Antimicrobial resistance profile and homology of carbapenemresistant Klebsiella pneumoniae isolated from patients and related surroundings

Abstract:

ObjectiveTo understand the homology of clinical isolates from patients with carbapenemresistant Klebsiella pneumoniae(CRKP) infection and isolates from environment in a medical institution. MethodsOne CRKP strain isolated from a patient in this hospital and 4 strains of Klebsiella pneumoniae(K. pneumoniae) isolated from patient’s surroundings were collected, susceptibility of 5 strains to commonly used antimicrobial agents was detected, production of carbapenems in 5 strains were detected by modified Hodge testing and carbapenem inactivation method（CIM）, homology analysis was performed by pulsedfield gel electrophoresis (PFGE). ResultsAntimicrobial susceptibility testing results showed that 5 strains of K. pneumoniae (1 from patient, 4 from the patient’s ward surroundings, including hands of nursing aides, solution bottle opening, handle for lifting and dropping bed, and bedrail) were all resistant to other antimicrobial agents except to cephamycin and aminoglycosides. The modified Hodge testing and CIM confirmed that 5 strains all produced carbapenemases; PFGE results showed that electrophoretogram of CRKP isolated from solution bottle opening of ward, bedrail, and handle for lifting and dropping bed were the same as CRKP isolated from patient, while electrophoretogram of CRKP isolated from hands of nursing aides had 2 different bands, there was a close relationship between the strains. ConclusionThe same type of CRKP were isolated from patient and his surroundings, it is necessary to implement healthcareassociated infection(HAI) control system, isolate infected patient, and strengthen environmental cleaning and disinfection, so as to avoid the outbreak of HAI.