Epidemiological typing of multidrug-resistant Klebsiella pneumoniae, which causes paediatric ventilator-associated pneumonia in Egypt

Abstract

Purpose. Multidrug-resistant Klebsiella pneumoniae is a common nosocomial pathogen that plays an important role in ventilator-associated pneumonia (VAP). This study aimed to define the clonal relatedness of K. pneumoniae strains isolated from paediatric VAP in addition to those isolated from environmental samples.Methodology. This study included 19 clinical and 4 environmental K. pneumoniae isolates recovered from the paediatric intensive care unit (PICU) in Assiut University Children's Hospital. The K. pneumoniae isolates were confirmed by biotyping using API strips and subjected to antimicrobial susceptibility testing. The genes coding K1 and K2 capsular types were detected by PCR. The clonal relationships between the K. pneumoniae isolates were determined by pulsed-field gel electrophoresis (PFGE).Results. Ten resistotypes were detected among all the K. pneumoniae isolates, while PFGE identified seventeen K. pneumoniae pulsotypes. Similar PFGE patterns were found between environmental and clinical isolates and between isolates recovered from different patients, suggesting the circulation of K. pneumoniae pathogens in the PICU and the role of the environment in the spread of infection. No correlation was found between the resistotypes and pulsotypes of the K. pneumoniae isolates. PFGE showed higher discriminatory power for the typing of nosocomial K. pneumoniae [Simpson's diversity index (DI)=0.96] than resistotyping (DI=0.72).Conclusion. As far as we know, this is the first report of the isolation of the same multidrug-resistant (MDR) K. pneumoniae pulsotype from patients and environmental samples in the same hospital ward in Egypt. This study provides a step on the way to understanding the genotyping and epidemiology of MDR K. pneumoniae for enhanced prevention of bacterial transmission.

Comparisons of microbiological characteristics and antibiotic resistance of Klebsiella pneumoniae isolates from urban rodents, shrews, and healthy people

“…Our samples were all ESBL-positive isolates, and PFGE profiles demonstrated high clonal dissemination of which in the humans and rodent animals. The higher discriminatory power of PFGE is consistent with the results of previous clinical isolates in the NICU or PICU and environmental samples [40,41]. In our study, two isolates from shrews and healthy people, respectively, were clustered in a PFGE clustering tree.…”

Molecular Characterization of Carbapenem-Resistant Klebsiella pneumoniae Species Isolated From a Tertiary Hospital, Ankara, Turkey

“…The PFGE type 1 included 6 species isolated from the patients hospitalized in 4 different services during a period of 12 months. Similar to the current study, PFGE of multidrugresistant K. pneumoniae isolates in Egypt revealed that clonally related strains were isolated from various sources such as different patients in the same hospital and environmental samples (17). A recent study performed on carbepenemresistant K. pneumoniae clinical isolates in Shandog, China, showed that the strains in the same PFGE type were isolated in the same clinic for more than 2 years (6).…”

“…Pulse-field gel electrophoresis provides very useful data to understand the epidemiology of carbapenemresistant K. pneumoniae isolates and to revise and enhance infection control programs to prevent bacterial transmission (17). In the current study, the results of PFGE showed that more than half of the carbapenem-resistant K. pneumoniae isolates were identified in clusters and according to the similarity coefficient higher than 85%, clonally relatedness among the tested isolates increased to 80.6%.…”

“…Although WGS has ultimate resolution and is already used for the molecular typing of many microorganisms in developed countries, it is still too laborious and time-consuming to obtain useful data in routine surveillance (15). Currently, among the DNA fingerprinting methods, PFGE is a worldwide used reliable, discriminative, and reproducible method for a variety of bacterial species including K. pneumoniae (16)(17)(18).…”

Epidemiology Aspects of Hospital-Acquired Infection Morbidity in Health Surgery Hospitals in Primorsky Region

“…Хирургический стационар в этом плане является объектом наибольшего риска инфицирования пациента. Другой про-блемой эпидемиологии ИСМП в стационарах хирургического профиля является проблема антибиотикорезистентности микроорганизмов, что приводит к социальным и экономическим потерям [7,[9][10][11]. Способность формирования устойчивых к антибиотикам и высоковирулент-ных госпитальных штаммов, адаптирующихся еще и к применяемым в лечебных учреждениях дезинфицирующим средствам и развитие ин-новационных высокотехнологичных методов диагностики и лечения при широком распро-странении микроорганизмов с множественной лекарственной устойчивостью определяют не-обходимость непрерывного совершенствования эпидемиологического надзора и микробиологи-ческого мониторинга данной группы инфекций.…”