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Molecular Markers for Differentiation of Multiresistant Klebsiella Pneumoniae Isolates in a Pediatric Hospital

Published online by Cambridge University Press:  02 January 2015

Sylvie Lhopital
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France
Stephane Bonacorsi
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France
Daniele Meis
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France
Naima Brahimi
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France
Stephanie Mathy
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France
Jean Navarro
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France
Yves Aigrain
Affiliation:
Service of Microbrblogy, Intensive-Care Surgery, and Gastroenterology, Hôpital Robert Debré, Paris, France

Abstract

Objective:

To study the spread of extended spectrum ß-lactamase-producing, but aminoglycoside-susceptible, Klebsiella pneumoniae strains in our hospital over an 8-month period, by using two genotypic markers.

Design:

Ribotyping (using two endonucleases) and randomly amplified polymorphic DNA analysis (RAPD; using two different 10-mer primers) were applied to the epidemiological typing of clinical K pneumoniae isolates from stools, ileal fluid, or urine of hospitalized children.

Setting and Patients:

The surgical intensive care ward (S1: 9 patients, 17 isolates), surgical unit (S2: 2 patients, 2 isolates), and gastroenterology ward (GE: 1 patient, 1 isolate) of the Robert Debre Hospital of Paris, France.

Results:

Ribotyping of the 20 clinical isolates, the type strain of the species, and two epidemiologically unrelated isolates with EcoRI and HindlII revealed 6 and 5 different patterns, respectively. Six ribotypes were identified by using these two enzymes. RAPD generated 6 distinct patterns, in complete agreement with ribotyping. Our geno-typic results showed that 11 patients from wards Sl, S2, and GE harbored genotypically related strains, suggesting nosocomial transmission and cross-colonization between and within the three wards.

Conclusions:

Ribotyping and RAPD appear to be reliable methods for distinguishing K pneumoniae strains. The spread of one strain of K pneumoniae in different units of our hospital was demonstrated by both methods. However, RAPD has the advantage of simplicity and rapidity conferred by polymerase chain reaction.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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