High rate of carbapenem-resistant Klebsiella pneumoniae detected from hospital equipments in Iran

The emergence of Klebsiella pneumoniae carbapenemase (KPC) resistance has led to the countdown of activity of carbapenems, which were considered as drugs of last resort for infections caused by Enterobacteriaceae. The aims of the present study were the detection of KPC-production among K. pneumoniae isolates, select the appropriate method for its detection and assess the consequence of KPC production on the antibiotics susceptibility. One hundred and four non-duplicated K. pneumoniae isolates were collected from University teaching hospitals of Tabriz, Iran. The disk diffusion, E-test, and Modified Hodge test were performed for the determination of antibiotic susceptibility pattern, Minimum Inhibitory Concentrations (MICs) determination and the production of carbapenemase, respectively. BlaKPC-2 gene was detected by using PCR. High levels of resistance were observed towards co-trimoxazole (69.2%), followed by cefazolin (66.3%), ceftriaxone (65.4%), ofloxacin and ciprofloxacin (54.8%), gentamicin (50%), and amikacin (39.4%). According to the disk diffusion method, the frequency of imipenem and meropenem resistance was 31.7% and 32.7%, respectively. Colistin was the most effective antibiotic among panels of antibiotics tested. Imipenem MICs range, MIC50 and MIC90 were 0.19-32 μg/ml, 4 μg/ml, and 16 μg/ml, respectively. Modified Hodge test was positive in 24 (63.2%) isolate however, blaKPC-2 gene was detected in 8 (21.1%) carbapenem- resistant isolates. Results of the present study revealed a high rate of carbapenem- resistance in K. pneumoniae by phenotypic method, however the presence of one of the molecular, namely blaKPC-2 was not found as predominant cause. Therefore, their reliable detection should be the first priority to combat the infections. Being a simple test, the imipenem disk diffusion could be considered as an appropriate method for the detection of carbapenem-resistant isolates in the routine diagnosis.

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Molecular Characterization of Carbapenem Resistant Klebsiella pneumoniae in Malaysia Hospital

Pathogens ◽

10.3390/pathogens10030279 ◽

2021 ◽

Vol 10 (3) ◽

pp. 279

Author(s):

Min Yi Lau ◽

Fui Enn Teng ◽

Kek Heng Chua ◽

Sasheela Ponnampalavanar ◽

Chun Wie Chong ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Hospital Mortality ◽

Teaching Hospital ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

High Rate ◽

Carbapenem Resistant ◽

Tertiary Teaching ◽

Carbapenemase Gene

The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is a great concern, as carbapenems are the last-line therapy for multidrug-resistant Gram-negative bacteria infections. This study aims to report the epidemiology of CRKP in a teaching hospital in Malaysia based on the molecular genotypic and clinical characteristics of the isolates. Sixty-three CRKP strains were isolated from a tertiary teaching hospital from January 2016 until August 2017. Carbapenemase genes were detected in 55 isolates, with blaOXA-48 (63.5%) as the predominant carbapenemase gene, followed by blaNDM (36.5%). At least one porin loss was detected in nine isolates. Overall, 63 isolates were divided into 30 clusters at similarity of 80% with PFGE analysis. Statistical analysis showed that in-hospital mortality was significantly associated with the usage of central venous catheter, infection or colonization by CRKP, particularly NDM-producers. In comparison, survival analysis using Cox proportional hazards regression identified a higher hazard ratio for patients with a stoma and patients treated with imipenem but a lower hazard ratio for patients with NDM-producing CRKP. OXA-48 carbapenemase gene was the predominant carbapenemase gene in this study. As CRKP infection could lead to a high rate of in-hospital mortality, early detection of the isolates was important to reduce their dissemination.

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Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella pneumoniae Isolated from Hospitalized Neonates and Adults in Khartoum

10.21203/rs.3.rs-26141/v1 ◽

2020 ◽

Author(s):

Aalaa Mahgoub Albasha ◽

Esraa Hassan Osman ◽

Saga Abd Alhalim ◽

Elianz Alshaib ◽

Leena Al-Hassan ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Virulence Genes ◽

Age Groups ◽

Hospitalized Patients ◽

High Rate ◽

Drug Resistant ◽

Carbapenem Resistant ◽

Resistant Genes ◽

Virulent Strains ◽

Wide Range

Abstract Background Carbapenems resistant hypervirulent strains of Klebsiella pneumoniae are one of the most critical organisms that cause fatal nosocomial infections. This study aimed to detect and characterize K. pneumoniae virulence genes (mrkD, entB, rmpA, K2, kfu, and magA) and carbapenem resistant (blaNDM, blaIMP, blaOXA−48, and blaKPC) genes Methods Sixty K. pneumoniae strains were isolated from urine, blood, wound swab, and sputum samples, in two age groups: neonates and adults. String test was used to detect hypervirulent strains. Susceptibility testing for a wide range of antibiotics was performed on all isolates. DNA was extracted by the guanidine chloride method, then multiplex PCR was used for the detection of carbapenem-resistance and virulence genes. Results Seventy percent of the isolates were resistant to ceftazidime and 8% to imipenem, 35% were multi-drug resistant, and 7% extensively drug-resistant, all neonatal blood isolates (n = 15) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA−48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA−48 and two for blaNDM genes. The study concluded that there is a high rate of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Conclusion The study reported for the first time in Sudan presence of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Presence of MDR and XDR strains of K. pneumoniae in neonatal ward in some Sudanese hospitals.

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Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella pneumoniae Isolated from Hospitalized Neonates and Adults in Khartoum

10.21203/rs.3.rs-22765/v1 ◽

2020 ◽

Author(s):

Aalaa Mahgoub Albasha ◽

Esraa Hassan Osman ◽

Saga Abd Alhalim ◽

Elianz Alshaib ◽

Leena Al-Hassan ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Virulence Genes ◽

Age Groups ◽

Hospitalized Patients ◽

High Rate ◽

Drug Resistant ◽

Carbapenem Resistant ◽

Resistant Genes ◽

Virulent Strains ◽

Wide Range

Abstract Background Carbapenems resistant hypervirulent strains of Klebsiella pneumoniae are one of the most critical organisms that cause fatal nosocomial infections. This study aimed to detect and characterize K. pneumoniae virulence genes (mrkD, entB, rmpA, K2, kfu, and magA) and carbapenem resistant (blaNDM, blaIMP, blaOXA−48, and blaKPC) genes Methods Sixty K. pneumoniae strains were isolated from urine, blood, wound swab, and sputum samples, in two age groups: neonates and adults. String test was used to detect hypervirulent strains. Susceptibility testing for a wide range of antibiotics was performed on all isolates. DNA was extracted by the guanidine chloride method, then multiplex PCR was used for the detection of carbapenem-resistance and virulence genes. Results Seventy percent of the isolates were resistant to ceftazidime and 8% to imipenem, 35% were multi-drug resistant, and 7% extensively drug-resistant, all neonatal blood isolates (n = 15) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA−48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA−48 and two for blaNDM genes. The study concluded that there is a high rate of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Conclusion The study reported for the first time in Sudan presence of carbapenems resistant genes in hyper-virulent strains of K. pneumoniae isolated from hospitalized patients. Presence of MDR and XDR strains of K. pneumoniae in neonatal ward in some Sudanese hospitals.

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High rate of colistin resistance among patients with carbapenem-resistant Klebsiella pneumoniae infection accounts for an excess of mortality

Clinical Microbiology and Infection ◽

10.1111/1469-0691.12070 ◽

2013 ◽

Vol 19 (1) ◽

pp. E23-E30 ◽

Cited By ~ 164

Author(s):

A. Capone ◽

M. Giannella ◽

D. Fortini ◽

A. Giordano ◽

M. Meledandri ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

High Rate ◽

Colistin Resistance ◽

Carbapenem Resistant

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Decreased carO gene expression and OXA-type carbapenemases among extensively drug-resistant Acinetobacter baumannii strains isolated from burn patients in Tehran, Iran

Acta Microbiologica et Immunologica Hungarica ◽

10.1556/030.2020.01138 ◽

2020 ◽

Cited By ~ 1

Author(s):

Elham Abbasi ◽

Hossein Goudarzi ◽

Ali Hashemi ◽

Alireza Salimi Chirani ◽

Abdollah Ardebili ◽

...

Keyword(s):

Gene Expression ◽

Acinetobacter Baumannii ◽

High Rate ◽

Burn Patients ◽

Drug Resistant ◽

Disc Diffusion ◽

Carbapenem Resistant ◽

Extensively Drug Resistant ◽

Sds Page ◽

Extensively Drug Resistance

AbstractA major challenge in the treatment of infections has been the rise of extensively drug resistance (XDR) and multidrug resistance (MDR) in Acinetobacter baumannii. The goals of this study were to determine the pattern of antimicrobial susceptibility, blaOXA and carO genes among burn-isolated A. baumannii strains. In this study, 100 A. baumannii strains were isolated from burn patients and their susceptibilities to different antibiotics were determined using disc diffusion testing and broth microdilution. Presence of carO gene and OXA-type carbapenemase genes was tested by PCR and sequencing. SDS-PAGE was done to survey CarO porin and the expression level of carO gene was evaluated by Real-Time PCR. A high rate of resistance to meropenem (98%), imipenem (98%) and doripenem (98%) was detected. All tested A. baumannii strains were susceptible to colistin. The results indicated that 84.9% were XDR and 97.9% of strains were MDR. In addition, all strains bore blaOXA-51 like and blaOXA-23 like and carO genes. Nonetheless, blaOXA-58 like and blaOXA-24 like genes were harbored by 0 percent and 76 percent of strains, respectively. The relative expression levels of the carO gene ranged from 0.06 to 35.01 fold lower than that of carbapenem-susceptible A. baumannii ATCC19606 and SDS – PAGE analysis of the outer membrane protein showed that all 100 isolates produced CarO. The results of current study revealed prevalence of blaOXA genes and changes in carO gene expression in carbapenem resistant A.baumannii.

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