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Klebsiella pneumoniae in a nephrological department
Abstract:
The repeated isolation of Klebsiella pneumoniae biotypes 16 and 17 from haemodialysis fluid in concentrations exceeding 10(4) cfu/ml led to an investigation of strains isolated from routine specimens of nephrological patients to elucidate whether the dialysate strains could be a source of infection. A total of 118 patient-isolates were identified over a 4-year period. Biotypes 16 and 17 accounted for only nine patient-isolates. The distribution pattern of biotypes among haemodialysis patients and other nephrological patients during a 2-year period, when K. pneumoniae colonized the dialysate, and during a succeeding 2-year period, when it had been eradicated from the dialysate, indicated that there was no epidemiological connection. The patient-isolates comprised 21 different biotypes. Biotype 36 (indole-positive) remained the predominant strain throughout the whole period studied.
Insights
Klebsiella pneumoniae biotypes 16 and 17 in haemodialysis fluid did not originate from nephrological patients. Patient Klebsiella pneumoniae isolates showed no epidemiological link to dialysate strains.
Area of Science:
- Microbiology
- Infectious Diseases
- Nephrology
Background:
- Repeated isolation of Klebsiella pneumoniae biotypes 16 and 17 from haemodialysis fluid above 10(4) cfu/ml.
- Need to determine if these dialysate strains were a source of infection in nephrological patients.
Purpose of the Study:
- To investigate the epidemiological connection between Klebsiella pneumoniae strains in haemodialysis fluid and those isolated from nephrological patients.
- To identify the predominant Klebsiella pneumoniae biotypes in nephrological patients.
Main Methods:
- Analysis of 118 patient-isolates of Klebsiella pneumoniae over a 4-year period.
- Comparison of biotype distribution in nephrological patients with and without dialysate contamination.
- Identification of Klebsiella pneumoniae biotypes using standard microbiological techniques.
Main Results:
- Klebsiella pneumoniae biotypes 16 and 17 were infrequent among patient isolates (9 out of 118).
- No epidemiological connection was found between dialysate strains and patient strains.
- Patient isolates comprised 21 different biotypes, with biotype 36 (indole-positive) being predominant throughout the study.
Conclusions:
- The Klebsiella pneumoniae strains found in haemodialysis fluid were not a source of infection for the studied nephrological patients.
- Klebsiella pneumoniae biotype 36 is the dominant strain in the nephrological patient population.
- Effective eradication of Klebsiella pneumoniae from the dialysate did not impact the overall distribution of patient isolates.