could be typed three subtypes, 4 strains in Bl, the other in B2 and B3 respectively, 2 strains was involved in C pattern, the other 6 strains belonged to D> E, F^ G, H, and I respectively.4. The investigation of the case on epidemiologyThe epidemic of Klebsiella pneumonia have broken during2000. 11-2001.1 as well as 2000.6-2000-7 , the most infection patients suffered from the infection of Klebsiella pneumoniae wore older or severe wound, 26 of 30 strains come from the infection of respiratory tract . In conclusion1. The incidence rate of ESBLs-producing strain was higher in ICU , and resistant mulantihiotLc to which close attentiong must be paid.2. The epidemic outbreak caused by Klebsiella pneumoniae occurred in the ICU of the First Affiliated Hospital, College of Medicine, and Zhejiang University.3. PFGE is a stable and reliable method in searching the source of nosocomail infection and is of great help in the surveillance of the nosocomail infection.