Extended-spectrum beta-lactamases among Klebsiella pneumoniae from Iraqi patients with community-acquired pneumonia

Abstract

OBJECTIVE: Beta-lactams resistance is a major clinical problem in treating pneumonia. This study aimed to detect the extended-spectrum betalactamases (ESBL) genes in Klebsiella pneumoniae among patients with community-acquired pneumonia (CAP) in Al-Najaf City, Iraq. METHODS: A total of 511 sputum samples were obtained from all suspected patients with CAP in Al-Najaf City, Iraq, from March 2020 to September 2020. Sputum samples were subjected to microbiological tests. The disk diffusion method was used to test antibiotic sensitivity. Production of ESBLs was identified using phenotypic and genotypic methods. RESULTS: The total prevalence of K. pneumoniae was 31.9% (163/511). Using CHROM agar, 41 (25.2%) isolates were ESBL producers. The imipenem 0.0% (n=0/41) and norfloxacin 0.0% (n=0/41) were the most effective antibiotics. The multiplex polymerase chain reaction showed that 46.3% (n=19/41) of isolates harbored ESBL genes. Out of 19 ESBL producers, 47.4% and 15.8% harbored bla CTX-M and bla SHV , respectively. While bla CTX-M and bla SHV genes were detected in 7 (36.8%) isolates, simultaneously. CONCLUSIONS: The imipenem and norfloxacin can be used in empirical treatment of K. pneumoniae isolates in Iraq. The emergence of K. pneumoniae strains harboring ESBL resistance genes necessitates the development of a regular surveillance program to prevent the spreading of these isolates more in Iraqi health care systems.

Beta-lactamase determinants and molecular typing of carbapenem-resistant classic and hypervirulent Klebsiella pneumoniae clinical isolates from southwest of Iran

“…In another study by Banerjee et al (2021) from India, all CR-hvKp ( n = 9) harbored bla SHV and bla CTX–M , whereas bla TEM was not detected. In this study, the bla CTX–M was the most frequent ESBL among carbapenem-resistant K. pneumoniae isolates that was in line with the previous report from Iraq ( Raouf et al, 2022 ). In the last decade, bla TEM and bla SHV variants have become less dominant than bla CTX–M , despite being the most universal ESBLs ( Soltani et al, 2020 ; Raouf et al, 2022 ).…”

“…In this study, the bla CTX–M was the most frequent ESBL among carbapenem-resistant K. pneumoniae isolates that was in line with the previous report from Iraq ( Raouf et al, 2022 ). In the last decade, bla TEM and bla SHV variants have become less dominant than bla CTX–M , despite being the most universal ESBLs ( Soltani et al, 2020 ; Raouf et al, 2022 ). Antibiotic use plans differ in each region, which may cause selection pressure for the circulation of ESBL-producing isolates and explain these inconsistencies.…”

“…Antibiotic use plans differ in each region, which may cause selection pressure for the circulation of ESBL-producing isolates and explain these inconsistencies. Also, the origin of collected samples and the geographical variances may contributed to these differences ( Raouf et al, 2022 ).…”

Isolation and characterization of three novel lytic phages against K54 serotype carbapenem-resistant hypervirulent Klebsiella pneumoniae

“…In recent years, K. pneumoniae has emerged as a significant nosocomial and opportunistic pathogen. Antibiotic resistance, with the production of extended-spectrum β-lactamases (ESBL), carbapenemases or aminoglycosides resistance, is common in K. pneumoniae ( Raouf et al., 2022 ; Jwair et al., 2023 ; Khoshnood et al., 2023 ), which brings big challenges to the therapy of infection of K. pneumoniae . The emergence of carbapenem-resistant hypervirulent K. pneumoniae (CR-hvKP) has exhibited prevalence since 2010 ( Lan et al., 2021 ).…”

Genetic detection of folate pathway inhibitors and outer membrane porins genes among gentamicin-resistant klebsiella pneumoniae isolates

“…Numerous studies are conducted by researchers in Iraq, such as obtaining 61 Klebsiella isolates (33.88%) from a total of 180 samples collected from two clinical sources in Baghdad province [17 In a local study by Hasan et al, [18] discovered that out of a total of 207 Gram-negative bacteria isolates, K. pneumoniae was the second most prevalent with a prevalence rate of 35.74 %; based on gender, 47 (63.51%) of the K. pneumoniae isolates were females and 27 (36.49%) were males. In a local study by Raouf et al, [19] who found out of a total of 308/511 (60.3%) Gram-negative bacteria isolates, K. pneumoniae was prevalent with the percentage of 163/511 (31.9%), from other hand depending on the gender the K. pneumoniae isolates were 61 (37.4%) females and 102 (62.6%) males.…”