Detection of NDM-1 and VIM Genes in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Health-Care Center in Kathmandu, Nepal

Chemotherapy ◽  
2021 ◽  
pp. 1-11
Author(s):  
Sabita Thapa ◽  
Nabaraj Adhikari ◽  
Anil Kumar Shah ◽  
Ishworiya Lamichhane ◽  
Binod Dhungel ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bacterial Infections ◽  
Care Center ◽  
Diffusion Method ◽  
Accurate Identification ◽  
Clinical Specimens ◽  
Health Care Center ◽  
Carbapenem Resistant ◽  
Resistant Genes ◽  
Specificity And Sensitivity

<b><i>Background:</i></b> <i>Klebsiella pneumoniae</i> is one of the leading causes of nosocomial infections. Carbapenems are used as the last resort for the treatment of multidrug resistant Gram-negative bacterial infections. In recent years, resistance to these lifesaving drugs has been increasingly reported due to the production of carbapenemase. The main objective of this study was to detect the carbapenem-resistant genes <i>bla</i><sub>NDM-1</sub> and <i>bla</i><sub>VIM</sub> in <i>K. pneumoniae</i> isolated from different clinical specimens. <b><i>Methods:</i></b> A total of 585 clinical specimens (urine, pus, sputum, blood, catheter tips, and others) from human subjects attended at Annapurna Neurological Institute and Allied Sciences, Kathmandu were obtained in the period between July 2018 and January 2019. The specimens were isolated and identified for <i>K. pneumoniae</i>. All <i>K</i>. <i>pneumoniae</i> isolates were processed for antimicrobial susceptibility testing (AST) using the disk diffusion method. The isolates were further phenotypically confirmed for carbapenemase production by the modified Hodge test (MHT) using imipenem (10 μg) and meropenem (10 μg) discs. Thus, confirmed carbapenemase-producing isolates were further screened for the production of <i>bla</i><sub>NDM-1</sub> and <i>bla</i><sub>VIM</sub> using conventional polymerase chain reaction (PCR). <b><i>Results:</i></b> Among the clinical isolates tested, culture positivity was 38.29% (224/585), and the prevalence of <i>K. pneumoniae</i> was 25.89% (58/224). On AST, <i>K. pneumoniae</i> exhibited resistance toward carbapenems including ertapenem, meropenem, and imipenem, while it showed the highest susceptibility rate against to tigecycline (93.1%; 54/58). Overall, AST detected 60.34% (35/58) carbapenem-resistant isolates, while the MHT phenotypically confirmed 51.72% (30/58) isolates as carbapenemase-producers and 48.28% (28/58) as carbapenemase nonproducers. On subsequent screening for resistant genes among carbapenemase-producers by PCR assay, 80% (24/30) and 3.33% (1/30) isolates were found to be positive for <i>bla</i><sub>NDM-1</sub> and <i>bla</i><sub>VIM</sub>, respectively. In the same assay among 28 carbapenem nonproducing isolates, 9 (32.14%) isolates were positive for <i>bla</i><sub>NDM-1</sub> gene while none of them were tested positive for <i>bla</i><sub>VIM</sub> gene. <b><i>Conclusions:</i></b> Molecular detection of resistant genes provides greater specificity and sensitivity than those with conventional techniques, thus aiding in accurate identification of antimicrobial resistance and clinical management of the disease.

scholarly journals ANTIMICROBIAL ACTIVITY OF AQUEOUS AND ETHANOLIC LEAF EXTRACTS OF ANACARDIUM OCCIDENTALE

2018 ◽  
Vol 11 (12) ◽  
pp. 474
Author(s):  
Shobha Kl ◽  
Amita Shobha Rao ◽  
Pai Ksr ◽  
Sujatha Bhat
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Activity ◽  
Klebsiella Pneumoniae ◽  
Bacterial Infections ◽  
Ethanolic Extract ◽  
Culture Collection ◽  
Anacardium Occidentale ◽  
Diffusion Method ◽  
Leaf Extracts

Objective: The objective of this study was to evaluate the antimicrobial activity of leaves of Anacardium occidentale (A. occidentale) against microorganisms including multidrug-resistant (MDR) bacteria. Methods: Agar well diffusion method was employed to demonstrate the antimicrobial activity of leaves A. occidentale. Ethanol and aqueous extracts of the leaves were used against microorganisms, which included American type culture collection strains of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, and Pseudomonas aeruginosa and the clinical isolates of Streptococcus pneumoniae, Candida albicans, MDR Escherichia coli, and MDR Klebsiella pneumoniae. Results: The ethanolic extract of leaves of A. occidentale showed significant antimicrobial activity. Aqueous extract had mild antifungal activity. Conclusion: Ethanolic extract of leaves of A. occidentale could be a good source for the antibacterials to combat MDR bacterial infections. Further studies are necessary for these potent plant extracts to evaluate the in vivo efficacy and toxicity.

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

2021 ◽  
Author(s):  
Sara Davoudabadi ◽  
Hossein Goudarzi ◽  
Mehdi Goudarzi ◽  
Abdollah Ardebili ◽  
Ebrahim Faghihloo ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Pcr Amplification ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
String Test ◽  
Pcr Method ◽  
Extensively Drug Resistance

Abstract In this study, we focused on the emergence of extensively drug-resistant (XDR), pandrug-resistant (PDR), and hypervirulent Klebsiella pneumoniae (hvKP) in Iran. During 2018 to 2020 a total of 52 K. pneumoniae isolates were collected from different clinical specimens. The hvKP isolates were identified by PCR amplification of virulence and capsular serotype-specific genes. Hypermucoviscous K. pneumoniae (hmKP) were identified by string test. Carbapenem-resistant hvKP (CR-hvKP), multidrug-resistant hvKP (MDR-hvKP), extensively drug-resistant hvKP (XDR-hvKP), and pandrug-resistant hvKP (PDR-hvKP) were determined by disc diffusion method, Carba-NP test and PCR method. XDR-hvKP isolates were typed by multilocus sequence typing (MLST). Among all K. pneumoniae isolates 14 (26.9%) were identified as hvKP and 78.6% (11/14) of them were hmKP however, none of the classic K. pneumoniae (cKP) isolates were hmKP. The predominant capsular serotype of hvKP was K2 (42.85%) followed by K1 (35.71%). The prevalence of MDR-hvKP, XDR-hvKP and PDR-hvKP isolates were 6 (42.9%), 5 (35.7%) and 1 (7.1%), respectively. ESBL production was found in 85.7% of hvKP isolates and most of them carried bla TEM gene (78.6%) and 6 isolates (42.9%) were CR-hvKP. Among hvKP isolates, 1 (7.1%), 2 (14.3%), 3 (21.4%), 8 (28.6%), and 11 (78.6%) carried bla NDM-6, bla OXA-48, bla CTX-M, bla SHV, and bla TEM genes, respectively. According to MLST analysis, 2, 1, 1, and 1 XDR-hvKP isolates belonged to ST15, ST377, ST442, and ST147, respectively. The occurrence of such isolates is deeply concerning due to the combination of hypervirulence and extensively drug-resistance or pandrug-resistance.

HIGH VAGINAL SWABS;

2017 ◽  
Vol 24 (04) ◽  
pp. 622-626
Author(s):  
Shamas Pervaiz ◽  
Faiza Sarwar ◽  
Abdul Rauf ◽  
Muhammad Saifullah
Keyword(s):  
Pathogenic Bacteria ◽  
Vaginal Discharge ◽  
Care Center ◽  
Diffusion Method ◽  
Sensitivity Testing ◽  
Gram Negative ◽  
Health Care Center ◽  
Sensitivity Pattern ◽  
Wide Range ◽  
Vaginal Swabs

Normal vaginal flora contains a wide range of microorganisms. Hydrogen peroxideproduced by Lactobacillus strains plays a vital role in maintaining the microenvironment of thevagina and in the inhibition of overgrowth of potentially pathogenic bacteria. Bacterial vaginosisBV is the main reason of vaginal discharge. Many gram positive and gram negative rods i.e.E.coli, Klebsiella, Proteus, Acinetobacter and Pseudomonas spp. are major contributors inbacterial vaginosis. Aim: The present study was conducted to elucidate the frequency of variousgram-negative rods in high vaginal swabs and sensitivity pattern of bacteria to antibiotics thatare currently used. Study Design: Cross sectional study. Setting: Department of Obstetricsand Gynecology of Benazir Bhutto Hospital Rawalpindi, a tertiary health care center for thepeople of Rawalpindi. Period: January 2015 to May 2016. Material and Methods: A total of220 High vaginal swabs (HVS) were collected both from indoor and outdoor patients presentingwith symptoms of vaginal discharge aged between 20 to 65 years. Swabs were inoculated onblood, Chocolate and MacConkey’s agar. After overnight incubation plates were examined forgrowth, colonial morphology, final confirmation was done on the basis of biochemical testingand API 20-E system (BioMerieux, France) up to species level. Antibiotic sensitivity testing wasdone by (modified Kirby-Bauer’s) disc diffusion method using amikacin, ampicillin, amoxicillinclavulanic acid, imipenem, ceftazidime, tigecycline, ciprofloxacin, sulzone and cefixime. Afterovernight incubation plates were examined to read the susceptibility zone. Results: Out of 220HVS samples, 100 samples showed bacterial growth and confirmed as Gram negative bacilli.Age wise distribution of infection showed highest rates b/w age 20-30 was 36% followed by 31-40 (23%), 41-50 (25%) and 11% above 50 years of age. Bacteria isolated from HVS were E.coli(53%), Klebsiella (22%), Pseudomonas (12%), citrobacter (6%), Proteus (5%) and Acinetobacter(2%) respectively. Highly sensitive antibiotics against bacteria were imipenem (96%), sulzone(90%) and Ciprofloxacin (88%), whereas least affective antibiotics against gram negative rodswere penicillins (ampicillin, amoxicillin-clavulanic acid), amikacin due to indiscriminate use ofantibiotics. Conclusion: High prevalence of gynecological infections demands that the patientswho have vaginosis must be investigated regularly and carefully through culture and identificationof causative bacteria. Emergence of antibiotic resistance must be controlled in order to avoidimproper use, frequent abuse, insufficient dosages, trouble-free availability of antibiotics andtreatment schedule must be designed subsequent to proper laboratory investigations.

scholarly journals Plasmid mediated colistin resistant mcr-1 and co-existence of OXA-48 among Escherichia coli from clinical and poultry isolates: first report from Nepal

Gut Pathogens ◽  
2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Bijaya Muktan ◽  
Upendra Thapa Shrestha ◽  
Binod Dhungel ◽  
Bagish Chandra Mishra ◽  
Nabaraj Shrestha ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Resistance Gene ◽  
Diffusion Method ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Colistin Resistance ◽  
Clinical Specimens ◽  
E Coli ◽  
Resistant Genes ◽  
Rectal Swabs

Abstract Background Plasmid-mediated resistance to the last-resort drugs: carbapenems and colistin is an emerging public health threat. The studies on the prevalence and co-expression of resistant genes among livestock and human pathogens are rare in Nepal. This is the first study in Nepal exploring the prevalence and co-existence of colistin resistance gene, mcr-1 along with carbapenemase resistance gene, OXA-48 in Escherichia coli isolated from poultry and clinical specimens. Methods A total of 240 rectal swabs from chickens of five different poultry farms of Kathmandu valley and 705 mid-stream urine samples from human subjects attending Kantipur Hospital, Kathmandu were collected between August, 2018 and March, 2019. Rectal swabs and urine specimens were cultured. E. coli isolated from the specimens were screened for antimicrobial susceptibility testing (AST) using disk diffusion method’. Minimum inhibitory concentration (MIC) of colistin was determined by agar dilution method using 0.5 µg/ml to 32 µg/ml. The E. coli isolates were first screened for mcr-1 followed by screening for OXA-48 genes using conventional Polymerase chain reaction (PCR). Results Of the total samples analyzed, E. coli was isolated from 31.7% (76/240) of poultry and 7.9% (56/705) of clinical specimens. In AST, 80% (61/76) of E. coli from poultry and 79% (44/56) from clinical specimens were MDR. The phenotypic prevalence of colistin resistance in poultry specimens were 31.6% (24/76) and clinical specimens were 21.4% (12/56). In PCR assay, 27.6% (21/76) of poultry and 19.6% (11/56) of clinical isolates had colistin resistant mcr-1 gene. MICs value of E. coli isolates ranged from 4 to 32 (µg/ml) in both clinical and poultry isolates. Prevalence of co-existing carbapenem resistance gene, OXA-48, among colistin resistant mcr-1 positive isolates was 38% (8/21) in poultry specimens and 18.2% (2/11) in clinical specimens. Conclusions The high prevalence of colistin and carbapenem resistant genes, and their co-existence in plasmid DNA of E. coli isolates in this study suggests the possible spread to other animal, human and environmental pathogens. Molecular methods in addition to the conventional diagnostics in laboratories can help in early diagnosis, effective management and control of their potential transmission.

scholarly journals Molecular Characterization of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae in the Countries of the Gulf Cooperation Council: Dominance of OXA-48 and NDM Producers

2014 ◽  
Vol 58 (6) ◽  
pp. 3085-3090 ◽  
Author(s):  
Hosam M. Zowawi ◽  
Anna L. Sartor ◽  
Hanan H. Balkhy ◽  
Timothy R. Walsh ◽  
Sameera M. Al Johani ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
United Arab Emirates ◽  
Gulf Cooperation Council ◽  
Mechanisms Of Resistance ◽  
Antibiotic Resistant ◽  
Content Type ◽  
Carbapenem Resistant ◽  
Resistant Genes ◽  
Gcc Countries

ABSTRACTThe molecular epidemiology and mechanisms of resistance of carbapenem-resistantEnterobacteriaceae(CRE) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, United Arab Emirates, Oman, Qatar, Bahrain, and Kuwait. Isolates were subjected to PCR-based detection of antibiotic-resistant genes and repetitive sequence-based PCR (rep-PCR) assessments of clonality. Sixty-two isolates which screened positive for potential carbapenemase production were assessed, and 45 were found to produce carbapenemase. The most common carbapenemases were of the OXA-48 (35 isolates) and NDM (16 isolates) types; 6 isolates were found to coproduce the OXA-48 and NDM types. No KPC-type, VIM-type, or IMP-type producers were detected. Multiple clones were detected with seven clusters of clonally relatedKlebsiella pneumoniae. Awareness of CRE in GCC countries has important implications for controlling the spread of CRE in the Middle East and in hospitals accommodating patients transferred from the region.

scholarly journals Determination of antibiotic resistance and minimum inhibitory concentration of meropenem and imipenem growth in Klebsiella strains isolated from urinary tract infection in Shahrekord educational hospitals

2019 ◽  
Vol 21 (2) ◽  
pp. 80-85
Author(s):  
Farshad Kakian ◽  
Behnam Zamzad ◽  
Abolfazl Gholipour ◽  
Kiarash Zamanzad
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Minimum Inhibitory Concentration ◽  
Bacterial Infections ◽  
Inhibitory Concentration ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Disc Diffusion Method ◽  
Accurate Identification ◽  
Tract Infections

Background and aims: Klebsiella is an opportunistic organism that is the cause of severe diseases such as pneumonia, septicemia, and urinary tract infections (UTIs). In addition, high antibiotic resistance has challenged the treatment of this bacterium. However, carbapenem antibiotics are considered as the therapeutic agents for selecting the treatment of penicillin- and cephalosporin-resistant gram-negative bacterial infections. The present study aimed to determine the resistance and minimum inhibitory concentration (MIC) of meropenem and imipenem. Methods: A total of 80 Klebsiella spp isolated from UTIs were collected in various educational wards (i.e., urology, obstetrics, and gynecology, as well as the units of infectious diseases, internal medicine, and intensive care) in different hospitals of Shahrekord. The isolates were then identified by using biochemical tests. Further, disc diffusion method was employed to determine the antibiotic resistance. Furthermore, MIC was estimated by the Epsilon-test strip. Moreover, P=Q=0.50, an error of 0.05, and an accuracy of 0.11 were considered for determining the sample size (n=80). Results: Based on the results of disc diffusion method, 24 strains were resistant to meropenem and imipenem. Additionally, the MIC was 24 (30%) by the E-test. In addition, 24 isolates had a MIC of ≥4 μg/mL for meropenem and imipenem and thus were resistant while 18 isolates were found to have a MIC of 1≤ MIC<4 μg/mL and therefore, were considered semi-sensitive (P<0.001). Conclusion: In general, Klebsiella strains were found to be resistant to meropenem and imipenem. Therefore, rapid and accurate identification of these strains and the selection of appropriate antibiotics can help quickly eradicate the infections caused by these bacteria. Accordingly, a waste of time, the consumption of medication, or even an increased resistance are prevented.

scholarly journals Colistin Susceptibility in Carbapenem Resistant Klebsiella Pneumoniae and their Ability of Biofilm Formation

2020 ◽  
pp. 517-527
Author(s):  
Sarab Murad Kadum
Keyword(s):  
Klebsiella Pneumoniae ◽  
Resistance Gene ◽  
Biofilm Formation ◽  
Rpob Gene ◽  
Resistance Rate ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Specific Primer ◽  
Carbapenem Resistant

A total of 157 clinical samples were collected from different clinical specimens (urine, sputum, blood, swabs, and cannula) from several hospitals in Iraq. Among the samples, 51 isolates (32.48%) of Klebsiella pneumoniae were identified according to morphologicaland cultural characteristics as well as the Enterosystem 18R test. Higher numbers of K. pneumoniae isolates were observed in urine samples (26, 52%) than the other samples, and in females (70.6%) than males (29.4%) (female: male ratio of about 2.4:1). Antibiotic susceptibility of K. pneumoniae against 12 commonly used antibiotics was determined through the disc-diffusion method. The results revealed a higher resistance rate in 51 isolates (100%) against Cephalexin, followed by Ceftazidime (50, 98%), while the lowest resistance rate (24, 47%) was against each of Imipenem and Meropenem. Also, the investigation of the minimum inhibitory concentration (MIC) of Colistin using E-test (strips) demonstrated that 33 isolates were resistance, as compared to 31 using the disk diffusion assay. DNA was extracted from K. pneumoniae isolates and molecularly tested using polymerase chain technique (PCR) with a specific primer and 108 bp product to detect the rpoB gene that represents this bacteria . Also, all of the 51 isolates of K. pneumoniae identified by the rpoB gene were detected for the expression of the Colistin drug resistance gene mgr-B , which was amplified (347 bp) using a specific primer. Colistin resistance gene mgr-B was amplified and sequenced from the twenty isolates. Only 6 isolates appeared with a single nucleotide substitution; G instead A, A instead G, C instead G and G instead C. Also, this study tested biofilm formation from K. pneumoniae isolates , using the microtiter plate method, in association with Colistin and Carbapenem resistant. The Colistin and Carbapenem resistance pattern was compared to the ability of biofilm-formation as weak formation versus strong and also, Multi-drug resistant isolates were more common among weak versus strong biofilm formers.

scholarly journals Investigation of carbapenemase and mcr-1 genes in carbapenem-resistant Klebsiella pneumoniae isolates

2019 ◽  
Vol 13 (06) ◽  
pp. 504-509 ◽  
Author(s):  
Çiğdem Arabacı ◽  
Tuba Dal ◽  
Tuğcan Başyiğit ◽  
Neslihan Genişel ◽  
Rıza Durmaz
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Infections ◽  
Resistance Mechanisms ◽  
Control Measures ◽  
Epidemiological Methods ◽  
Infection Control Measures ◽  
Microdilution Method ◽  
Carbapenem Resistant ◽  
Susceptibility Tests

Introduction: Carbapenem-resistant Klebsiella pneumoniae are a major problem. We aimed to investigate carbapenemase-encoding genes and transferable mcr-1 genes among 57 carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates from hospitalized patients. Methodology: Antibiotic susceptibility tests were performed by Phoenix (BD). Results for ertapenem and colistin were confirmed by gradient diffusion and microdilution methods. Carbapenemase and mcr-1 genes were investigated by Polymerase Chain Reaction (PCR). Results: Thirty-two (56.14%) isolates were from intensive care units (ICU). Antibiotic resistance rates by Phoenix: 52.63% for amikacin; 73.69% trimethoprim sulfamethoxazole; 91.23% cefepime; 82.46% tigecycline; 59.65% colistin. Carbapenemases positivity: 82.45% (47) for blaOXA-48, 40.35% (23) blaOXA-55, 3.50% (2) blaOXA-51, 1.75% (1) blaOXA-23, 1.75% (1) blaOXA-24, 1.75% (1) blaIMP. blaOXA-58, blaKPC, blaNDM-1, and blaVIM were not detected. Twenty (35.08%) isolates had both blaOXA-48 and blaOXA-55. Three isolates were mcr-1 (+) and blaOXA-48 (+). One mcr-1 (+) isolates was blaOXA-51 (+). One colistin sensitive isolate determined by Phoenix, was found colistin resistant by microdilution. Conclusion: OXA-48 and OXA-55 co-harboring isolates and mcr-1 gene (+) isolates were spreading. Automated colistin susceptibility results should be confirmed by microdilution method. Resistance mechanisms in Enterobacteriaceae should be determined and the isolates should be monitored by molecular epidemiological methods. Effective infection control measures will contribute to reduce risk of antibiotic resistant bacterial infections and dissemination of antibiotic resistance.

scholarly journals Prevalence of Group A Streptococci in Moroccan Children with Pharyngitis and Emm Type Distribution

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sara Himri ◽  
Bouchra Oumokhtar ◽  
Samira Atmani ◽  
Btissam Arhoune ◽  
Kaoutar Moutaouakkil ◽  
...  
Keyword(s):  
Care Center ◽  
Hypervariable Region ◽  
Diffusion Method ◽  
Group A Streptococci ◽  
Sensitivity Testing ◽  
Typing Method ◽  
Disk Diffusion Method ◽  
Health Care Center ◽  
Group A ◽  
Emm Type

Background: Streptococcus pyogenes is responsible for a wide variety of diseases, including noninvasive and severe invasive infections. The emm gene encodes the M protein that is the avirulence factor and immunological determinant of group A streptococci. Emm typing is the group A Streptococci (GAS) standard molecular typing method based on the amplification of the N terminal hypervariable region of the emm gene. Objectives: The aim of the present study was to determine the prevalence of GAS in children with pharyngitis and determine different types of emm gene in the GAS isolates using emm typing. Methods: The study was carried out over a period of 14 months (from February 2017 to March 2018). Throat samples were collected from cases aged ≤ 18 years with pharyngitis referring to a primary health care center in Fez, Morocco. GAS isolates were subjected to conventional tests to confirm species identification. Antimicrobial susceptibility testing was performed using the standard disk diffusion method. We researched emm gene by a polymerase chain reaction (PCR). Emm types were determined by a sequence-based protocol. Demographic and clinical data were recorded from each patient. Results: From a total of 177 throat samples, 11 isolates (6.2%) were identified as GAS in children with pharyngitis. Antibiotic sensitivity testing revealed that all the GAS isolates were sensitive to penicillin. The sequencing of the PCR products of the emm gene revealed that emm90 was the most obtained emm type (30,77%); while emm75 was the least type observed (7.7%). Conclusions: The emm90 is the most prevalent type detected from patients with tonsillitis. Penicillin and erythromycin are still the foremost effective antibiotics to treat GAS pharyngitis.

scholarly journals A 7-year surveillance of the drug resistance in Klebsiella pneumoniae from a primary health care center

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Guogang Li ◽  
Sheng Zhao ◽  
Sipei Wang ◽  
Yingqian Sun ◽  
Yangxiao Zhou ◽  
...  
Keyword(s):  
Health Care ◽  
Drug Resistance ◽  
Primary Health Care ◽  
Klebsiella Pneumoniae ◽  
Care Center ◽  
Urine Samples ◽  
Health Care Center ◽  
Primary Health ◽  
Vitek 2 ◽  
Resistance Rates

Abstract Background The increased prevalence of Klebsiella pneumoniae infections and resistance rates are a current cause for concern. However, data for resistance rates in K. pneumoniae strains from primary hospitals and the resistance distribution among the different isolate sample sources are scarce. Methods All the K. pneumoniae strains were isolated from patients who visited a primary health care center located in Central Zhejiang Province from January 2011 to December 2017. The specimens included blood, sputum, cervical secretions and urine. The species were identified by the Vitek 2 Compact Bacterial Identification and Monitoring System or VITEK-MS and the extended spectrum β-lactamase (ESBL) and drug resistance profiles were identified using the AST-GN13 Gram negative susceptibility card (VITEK-2). The genotype of strains from urine sources was analyzed by detecting TEM and SHV genes. Finally, the drug resistance rates among the isolates from different sample sources were analyzed using the Chi square test with SPSS software. Results A total of 5319 K. pneumoniae strains were isolated in this study. Among the 20 antimicrobial drugs studied, the resistance rates of K. pneumoniae strains varied from 1.4% (ertapenem) to 23.1% (nitrofurantoin). The antibiotic resistance rates varied significantly among the isolate samples sources for all, with the highest rates for all antibiotics except for nitrofurantoin found in urine samples. In addition, the ESBL-positive rate in urine samples was 27.1%, significantly higher than that of cervical secretions (20.2%), blood (16.5%) and sputum (15.2%). Compared to the ESBL-negative strains, higher resistance rates were detected in the ESBL-positive strains. The most common genotype of isolates from urine was SHV (28%, 23/82), following by TEM (14.6%, 12/82). Conclusion The highest resistance rates of K. pneumoniae strains to most antibiotics found in urine samples are partly due to the ESBLs, indicating that a special attention should be paid in the treatment of urinary tract infection.

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