Virulent and multidrug‐resistant Klebsiella pneumoniae from clinical samples in Balochistan

AbstractHypervirulent Klebsiella pneumoniae (hvKp) has emerged as a pathogen of global concern. In this study, both phenotypic and genotypic tests were used to detect hvKp. Antimicrobial resistance profiles and clonal relatedness of clinical isolates were also determined. We found that 34.2% (163/477) of the isolates were tellurite resistant, and among them 102 hvKp isolates detected with iucA or iutA or peg-344 as molecular markers. The blaSHV (80.4%), followed by blaCTX-M-15 (76.5%) and blaTEM (67.6%), blaOXA-48 (53.9%), and blaNDM-1 (32.3%) were detected, while blaKPC-1 was not present in any hvKp isolates. It was found that the majority of hvKp isolates belonged to capsular serotype K20 and ompK36 group C, which is related to clonal group (CG) 23 (e.g. ST23). A high percentage of multidrug-resistant hvKp (76.6%) and high resistance to imipenem (67%) indicated a serious problem that should be addressed in the clinical setting.

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The Face of Hypervirulent Klebsiella Pneumoniae (hvKp) Isolated from Clinical Samples of Two Iranian Teaching Hospitals

10.21203/rs.3.rs-589877/v1 ◽

2021 ◽

Author(s):

Rahimeh Sanikhani ◽

Mohammad Moeinirad ◽

Hamid Solgi ◽

Azar Haddadi ◽

Fereshteh Shahcheraghi ◽

...

Keyword(s):

Molecular Markers ◽

Klebsiella Pneumoniae ◽

Multidrug Resistant ◽

Teaching Hospitals ◽

Clinical Samples ◽

Clinical Settings ◽

Urgent Problem ◽

Clonal Relatedness ◽

The Face ◽

Global Concern

Abstract Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a pathogen of global concern. In this study, both phenotypic and genotypic tests were used to detect hvKp. Antimicrobial resistance profiles and clonal relatedness of clinical isolates were also determined. We found that 62.6% of the isolates were tellurite resistant and among them iucA or iutA or peg344 as hvKp molecular markers, were positive. The blaSHV (81.4%), followed by blaCTX−M15 (75.5%) and blaTEM (67.6%), blaOXA−48 (33.7%), blaNDM−1 (32.3%) were detected, while blaKPC−1 was not present in any hvKp isolates. It was found that the majority of hvKp isolates belonged to capsular serotype K20 and ompK36 group C, which is related to CG23 (e.g. ST23). A high percentage of multidrug-resistant hvKp (MDR-hvKp) and high resistance to imipenem (66%) indicated that there is an urgent problem that should be addressed in the clinical settings.

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The Face of Hypervirulent Klebsiella Pneumoniae (hvKp) Isolated from Clinical samples of Two Iranian Teaching Hospitals

10.21203/rs.3.rs-589877/v2 ◽

2021 ◽

Author(s):

Rahimeh Sanikhani ◽

Mohammad Moeinirad ◽

Hamid Solgi ◽

Azar Hadadi ◽

Fereshteh Shahcheraghi ◽

...

Keyword(s):

Molecular Markers ◽

Klebsiella Pneumoniae ◽

Multidrug Resistant ◽

Teaching Hospitals ◽

Clinical Samples ◽

Clinical Settings ◽

Urgent Problem ◽

Clonal Relatedness ◽

The Face ◽

Global Concern

Abstract Hypervirulent Klebsiella pneumoniae (hvKp) has emerged as a pathogen of global concern. In this study, both phenotypic and genotypic tests were used to detect hvKp. Antimicrobial resistance profiles and clonal relatedness of clinical isolates were also determined. We found that 62.6% of the isolates were tellurite resistant and among them iucA or iutA or peg344 as hvKp molecular markers, were positive. The blaSHV (81.4%), followed by blaCTX−M15 (75.5%) and blaTEM (67.6%), blaOXA−48 (33.7%), blaNDM−1 (32.3%) were detected, while blaKPC−1 was not present in any hvKp isolates. It was found that the majority of hvKp isolates belonged to capsular serotype K20 and ompK36 group C, which is related to CG23 (e.g. ST23). A high percentage of multidrug-resistant hvKp (MDR-hvKp) and high resistance to imipenem (66%) indicated that there is an urgent problem that should be addressed in the clinical settings.

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Extended Spectrum Beta Lactamase (ESBL) Producing Klebsiella pneumoniae , a therapeutic challenge.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v13i1.12996 ◽

2015 ◽

Vol 13 (1) ◽

pp. 22-25

Author(s):

Raina Chaudhary ◽

Sabita Bhatt Bhatt ◽

Eva Piya

Keyword(s):

Klebsiella Pneumoniae ◽

Multidrug Resistant ◽

Diffusion Method ◽

Clinical Samples ◽

Gram Negative Bacteria ◽

Beta Lactamase ◽

Esbl Producer ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Sensitivity Pattern

Introduction: Klebsiella pneumoniae is one of the most common Gram negative bacteria encountered byclinicians worldwide as a cause of infections in human. Most of the infections are acquired in hospital settingtherefore, it is reported to be the amongst the 10 most common nosocomial pathogen in various studies. Nowadays,Klebsiella pneumoniae infections are complicated by increase in Extended Spectrum Beta Lactamase (ESBL)producing isolates. Therefore, this study is being conducted with the objective to fi nd out the prevalence ofESBL producing Klebsiella pneumoniaein various clinical samples and to fi nd out there sensitivity pattern.Methods: A total of 100 Klebsiella pneumoniae were isolated from various samples during the period of April2013 to November 2013 in Microbiology Unit of Shree Birendra Hospital. All the isolates were identifi ed withtheir sensitivity pattern according to standard methodology. Combination disc diffusion method was followedfor identifi cation of ESBL.Results: Out of total 100 isolates of Klebsiella pneumoniae21% were ESBL producer.ESBL producer isolatesshowed 100% sensitivity to Imepenem followed by Amikacin 57.1% and Chloramphenicol 47.6%. All theESBL isolates were resistant to both Cefotaxime and Ceftazidime.Conclusions: ESBL producer Klebsiella pneumoniae isolates were multidrug resistant. Continuous surveillanceand timely intervention with discouraging the use of cephalosporin group of antibiotics is mandatory.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.12996

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Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples

AMB Express ◽

10.1186/s13568-021-01282-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Amir Mirzaie ◽

Reza Ranjbar

Keyword(s):

Antibiotic Resistance ◽

Klebsiella Pneumoniae ◽

Molecular Typing ◽

Efflux Pump ◽

Opportunistic Pathogen ◽

Relevant Information ◽

Multidrug Resistant ◽

Clinical Samples ◽

Microbiological Methods ◽

High Level

AbstractKlebsiella pneumoniae is a multidrug-resistant (MDR) opportunistic pathogen that causes nosocomial infections. Virulence analysis and molecular typing as powerful approaches can provide relevant information on K. pneumoniae infection. In the current study, antibiotic resistance, virulence-associated genes analysis, as well as molecular typing of K. pneumoniae strains were investigated. Out of 505 clinical samples collected from hospitalized patients, 100 K. pneumoniae strains were isolated by standard microbiological methods and subjected to the phenotypic and genotyping analysis. The highest prevalence of resistance was observed against ciprofloxacin (75%), trimethoprim–sulfamethoxazole (73%) and nitrofurantoin (68%). Virulence associated genes including entB, traT, ybts, magA, iucC, htrA and rmpA were found in 80%, 62%, 75%, 5%, 30%, 72% and 48%, of the isolates, respectively. The prevalence of biofilm-associated genes including mrkA, fimH, and mrkD were equally 88% for all tested isolates. Moreover, the efflux pump genes including AcrAB, TolC and mdtK were observed in 41 (41%), 33 (33%) and 26 (26%) of the strains respectively. A significant statistical association was observed between MDR strains and high expression of efflux pump and biofilm genes. The K. pneumoniae strains were differentiated into 11 different genetic patterns using the repetitive element sequence-based PCR (rep-PCR) technique. High prevalence of resistance, presence of various virulence factors, high level of efflux pump, and biofilm gene expression in diverse clones of K. pneumoniae strains pose an important health issue in clinical settings.

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Genomic Characterization of Nonclonal mcr-1-Positive Multidrug-Resistant Klebsiella pneumoniae from Clinical Samples in Thailand

Microbial Drug Resistance ◽

10.1089/mdr.2017.0400 ◽

2018 ◽

Vol 24 (4) ◽

pp. 403-410 ◽

Cited By ~ 15

Author(s):

Apichai Srijan ◽

Katie R. Margulieux ◽

Sirigade Ruekit ◽

Erik Snesrud ◽

Rosslyn Maybank ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Multidrug Resistant ◽

Clinical Samples ◽

Genomic Characterization

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Characterization of CTX-M-15-Klebsiella pneumoniae from inpatients and outpatients of a teaching hospital

F1000Research ◽

10.12688/f1000research.53221.1 ◽

2021 ◽

Vol 10 ◽

pp. 444

Author(s):

Muzaheed Muzaheed ◽

Naveed Sattar Shaikh ◽

Saeed Sattar Shaikh ◽

Sadananda Acharya ◽

Shajiya Sarwar Moosa ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Hospital Setting ◽

Multidrug Resistant ◽

Influential Factor ◽

Detection Methods ◽

Clinical Samples ◽

Resistant Bacteria ◽

Drug Resistant ◽

Drug Resistant Bacteria

Background The presence of Extended-spectrum β-lactamase (ESBL) positive bacteria in hospital setting is an aggravating influential factor for hospitalized patients, and its consequences may be hazardous. Therefore, there is a need for rapid detection methods for newly emerging drug-resistant bacteria. This study was aimed at the molecular characterization of ESBL-positive Klebsiella pneumoniae isolates recovered from clinical samples. Methods A total of 513 K. pneumoniae isolates were obtained from various clinical samples during June 2019 to May 2020. The collected isolates were investigated for antimicrobial susceptibility (antibiogram), and PCR and DNA sequencing were performed to analyse the ESBL genes. Results Among the 513 isolates, as many as 359 (69.9%) were ESBL producers and 87.5% were multi-drug resistant, while none had resistance to imipenem. PCR scored 3% blaTEM, 3% blaSHV, and 60% blaCTX-M-15 genes for the tested isolates. Conclusion The study showed that CTX-M-15 was the major prevalent ESBL type among the isolates. Additionally, all the isolates were susceptible to carbapenems. Screening and detection of ESBL tests are necessary among all isolates from the enterobacteriaceae family in routine microbiology laboratory to prevent associated nosocomial infections. A larger study is essential to understand molecular epidemiology of ESBL producing organisms to minimize morbidities due to these multidrug resistant organisms.

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Prevalence of Multidrug-resistant and Carbapenemase-producing Klebsiella Pneumoniae and Pseudomonas Aeruginosa Isolates in Tertiary Care Hospital in Kathmandu, Nepal

Nepal Medical College Journal ◽

10.3126/nmcj.v23i4.42209 ◽

2021 ◽

Vol 23 (4) ◽

pp. 290-296

Author(s):

Rojina Darnal ◽

Mehraj Ansari ◽

Ganesh Rai ◽

Kul Raj Rai ◽

Shiba Kumar Rai

Keyword(s):

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Multidrug Resistant ◽

Diffusion Method ◽

Clinical Samples ◽

Resistant Bacteria ◽

Care Hospital ◽

Disk Diffusion Method

Carbapenemases are the enzymes that catalyze β–lactam groups of antibiotics. The carbapenemase producers are resistant to β–lactam antibiotics and are usually multidrug-resistant bacteria challenging widely used therapeutics and treatment options. Therefore, the detection of carbapenemase activity among clinical isolates is of great therapeutic importance. We aimed to study the MDR and carbapenemase-producing Klebsiella pneumoniae and Pseudomonas aeruginosa isolated from various clinical samples at a tertiary care hospital in Nepal. A total of 3,579 clinical samples were collected from the patients visiting the Department of Microbiology, B&B Hospital, Gwarko, Lalitpur. The samples were processed to isolate K. pneumoniae and P. aeruginosa and then subjected to antibiotic susceptibility testing (AST) by the Kirby-Bauer disk diffusion method. Phenotypic detection of carbapenemase activity was performed in the imipenem-resistant isolates by the modified Hodge test (MHT). Of the total samples, 1,067 (29.8%) samples showed significant growth positivity, out of which 190 (17.3%) isolates were K. pneumoniae and 121 (11.3%) were P. aeruginosa. Multidrug resistance was seen in 70.5% of the K. pneumoniae isolates and 65.3% of the P. aeruginosa isolates. Carbapenemase production was confirmed in 11.9%, and 12.2% of the imipenem-resistant K. pneumoniae and P. aeruginosa isolates, respectively, by the MHT. This study determined the higher prevalence of MDR among K. pneumoniae and P. aeruginosa; however, carbapenemase production was relatively low.

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Carbapenemase production in hospital isolates of multidrug-resistant Klebsiella pneumoniae and Escherichia coli in Serbia

Vojnosanitetski pregled ◽

10.2298/vsp150917260t ◽

2017 ◽

Vol 74 (8) ◽

pp. 715-721 ◽

Cited By ~ 2

Author(s):

Anika Trudic ◽

Zora Jelesic ◽

Mira Mihajlovic-Ukropina ◽

Deana Medic ◽

Branka Zivlak ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Clinical Samples ◽

Reference Laboratory ◽

Bacterial Strains ◽

Beta Lactamases ◽

E Coli ◽

Novi Sad

Background/Aim. Carbapenem resistance has escalated in medically important enterobacteria such as Klebsiella pneumoniae and Escherichia coli worldwide. Multidrug-resistant strains represent an important source of concern as effective therapeutic options of infections they cause are limited or none. There were no comprehensive studies considering the presence of carbapenemase production in enterobacteria in Serbia so far. The aim of the study was to determine carbapenemase production in hospital isolates of multidrug-resistant K. pneumoniae and E. coli in Serbia. Methods. Strains of K. pneumoniae and E. coli resistant to at least one carbapenem (imipenem, meropenem, ertapenem) were collected from November 2013 to May 2014. Isolates were obtained from clinical samples of patients treated in 14 hospitals in Serbia. Carbapenem resistance was confirmed using phenotypic tests and polymerase chain reaction (PCR) in National Reference Laboratory for Registration and Surveillance of Antimicrobial Resistance of Bacterial Strains in Novi Sad. Results. Of 129 collected strains, 121 (93.8%) were K. pneumoniae and 8 (6.2%) were E. coli. Seventy (54.3%) strains were obtained from urine, 26 (20.2%) from blood, 19 (14.7%) from wound secretions and 14 (10.9%) from lower respiratory tract secretions. Carbapenemase genes were detected in 58 (45%) isolates. The gene bla New Delhimetallo-beta-lactamases (blaNDM) was found in 33 (27.3%) K. pneumoniae, bla oxacillinases-48 (blaOXA-48) in 10 (8.3%), bla K. pneumonia carbapenemase (blaKPC) in 1 (0.8%), and 7 (5.4%) strains harbored both blaOXA-48 and blaNDM. Seven E.coli harbored blaNDM gene. Conclusions. In Serbia, the most common type of carbapenemase in both multidrug-resistant K. pneumoniae and E. coli is NDM. Co-production of OXA-48 and NDM was found in K. pneumoniae. To our knowledge, KPC production was detected for the first time in Serbia.

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Molecular Characterization of Carbapenemase Producing Klebsiella Pneumoniae Dominance of OXA-48, KPC, VIM and NDM Producers in Khartoum, Sudan

Journal of Clinical Review & Case Reports ◽

10.33140/jcrc/02/03/00003 ◽

2017 ◽

Vol 2 (3) ◽

Keyword(s):

Klebsiella Pneumoniae ◽

Carbapenem Resistance ◽

Multidrug Resistant ◽

Clinical Samples ◽

Medical Laboratories ◽

Molecular Microbiology ◽

Diffusion Technique ◽

Carbapenemase Gene ◽

First Time

Background and Objectives: Little is known about carbapenemase producing Klebsiella pneumoniae (CPK) in Sudan. This study aimed to determine the prevalence of CPK in a major hospital in Khartoum, Sudan between may 2015 - January 2017 and to characterize the isolates and detect the types of carbapenemase (s) they produced. Materials and Methods: The study was done in the Department of Molecular Microbiology, Faculty of Medical Laboratories Science, Al-Neleen University. All the isolates were obtained from clinical samples of patients treated inside the hospitals. Strains of K. pneumoniae resistant to at least one carbapenem (imipenem or meropenem) by using disc diffusion technique according to the CLSI guidelines were included in this study. Molecular detection of carbapenemase genes was achieved using Real-Time PCR (Sacace Biotechnologie, Italie). Results: A total 96 strains of K. pneumoniae of different non duplicated isolates were obtained from different hospitals. Seventy-two percent (70/96) isolates were positive for carbapenemase genes; 59.4% (57/96) were positive for blaKPC genes, 57.3% (55/96) were positive for blaNDM genes, 37.5% (36/96) were positive for blaVIM genes and 35.4% (34/96) were positive for blaOXA-48 genes. Nineteen isolates possessed four genes (blaKPC, blaNDM, blaVIM and blaOXA-48), fourteen isolates possessed three genes{( blaNDM, blaVIM and blaOXA-48=6), (blaKPC, blaNDM, and blaOXA-48=3), (blaKPC, blaNDM and blaVIM =3), (blaKPC, blaVIM and blaOXA-48=2)}, 27 isolates possessed two genes{( blaKPC and blaNDM =21), (blaKPC, blaOXA-48=2), (blaNDM and blaVIM =3), (blaNDM and blaOXA-48=1)}, 10 isolates possessed only one gene (blaKPC =8, blaOXA-48=1 and blaVIM =1) and the remaining 26 isolates were free from these genes. Conclusion & Recommendation: In Sudan, the most common type of carbapenemase gene multidrug-resistant K. pneumoniae is KPC. Co-production of KPC, VIM, NDM and OXA-48 genes are found in K. pneumoniae. To our knowledge, this study was done for the first time in Sudan. Therefore, it is necessary to determine carbapenem resistance in K. pneumoniae isolates and take essential infection control precautions to avoid spread of this resistance.

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