Epidemiology and molecular typing of klebsiella pneumonia with the extended spectrum of b lactamase specific genes causing nosocomial infection in gaza strip

Background &Objective: Klebsiella pneumonia causes different serious nosocomial infections for human and several strains became multiple drug resistance .This study was conducted to describe the epidemiology and molecular typing of Klebsiella pneumonia with the extended spectrum of B lactamase enzyme in Gaza strip .Methods :A cross-sectional survey was conducted during the period of December 2008 to November2009. One hundred and fifty clinical specimens were collected from patients admitted in different wards . Results : Sixty six percentage of the isolates were K.pneumonia .These were isolated from different infected sites : urine 24% , sputum 14%, wound 11% , stool11% , blood14% , cerebrospinal fluid 11% , skin16% . The ESBLs was detected in 67% of the strains ,53% strains were resistant for more than eight antibiotics , PCR demonstrated different patterns for the presence of SHV(80%) , TEM(60%) enzyme and CTX-M(20%), PFGE Showed 10 clusters of genetically unrelated strains with high prevalence of polyclonal strains of Klebsiella pneumonia. Antibiotic resistance was found against Cephalothin(95.0%),Cefotaxime(82.0%),Ceftazidime(59.0%),Ceftriaxone(86.0%),Gentamicin(56.0%),Trimethoprim/sulphamethoxazole(47.0%)..Chloramphenicol(42%),Amikacin(33%),Aztreonam (32%) and Imipenem(0%). Interpretation, Conclusion : our findings showed that genetically-related isolates of K. pneumoniae producing SHV and TEM and CTX-M were present in Gaza Strip. Larger studies need to be done to better define the molecular epidemiology of ESBL producing K. pneumoniae and its clinical implications.