Surveillance in Taiwan using molecular epidemiology for extended-spectrum beta-lactamase-producing Klebsiella pneumoniae

Wen-Liang Yu, Patricia L. Winokur, Ronald N. Jones, Hélio S. Sader

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate intrahospital and interhospital clonal dissemination of extended-spectrum beta-lactamase (ESBL)-producing strains of Klebsiella pneumoniae. SETTING: Eight tertiary-care university hospitals and 16 regional hospitals in Taiwan. METHODS: Two hundred eleven confirmed ESBL-producing isolates of K. pneumoniae were collected from January 1998 to June 2000. The isolates were characterized by various typing methods, including antibiogram (9 antimicrobial agents), computer-based ribotyping, pulsed-field gel electrophoresis (PFGE), and isoelectric focusing of beta-lactamase. RESULTS: Ribotyping identified 70 distinct ribogroups among 200 isolates evaluated. Forty-three of these ribogroups were unique. Eleven ribogroups, comprising 115 isolates, were detected in more than one hospital (interhospital dissemination), whereas 16 groups (42 isolates) were detected in more than one patient within a hospital (intrahospital dissemination). The combination of ribotyping and PFGE identified two large epidemic clones, which were called 691.5/PFGE-G and 595.7/PFGE-A. These epidemic clones were detected mainly in the hospitals located in the northern and central regions of Taiwan. However, variation of the profiles of antibiograms and isoelectric focusing was apparent within each clone. In addition, isolates with the same isoelectric focusing profile (isoelectric points 7.9, 8.2, and 8.4) and antibiogram (resistance to 9 compounds evaluated) were present among different molecular-typed clones. CONCLUSIONS: Our results showed that clonal dissemination (both interhospital and intrahospital dissemination) is occurring in several regions of Taiwan. Rapid computer-based ribotyping associated with PFGE demonstrated multiple epidemic clones of ESBL-producing K. pneumoniae in Taiwan. The combination of phenotypic and molecular methods has proved useful to characterize these epidemic clones.

Original languageEnglish
Pages (from-to)812-818
Number of pages7
JournalInfection Control and Hospital Epidemiology
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 2004
Externally publishedYes

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Molecular Epidemiology
Klebsiella pneumoniae
beta-Lactamases
Taiwan
Pulsed Field Gel Electrophoresis
Ribotyping
Clone Cells
Isoelectric Focusing
Microbial Sensitivity Tests
Isoelectric Point
Tertiary Healthcare
Anti-Infective Agents

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

Surveillance in Taiwan using molecular epidemiology for extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. / Yu, Wen-Liang; Winokur, Patricia L.; Jones, Ronald N.; Sader, Hélio S.

In: Infection Control and Hospital Epidemiology, Vol. 25, No. 10, 10.2004, p. 812-818.

Research output: Contribution to journalArticle

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N2 - OBJECTIVE: To evaluate intrahospital and interhospital clonal dissemination of extended-spectrum beta-lactamase (ESBL)-producing strains of Klebsiella pneumoniae. SETTING: Eight tertiary-care university hospitals and 16 regional hospitals in Taiwan. METHODS: Two hundred eleven confirmed ESBL-producing isolates of K. pneumoniae were collected from January 1998 to June 2000. The isolates were characterized by various typing methods, including antibiogram (9 antimicrobial agents), computer-based ribotyping, pulsed-field gel electrophoresis (PFGE), and isoelectric focusing of beta-lactamase. RESULTS: Ribotyping identified 70 distinct ribogroups among 200 isolates evaluated. Forty-three of these ribogroups were unique. Eleven ribogroups, comprising 115 isolates, were detected in more than one hospital (interhospital dissemination), whereas 16 groups (42 isolates) were detected in more than one patient within a hospital (intrahospital dissemination). The combination of ribotyping and PFGE identified two large epidemic clones, which were called 691.5/PFGE-G and 595.7/PFGE-A. These epidemic clones were detected mainly in the hospitals located in the northern and central regions of Taiwan. However, variation of the profiles of antibiograms and isoelectric focusing was apparent within each clone. In addition, isolates with the same isoelectric focusing profile (isoelectric points 7.9, 8.2, and 8.4) and antibiogram (resistance to 9 compounds evaluated) were present among different molecular-typed clones. CONCLUSIONS: Our results showed that clonal dissemination (both interhospital and intrahospital dissemination) is occurring in several regions of Taiwan. Rapid computer-based ribotyping associated with PFGE demonstrated multiple epidemic clones of ESBL-producing K. pneumoniae in Taiwan. The combination of phenotypic and molecular methods has proved useful to characterize these epidemic clones.

AB - OBJECTIVE: To evaluate intrahospital and interhospital clonal dissemination of extended-spectrum beta-lactamase (ESBL)-producing strains of Klebsiella pneumoniae. SETTING: Eight tertiary-care university hospitals and 16 regional hospitals in Taiwan. METHODS: Two hundred eleven confirmed ESBL-producing isolates of K. pneumoniae were collected from January 1998 to June 2000. The isolates were characterized by various typing methods, including antibiogram (9 antimicrobial agents), computer-based ribotyping, pulsed-field gel electrophoresis (PFGE), and isoelectric focusing of beta-lactamase. RESULTS: Ribotyping identified 70 distinct ribogroups among 200 isolates evaluated. Forty-three of these ribogroups were unique. Eleven ribogroups, comprising 115 isolates, were detected in more than one hospital (interhospital dissemination), whereas 16 groups (42 isolates) were detected in more than one patient within a hospital (intrahospital dissemination). The combination of ribotyping and PFGE identified two large epidemic clones, which were called 691.5/PFGE-G and 595.7/PFGE-A. These epidemic clones were detected mainly in the hospitals located in the northern and central regions of Taiwan. However, variation of the profiles of antibiograms and isoelectric focusing was apparent within each clone. In addition, isolates with the same isoelectric focusing profile (isoelectric points 7.9, 8.2, and 8.4) and antibiogram (resistance to 9 compounds evaluated) were present among different molecular-typed clones. CONCLUSIONS: Our results showed that clonal dissemination (both interhospital and intrahospital dissemination) is occurring in several regions of Taiwan. Rapid computer-based ribotyping associated with PFGE demonstrated multiple epidemic clones of ESBL-producing K. pneumoniae in Taiwan. The combination of phenotypic and molecular methods has proved useful to characterize these epidemic clones.

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