A Molecular Epidemiologic Study On Multiresistant Klebsiella Pneumoniae

OBJECTIVE To study the epidemiologic feature of Multiresistant Klebsiella pneumoniae and random amplified polymorphic DNA typing technology used in it .METHODS To collect 40 strains of Klebsiella pneumoniae isolated from our hospital and another hospital during five monthes , including specimens come from enviroment. Isolates were identified as well as subjected to drug susceptibility test,ESBL detection,DNA extracted from all isolates was amplified by polymerase chain reaction using random primers. By compared RAPD pattern between .strains to judge the homology of strains and suspect the mode of transmission and other epidemiologic feature .RESULTS Total of 17 isolates (42.5%) of 40 strains were ESBL positive by E test ESBL detect. Seventeen strains were divided into four RAPD profiles. Seven strains isolated from intensive care unit (ICU) had the same profiles (genotype A);four of them are isolated from patients; The other three strains are isolated from the condensation in pipe of respirator .stethoscope and nursing personnel's hands ;Genotype B included five strains, two of them are isolated from department of respiration ,three of them are collected from ICU. Another two strains came fromICU belong to genotype D; The rest three strains were collected from another hospital and were named genotype C. The antimicrobial susceptibility testing indicated that all of the 17 strains were resistant to cefotaxime and Azthreonam; Four of them were resistant to Piperacillin/tazobactom; ALL but two genotype D strains were resistant to Imipenem. The results of RAPD showed that there was no significant relationship between the genotype and antibiotic type. CONCLUSION The results showed that an outbreak of Klebsiella pneumoniae occurred in intensive care unit.The means by which Multiresistant Klebsiella pneumoniae was transmitted among patients was nursing staffs hands, stethoscope and respirator. RAPD proved to be a useful tool for molecular epidemiology study with high typeability, simplicity, and rapidness, cost less.Limited the usage of cefotaxime and Azthreonam, reinforced the measures of sterilization and insulation, are important infection control measures. Postgraduate BI QiaoJie(respiration ) Directed by-CHENG ZhaoZhong...