Molecular analysis of Klebsiella pneumoniae ESBL (+) isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute at the Intensive Care Unit

Abstract

Introduction. Bacillus from Enterobacteriaceae ESBL (+) including Klebsiella pneumoniae are the most common pathogen of digestive tract. Patients colonized with hospital-acquired infections fall sick on hospital-pneumonia eight times more often than patients with their own bacterial flora. ESBL (+) strains determine serious threat with limited ways of treatment. Transfer of microorganisms in hospitals is followed by nursery and medicinal operations (thermometers, hands of staff). When the epidemic outbreak occurs in the hospital the procedure of contact isolation and microbiological monitoring must be conducted. Aim. The aim of the study was to analyze of genetic relationship between Klebsiella pneumoniae ESBL (+) strains isolated from patients hospitalized in the National Tuberculosis and Lung Diseases Research Institute (NTLDRI). Material and methods. Material of analysis were 64 strains of Klebsiella pneumoniae ESBL (+) isolated from 27 patients hospitalized on ICU. The phenotypic qualities were taken to the analysis and also the analysis of genetic relationship was conducted. The identification of species and the drug resistance phenotype were determined by the automatic system Vitek 2 Compact. Results. All of the isolated strains belonged to the Klebsiella pneumoniae species and presented the mechanism of ESBL (+) resistance type. The analysis of genetic relationship of 7 strains indicated the existence of the same molecular pattern for 5 of the isolated strains. Strains which belonged to the same genotype were isolated from patients hospitalized on the same units. Therefore it can be assumed that the transmission of infection occurred in the area of patient's residence. Conclusions. Molecular studies together with an indication of drug resistance should be the duty of laboratories and epidemiological investigation conducted in the supervision of nosocomial infections. S t r e s z c z e n i e Wstęp. Jednym z elementów kontroli zakażeń szpitalnych jest nadzór mikrobiologiczny, którego głównym celem jest analiza czynników etiologicznych zakażenia i określenie wzorów lekooporności na leki. Transmisja zakażenia w warunkach szpitalnych następuje podczas czynności pielęgnacyjnych i leczniczych chorego. W przypadku identyfikacji ogniska epidemicznego należy wprowadzić procedurę izolacji kontaktowej oraz monitorować wyniki badań. Postępowanie to jest konieczne w celu eliminacji lub ograniczenia ryzyka rozprzestrzeniania się zakażenia szpitalnego.