Clinical and economic benefits associated with the management of a nosocomial outbreak resulting from multidrug-resistant Klebsiella pneumoniae
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Centre Hospitalier Avranches-Granville, Rue des menneries, Granville, France University Hospital of Caen, Caen, FranceKeywords:
Klebsiella
We describe the detection of the CTX-M-12 beta-lactamase from a clinical isolate of Klebsiella pneumoniae in Colombia. Screening of nosocomial Klebsiella spp. and Escherichia coli isolates from a network of teaching hospitals revealed the presence of CTX-M enzymes in multiple cities. This is the first description of CTX-M in Colombia.
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Study on Multiple-resistance of Klebsiella pneumoniae and its aminoglycosides-modifying enzymes gene
Objective To study the multiple-resistance of Klebsiella pneumoniae and its aminoglycosides-modifying enzymes gene for the evidence to clinic. Methods Using K-B paper disc test antibiotics sensitivity and screen Klebsiella pneumoniae strains with multiple-resistance. ESBLs and AmpC enzymes were detected with 3-D test. AMEs gene was analyzed by PCR. Results 61 strains of Klebsiella pneumoniae with multiple-resistance showed no resistance to IMP. The resistant rate to aminoglycosides antibiotics was from 60.7% to 100.%, and with 44.3% to 100% of other antibiotics. The detective rates of Klebsiella pneumoniae producing either ESBLs or AmpC enzyme and producing both were 31.1%,14.8% and 45.9% respectively. The positivity of AMEs gene was 86.9%, including aac(3)-Ⅰ, aac(3)-Ⅱ, aac(6')-Ⅰb, aac(6')-Ⅱ, ant(3)-Ⅰ and ant(2)-Ⅰ, were 13.1%, 60.7%, 55.7%, 11.5%, 6.6% or 26.2% respectively. Conclusions The drug-resistance of Klebsiella pneumoniae with high production with ESBLs and AmpC enzymes and high carriage of AMEs gene is serious. Effective antibiotics based on antibiotic-sensitivity is helpful to reduce the spread of Klebsiella pneumoniae strains with antibiotics-resistance.
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Klebsiella pneumoniae, Klebsiella variicola and Klebsiella quasipneumoniae are difficult to differentiate phenotypically, leading to misinterpretation of their infection prevalence. We propose a multiplex PCR for blaSHV, blaLEN and blaOKP and their flanking gene (deoR). Since this scheme focuses only on chromosomal genes, it will be feasible for Klebsiella identification in the clinical routine.
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A case of endogenous Klebsiella pneumoniae endophthalmitis, cryptogenic in origin, is presented. It was treated initially with success, only to recur three months later with loss of the eye. Common sites of Klebsiella infection are reviewed. This organism rapidly destroys retinal photoreceptors. A link between Klebsiella and acute anterior uveitis has been suggested but is not supported by prospective data.
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The Sensitivity pattern of Klebsiella pneumoniae strains to Levofloxacin in a tertiary care hospital
To study the sensitivity pattern of Klebsiella pneumoniae to Levofloxacin in a tertiary care hospital. The study was done for a period of 2 years from January 2010 to December 2011. A total number of 945 patients were included in the study. Cases which were culture positive for Klebsiella pneumoniae were identified and their sensitivity pattern for Levofloxacin was assessed. 102 patients were found to be having Klebsiella infection . Among these 102 patients having Klebsiella infection 87 patients (85.3%) were sensitive to Levofloxacin. Klebsiella is sensitive to Levofloxacin. Keywords:- Klebsiella pneumoniae, Levofloxacin, Sensitivity
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Klebsiella spp., particularly Klebsiella pneumoniae, are important causes of nosocomial infections due to the presence of capsular polysaccharide which is a major surface-located virulence properties associated with the pathogenesis of Klebsiella pneumoniae. The capsule is an elaborate polysaccharide matrix that encases the entire cell surface and provides resistance against many host defense mechanisms. D-galacton II has an important role in synthesising the lipopolysaccharide of Klebsiella pneumoniae and many other gram negative bacteria. This study included the isolation of Klebsiella pneumoniae bacteria from different sources in the environment and identification by using API-20E system and a conventional Polymerase chain reaction assay which detects Klebsiella pneumoniae wbbZ gene that involved in expression of D-galacton. The results of our study confirmed the positive identification of the bacteria using API-20E analytical system and also the presence of wbbZ gene in two of Klebsiella pneumoniae tissue invasive strains using conventional PCR assay.
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Biological properties of 350 strains of Klebsiella pneumoniae isolated in newborns during the outbreak of intrahospital infection have been studied. Experimental infection with isolated strains of a similar plasmid profile is simulated, interrelation between the presence of plasmids and ability of the strain to induce generalized Klebsiella infection is shown. Pathological processes in the newborns with generalized infection and in animals with the reproduced experimental Klebsiella infection are shown to be similar in principle.
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Objective: To determine the existence and resistance of plasmid-mediated AmpC-lactamase genes continuously isolated from different hospital′s Klebsiella pneumoniae.Methods: AmpC-lactamase DHA and ACT-1 genes were detected and analyzed by PCR for resistant Klebsiella pneumoniae which were continuously separated.Results: Though PCR detection,DHA genes of 4 strains were positive of 44 of Klebsiella pneumoniae in A hospital(9.1%),and DHA genes of 8 strains were positive of 25 of Klebsiella pneumoniae in B hospital(32%);ACT-1 genes were negative in A and B hospital.There were significant difference between A and B hospital about DHA genes detecting rate.Conclusion: Plasmid-mediated AmpC-lactamase genes can transform by translation and integration to other homologic bacteria and different bacteria,also be prone to transmit.There were significant difference on DHA genes detecting rate of two hospitals,and had a epidemic evidence.
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Objective:To explore the bacteriostasis effect of freezing-dried Shuanghuanglian powder on Klebsiella pneumoniae.Methods:Based on the principle of liquid with different concentrations having their own number of bacteria,ESBLs positive SHV Klebsiella pneumoniae was selected to draw the time-turbidy curve by borth dilution method.Results:Klebsiella pneumoniae has different growth staus at different concentration of Shuanghuanglian.As far as the standard strain(ATCC 700603) of Klebsiella pneumoniae was concerned,freezing-dried Shuanghuanglian powder has no significant effect on the growth of bacteria when the concentration of Shuanghuanglian was below 12.50 mg/mL.However,the growth of the standard strain of Klebsiella pneumoniae was significantly inhibited when Shuanghuanglian concentration was at 12.50 mg/mL.For the clinical strains of Klebsiella pneumoniae,different concentration of Shuanghuanglian all had bacteriostasis effect on Klebsiella pneumoniae,and the bacteriostasis effect was enhenced with the increase of concentration.The growth of all kinds of bacteria was completely inhibited at the concentration of Shuanghuanglian at 50 mg/mL.Conclusion:Freezing-dried Shuanghuanglian powder has significant bacteriostasis effect on Klebsiella pneumoniae.
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457 Klebsiella strains isolated from newborns and young children with different clinical manifestations of infections, as well as from adults having contacts with them and from various objects of the environment in the foci of these infections, have been studied. All the isolated cultures, with the exception of one strain isolated from the pus of a gluteal abscess and identified as K. ozaenae K4, have been identified as K. pneumoniae. The use of experimental Klebsiella K-sera has allowed one to establish the presence of 27 K-antigen varieties in K. pneumoniae; among them K2, K9, K10, K13, K18, K20, K24, K33, K46, K47 have been found to occur most frequently . In group diseases of infants serovars K2, K9, K10, K18, K20, K24, K33 have been identified, serovars K9, K10 and K20 being detected for the first time in such cases. The data confirming the etiological role of the isolated Klebsiella organisms point out to the necessity of maintaining the constant microbiological control of Klebsiella infection in maternity homes and children's somatic hospitals.
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