Estudio de clonalidad de cepas de Klebsiella pneumoniae multidrogoresistentes circulantes en el Instituto Nacional Materno Perinatal de Lima, Perú (2015-2018)

Abstract

Objective: To determine the clonality relationship in Klebsiella pneumoniae strains that present multiresistance circulating in the Maternal-Perinatal Institute of Lima, Peru. Methodology: the present study is retrospective, experimental, transversal and includes K.pneumoniae strains isolated during the period 2015-2018. Antimicrobial sensitivity levels were analyzed using the diffusion technique interpreted according to the CLSI 2019. The clonal relationship was established by the technique of Pulsed Field Electrophoresis Gel (PFGE). Results: A total of 36 K. pneumoniae isolates from different clinical origins were analyzed, 23 (64%) blood cultures, 9 (25%) secretions and 4 (11%) stool samples. High levels of antimicrobial resistance were found in cotrimoxazole (97%), cephalosporin (67%-89%) and gentamicin (67%). It should be noted that decreased sensitivity is important in quinolones (36-47%), and moderate to Piperacillin-tazobactam, also in nitrofurantoin and chloramphenicol (25%), while Amikacin presented only 14% resistance. A 78% of the strains were extended spectrum beta-lactamase (ESBL) producing strains. PFGE showed 16 different pulses, showing related strains in the same space and time.    Conclusion: The levels of resistance found were high, and the number of related strains was also important, showing a transmission of K.pneumoniae between different patients, showing a dissemination of the microorganism.