scholarly journals Antimicrobial resistance of Klebsiella pneumoniae strains isolated from urine in hospital patients and outpatients

2021 ◽  
Vol 5 (1) ◽  
pp. 001-007
Author(s):  
Ostojic Maja ◽  
Hubana Mahir ◽  
Cvetnić Marija ◽  
Benić Miroslav ◽  
Cvetnić Zeljko
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Species ◽  
Urine Samples ◽  
Klebsiella Pneumonia ◽  
Immunocompromised Patients ◽  
Therapeutic Results ◽  
Highly Effective ◽  
Hospital Patients ◽  
Almost All

Background: Klebsiella pneumoniae is a bacterial species that often causes infections in humans. Infections occur most frequently in hospitalised or immunocompromised patients and are treated with antimicrobials. In recent decades, K. pneumoniae has developed significant resistance to many antimicrobials. Objective: The main goal of this study was to determine the frequency of resistance of isolated K. pneumoniae strains from urine samples of hospital patients and outpatients, and to find evidence of ESBL strains and their resistance to certain antibiotics. Methods: During the study period, Klebsiella pneumonia was isolated from the urine samples of 430 patients. The procedure for processing of urine samples, identification, susceptibility toward antimicrobials and evidence of ESBL strains were carried out according to the recommended standards. Results: Of the total K. pneumoniae isolates, 153 (35.6%) were isolated from hospital patients and 277 (64.4%) from outpatients. Strains isolated from hospital patients were resistant to each tested antibiotic. ESBL strains were detected in 169 (39.30%) samples, 92 (60.13%) from hospital patients and 77 (27.8%) from outpatients. Conclusion: Strains of K. pneumoniae isolated from the urine of hospital patients and outpatients have developed significant resistance against all tested antibiotic substances. A higher occurrence of ESBL strains was observed in hospital patients than in outpatients. ESBL strains were resistant to all penicillins and almost all cephalosporins. Highly effective antimicrobials were amikacin, colistine, carbapenem and fosfomycin. The best therapeutic results were achieved when patients were treated with fosfomycin and imipenem.

scholarly journals Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia

2021 ◽  
Vol 11 (3) ◽  
pp. 650-658
Author(s):  
Mohammed Yahia Alasmary
Keyword(s):  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Urine Samples ◽  
Klebsiella Species ◽  
E Coli ◽  
Government Hospitals ◽  
Resistance Patterns ◽  
Tract Infections

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.

scholarly journals Frequency of Iron Uptake Proteins Related Genes Among Klebsiella pneumoniae Isolates

2020 ◽  
Vol 14 (1) ◽  
pp. 107-112
Author(s):  
Tahereh Elhaki ◽  
Ali Gheysarzadeh ◽  
Nourkhoda Sadeghifard ◽  
Iraj Pakzad ◽  
Ava Behrouzi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
High Frequency ◽  
Iron Uptake ◽  
Ferric Iron ◽  
Opportunistic Pathogen ◽  
Clinical Isolates ◽  
Klebsiella Pneumonia ◽  
Immunocompromised Patients ◽  
Environmental Isolates ◽  
Pcr Method

Aims: The present study aimed to evaluate Iron uptake protein-related genes in clinical and environmental Klebsiella pneumoniae isolates. Background: Klebsiella pneumoniae as an opportunistic pathogen cause infections in immunocompromised patients. Iron uptake systems play an important role in the pathogenesis of Klebsiella pneumonia. Objectives: This study was designed to investigate the prevalence of iron uptake coding genes among isolates of Klebsiella pneumonia. Materials and Methods: A total of 300 isolates of Klebsiella pneumonia including 150 clinical isolates and 150 environmental isolates were selected. Finally, the frequency of iroN, iucD, kfuA,hmuR, and ybt [yHPI] genes were detected by PCR method. Results: The frequency of kfuA, iucD, iroN, yHPI in clinical isolates were 33.3%, 16.7%, 24.7%, 15.3%, respectively and these genes among environmental isolates were 20.7%, 6%, 49.3% and 0.7%, respectively. Among the clinical isolates, the most frequency genes were kfuA gene [50 isolates] and after that iroN [37 isolates], iucD [25 isolates] and yHPI [23 isolates], the genes with the most frequency among environmental isolates were iroN gene [74 isolates] and following that kfuA [31 isolates], iucD [9 isolates] and yHPI [1 isolate]. No hmuR positive samples among all clinical or environmental isolates were found. Conclusion: The result of this study showed that because of the high frequency of ferric iron system coding gene kfu among clinical isolates, this system might play an important role in the survival of bacteria against its host.

scholarly journals Phenotypic and genotypic characteristics of carbapenemase- and extended spectrum β-lactamase-producing Klebsiella pneumoniae ozaenae clinical isolates within a hospital in Panama City

2021 ◽  
Vol 8 ◽  
pp. 204993612110549
Author(s):  
Silvio Vega ◽  
Fermín Acosta ◽  
Iván Landires ◽  
Mitchelle Morán ◽  
Johanna Gonzalez ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Stewardship ◽  
Resistance Genes ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Hospital Environment ◽  
Genetic Characteristics ◽  
Panama City ◽  
Extended Spectrum

Klebsiella pneumoniae spp ozaenae is a versatile bacterial species able to acquire antimicrobial resistance; the species presents a higher antimicrobial resistance profile compared to Klebsiella pneumoniae spp pneumoniae. Carbapenemase and extended spectrum β-lactamase (ESBL)-producing bacteria commonly arise in clinical settings where antimicrobial stewardship is limited. Our study aims to report the phenotypical and genetic characteristics of nosocomial Klebsiella pneumoniae spp ozaenae isolates associated with mortality collected from a tertiary-level hospital in Panama City. In October 2020, 11 consecutive multidrug-resistant Gram-negative isolates were recovered from secretions and blood cultures from hospitalized patients. Nearly 90% (10/11) of these patients died, and bacteria was obtained from six patients for investigation. Biochemical evaluation of the six isolates revealed the presence of multidrug-resistant Klebsiella pneumoniae spp ozaenae. Phenotypic evaluation indicated resistance to carbapenemase and EBSL. In contrast, genetic evaluation by PCR showed that only 30% (2/6) were resistant to CTX-M-1 (CTX-M group 1), whereas 60.7% (4/6) presented carbapenemase resistance genes, and 33.3% (2/6) presented New Delhi metallo-β-lactamase ( NDM) resistance genes. Klebsiella pneumoniae ST258 was identified in 83.3% (5/6) of the isolates. Phylogenetic analysis using 16S revealed low homology among the six isolates. These results suggest that antibiotic resistance genes may have been incorporated into these Klebsiella pneumoniae spp ozaenae isolates within the hospital environment. We recommend strengthening the antimicrobial stewardship program and antibiotic control policy, as well as heightened infection control and prevention measures, such as ward sanitation and increased hand washing frequency.

scholarly journals Modeling the antimicrobial resistance of enterobacteria responsible for Urinary Tract Infections in Benin: another way to Control or survey Antimicrobial Resistance

2019 ◽  
Author(s):  
VICTORIEN DOUGNON ◽  
Phénix ASSOGBA ◽  
Jean-Pierre GNIMATIN ◽  
Jerrold AGBANKPE ◽  
Hornel KOUDOKPON ◽  
...  
Keyword(s):  
Public Health ◽  
Mathematical Modeling ◽  
Escherichia Coli ◽  
Developing Countries ◽  
Urinary Tract ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Urine Samples ◽  
Tract Infections

Abstract Background: Infectious diseases are serious public health issue both in developing countries and industrialized countries. In developing countries, they are the main cause of high mortality rates. In the second group, existing resistance to antibiotics is developing growing at an alarming rate. The purpose of this study was to produce data of national interest to implement sustainable control of antimicrobial resistance as well as it spreads. Methods: One hundred ninety (190) urine samples were collected in several hospitals in Benin from patients suspected of having a urinary tract infection. After getting the inform consent from patients, samples collections were performed under aseptic conditions and were further subjected to bacteriological tests in the laboratory. The resistance profile of the bacterial strains identified was then established. The search for betalactamase production was performed by the synergy test between amoxicillin + clavulanic acid and cephalosporins. Mathematical modeling of the resistance of the strains identified by 2024 was finally carried out using compartmental deterministic models. Results: Two hundred thirty (230) strains were identified from urine samples. Male individuals were the most affected by urinary tract infections. Individuals in the 21-30 age groups were predominant. Escherichia coli was the most isolated bacterial species (32.43%) in this study followed by Klebsiella pneumoniae (26.85%) and Enterobacter cloaceae (25.92%). The susceptibility testing of isolates bacteria to antibiotics showed a strong resistance of strains to amoxicillin (91.82%). The lowest resistance obtained was observed with imipenem (2%). The betalactamase was produced by 24.03% of the strains identified. Escherichia coli (32.43%) was indeed the most productive of betalactamase followed by Klebsiella pneumoniae (31.03%). Mathematical modeling revealed a rampant rise in the resistance of bacteria to the antibiotics tested. Conclusions: These results provide important data for public health. They deserve constructive advocacy so that more specific actions are taken in relation to antimicrobial resistance.

scholarly journals Replicon typing characterization of plasmids encoding resistance to gentamicin and apramycin inEscherichia coliandSalmonella typhimuriumisolated from human and animal sources in Belgium

1993 ◽  
Vol 111 (2) ◽  
pp. 229-238 ◽  
Author(s):  
P. Pohl ◽  
Y. Glupczynski ◽  
M. Marin ◽  
G. Van Robaeys ◽  
P. Lintermans ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Species ◽  
Gene Encoding ◽  
E Coli ◽  
Molecular Weights ◽  
Electrophoretic Patterns ◽  
Rapid Spread ◽  
Hospital Patients ◽  
Resistance Patterns ◽  
Gentamicin Resistance

SummaryEscherichia coliand salmonella strains with plasmids conferring resistance to gentamicin and apramycin have been isolated with increasing frequency both from cattle and hospital patients in Belgium. The apramycin-gentamicin resistance plasmids were characterized in recipient strains by their profiles and molecular weights using agarose gel electrophoresis, by their antimicrobial resistance patterns and by replicon typing using a series of DNA probes specific for the genes controlling their systems of replication. Overall, most of the plasmids differed in their DNA electrophoretic patterns. Seventeen different antimicrobial resistance profiles were observed, and there were six different types of replicons. However, two replication genes predominated and had a preferential distribution in different bacterial species. The rep FIC.a plus rep Q multireplicon was found mainly in plasmids recovered from gentamicin- and apramycin-resistantE. coliwhile replicon of the type rep FIC.b largely prevailed inS. typhimurium. Identical replication genes were found in most animal and human strains, hence suggesting a high homology between apramycin- gentamicin plasmids in these communities. Finally, our results indicate that the rapid spread of apramycin-gentamicin-resistance in several species of Enterobacteriaceae isolated from animals and from humans in Belgium is not due to a single plasmid, but rather that the gene encoding AAC(3)-IV is carried by various replicons.

Clin-mNGS: Automated Pipeline for Pathogen Detection from Clinical Metagenomic Data

2020 ◽  
Vol 15 ◽  
Author(s):  
Akshatha Prasanna ◽  
Vidya Niranjan
Keyword(s):  
Antimicrobial Resistance ◽  
High Performance ◽  
Pathogen Detection ◽  
Bacterial Species ◽  
Workflow Management ◽  
Metagenomic Data ◽  
Antimicrobial Resistance Genes ◽  
Culture Independent ◽  
Automated Pipeline ◽  
User Friendly

Background: Since bacteria are the earliest known organisms, there has been significant interest in their variety and biology, most certainly concerning human health. Recent advances in Metagenomics sequencing (mNGS), a culture-independent sequencing technology have facilitated an accelerated development in clinical microbiology and our understanding of pathogens. Objective: For the implementation of mNGS in routine clinical practice to become feasible, a practical and scalable strategy for the study of mNGS data is essential. This study presents a robust automated pipeline to analyze clinical metagenomic data for pathogen identification and classification. Method: The proposed Clin-mNGS pipeline is an integrated, open-source, scalable, reproducible, and user-friendly framework scripted using the Snakemake workflow management software. The implementation avoids the hassle of manual installation and configuration of the multiple command-line tools and dependencies. The approach directly screens pathogens from clinical raw reads and generates consolidated reports for each sample. Results: The pipeline is demonstrated using publicly available data and is tested on a desktop Linux system and a High-performance cluster. The study compares variability in results from different tools and versions. The versions of the tools are made user modifiable. The pipeline results in quality check, filtered reads, host subtraction, assembled contigs, assembly metrics, relative abundances of bacterial species, antimicrobial resistance genes, plasmid finding, and virulence factors identification. The results obtained from the pipeline are evaluated based on sensitivity and positive predictive value. Conclusion: Clin-mNGS is an automated Snakemake pipeline validated for the analysis of microbial clinical metagenomics reads to perform taxonomic classification and antimicrobial resistance prediction.

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