Molecular Typing of Klebsiella pneumoniae Isolated from Medical Centers in Kermanshah Using Pulse Field Gel Electrophoresis

Background: Klebsiella pneumoniae is one of the important opportunistic pathogens causing serious infections, both community and hospital-acquired, with high resistance to antibiotics. Objectives: We aimed to determine the molecular typing of K. pneumoniae isolates using pulse field gel electrophoresis (PFGE). Methods: Sixty-two consecutive non-duplicate K. pneumoniae isolates were isolated from clinical specimens in three hospitals of Kermanshah, west of Iran. A total of K. pneumoniae was confirmed by API-20E kit. Antibiotic susceptibility testing and ESBL screening were performed following the genotyping of isolates using PFGE. The pattern of DNA bands was examined by the 6.6 version of the Gelcompar II (Applied Maths, Belgium). The calculation of similarities was done by the Dice coefficient, and the unweighted paired group method was used for cluster analysis (UPGMA). Results: Fifty-eight percent of isolates were phenotypically ESBL positive. Twenty-nine pulsotypes (X1-29) were determined with various genotype patterns. Four clones (including 18 isolates) showed a close genetic relationship and were from ICU, burn and infectious wards in one hospital. Pulsotypes X15 to X29, each presented a unique genotype and the majority of these strains (> 50%) were from the emergency ward. Four isolates were non-typable. Conclusions: Our results indicate the genotypic variation of K. pneumoniae isolates, which may suggest the different origins for isolates, as well as ongoing changes of bacterial genome. However, the presence of the isolates with similar genotype may show a common origin and consequently, the dissemination of strains in hospital wards, especially in ICU and burn wards. Therefore, Kermanshah hospitals need to establish an effective infectious control system to manage and monitor the spread of resistant strains.