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in the design of the study, carried out most experiments, analyzed and interpreted the data, and performed statistical analysis. YC generated molecular tools and some bacterial mutants. XO performed the TEM. YHG conceived of the study, participated in its design and interpretation of data and wrote the manuscript. All authors read and approved the final manuscript.”
“Background The increasing prevalence of multidrug resistant (MDR) pathogens causing nosocomial infection constitutes a major health problem . Klebsiella pneumoniae ranks among the top ten organisms causing blood stream infection, pneumonia and other invasive infections in hospitalized patients in different Wnt antagonist countries [2–4]. An increasing prevalence of multidrug resistant strains of K. pneumoniae which possess extended spectrum beta-lactamases (ESBL) enzymes, encoded by plasmid-borne genes which confer resistance to broad spectrum cephalosporins
and other antibiotics used to treat serious infection has been widely reported . Multidrug resistance contributes to unfavourable clinical outcomes, impacts the utilization of hospital resources, increases the burden of effective infection control practice and the overall health economic cost [1, 2]. The prevalence of ESBL producing strains of K. pneumoniae differs between countries. In the developing world a recent study from SPTLC1 Jamaica reported that almost one-fifth of K. pneumoniae isolates at a tertiary referral teaching hospital were ESBL producers . The presence of ESBL-producing Gram negative bacilli in hospitals in other Caribbean islands also has been reported [6, 7]. This study reports the clonal relationships of MDR ESBL producing K. pneumoniae at a Jamaican hospital. Results The majority of the MDR K. pneumoniae isolates were from urine specimens (31/66, 47%), blood (9/66, 13%) and sputum (7/66, 10%). Almost a third (19/66, 29%) were isolated from children admitted to paediatric wards while 15% (10/66) were from intensive care unit (ICU) patients.