Abstract
BackgroundThe accurate identification of a pathogen beyond the species level is critical in epidemiological studies and investigations of nosocomial outbreaks of infection. The clonal relatedness of 66 multidrug resistant (MDR) strains of extended spectrum beta-lactamase (ESBL) producing K. pneumoniae isolated from clinical specimens from hospitalized patients at a Jamaican hospital during a 5 year period were determined by pulsed field gel electrophoresis (PFGE).ResultsA total 10 different ESBL producing K. pneumoniae genotypes designated Clones I-X were found. The most frequently occurring strains belonged to Clones I (21/66, 32%), II (15/66, 26%), III (13/66, 20%) and IV (8/66, 12%) which accounted for 86% (57/66) of ESBL producing K. pneumoniae strains over the 5 year period. The remaining 9 (14%) cases of ESBL producing K. pneumoniae were due to strains of Clones V-X. The 4 predominant clones persisted for several years in the hospital.ConclusionsThe clonal and temporal distribution of the MDR ESBL producing K. pneumoniae strains among clinical service areas did not suggest outbreaks of the organism during the period of study. Instead the molecular epidemiology of ESBL producing K. pneumoniae at this hospital was more representative of an endemic persistence of clones of the organism with limited dissemination from patient to patient. Further studies to investigate the factors which determine the emergence and persistence of MDR ESBL producing K. pneumoniae in Jamaican hospitals and their impact on clinical and economic outcomes at such institutions would be useful.
Highlights
The accurate identification of a pathogen beyond the species level is critical in epidemiological studies and investigations of nosocomial outbreaks of infection
This study reports the clonal relationships of multidrug resistant (MDR) extended spectrum beta-lactamase (ESBL) producing K. pneumoniae at a Jamaican hospital
The majority of the MDR K. pneumoniae isolates were from urine specimens (31/66, 47%), blood (9/66, 13%) and sputum (7/66, 10%)
Summary
The accurate identification of a pathogen beyond the species level is critical in epidemiological studies and investigations of nosocomial outbreaks of infection. The clonal relatedness of 66 multidrug resistant (MDR) strains of extended spectrum beta-lactamase (ESBL) producing K. pneumoniae isolated from clinical specimens from hospitalized patients at a Jamaican hospital during a 5 year period were determined by pulsed field gel electrophoresis (PFGE). The increasing prevalence of multidrug resistant (MDR) pathogens causing nosocomial infection constitutes a major health problem [1]. An increasing prevalence of multidrug resistant strains of K. pneumoniae which possess extended spectrum beta-lactamases (ESBL) enzymes, encoded by plasmid-borne genes which confer resistance to broad spectrum cephalosporins and other antibiotics used to treat serious. The prevalence of ESBL producing strains of K. pneumoniae differs between countries. This study reports the clonal relationships of MDR ESBL producing K. pneumoniae at a Jamaican hospital The presence of ESBL-producing Gram negative bacilli in hospitals in other Caribbean islands has been reported [6,7].
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