Carpabenem Resistant Klebsiella Species in Neonatal ICU in Beni-Suef University Hospital: Molecular Characterization and In-vitro Efficacy of Synergistic Antibiotic Combinations

Abstract

Background: Carbapenem resistant Klebsiella species [CRK] is increasing worldwide that may necessitate the use of combination therapy of antibiotics. Objectives: our aim was to characterize the main mechanisms of resistance carried by CRK isolates and to investigate the in-vitro efficacy of antibiotic combinations. Methodology: One hundred Klebsiella isolates were used for detection of KPC by modified Hodge test and boronic acid combination disc. PCR was done for detection of KPC, genes. The efficacy of antimicrobials combination against these isolates was also tested. Results: By boronic acid combination disc 62% were positive, by modified Hodge test 12% were positive. By PCR; 18% of isolates were positive for OMP-35, 16% for KPC, 14% OXA-48 and 6% for OMP36 genes. Antibiotic combination results showed that 64 and 26 isolates were sensitive to gentamicin-ciprofloxacin, meropenemciprofloxacin combinations respectively. Conclusion: We concluded that OXA-48, KPC, OMP-35 and OMP-36 genes were circulating in our hospital. Gentamycin and ciprofloxacin Combination may be effective. METHODOLOGY Bacterial isolates:This study was conducted on clinical isolates of 100 CRK isolated from samples sent from Neonatal ICU to the