Molecular Characterization of Extended Spectrum â-lactamase and Carbapenemase Producing Klebsiella pneumoniae from a Tertiary Care Hospital

Bhaskar, Beena Hosdurg; Mulki, Shalini Shenoy; Joshi, Sangeeta; Adhikary, Ranjeeta; Venkatesh, Bhavana Malavalli

doi:10.5005/jp-journals-10071-23118

Cited by 17 publications

(14 citation statements)

References 44 publications

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“…Several studies have reported that AmpC producer in K. pneumoniae ranged from 7.8% to 43%. [37][38][39] Similar to a previous study, resistance to carbapenem among Enterobacter spp. was high.…”

Section: Discussionsupporting

confidence: 78%

Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae

Alizadeh¹,

Rezaee²,

Kafil³

et al. 2020

IDR

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Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a major concern leading to morbidity and mortality in the world. CRE often is becoming a cause of therapeutic failure in both hospital and community-acquired infections. Aim: This study aimed to investigate the resistance mechanisms of CRE by phenotypic and molecular methods. Materials and Methods: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Antimicrobial susceptibility testing was carried out using phenotypic methods. The carbapenem resistance mechanisms including efflux pump hyperexpression, AmpC overproduction, carbapenemase genes, and deficiency in OmpK35 and OmpK36 were determined by phenotypic and molecular methods, respectively. Results: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Amikacin was found to be the most effective drug against CRE isolates. All isolates were resistant to imipenem and meropenem by the micro-broth dilution. AmpC overproduction was observed in all Enterobacter spp. and three K. pneumoniae isolates. No efflux pump activity was found. Carba NP test and Modified Hodge Test could find carbapenemase in 59 (98%) isolates and 57 (95%) isolates, respectively. The most common carbapenemase gene was bla OXA-48-like (72.8%) followed by bla NDM (50.8%), bla IMP (18.6%), bla VIM (11.8%), and bla KPC (6.7%). The ompK35 and ompK36 genes were not detected in 10 and 7 K. pneumoniae isolates, respectively. Conclusion: The amikacin is considered as a very efficient antibiotic for the treatment of CRE isolates in our region. Carbapenemase production and overproduction of AmpC are the main carbapenem resistance mechanisms in CRE isolates. Finally, Carba NP test is a rapid and reliable test for early detection of carbapenemase-producing isolates.

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Section: Discussionsupporting

confidence: 78%

Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae

Alizadeh¹,

Rezaee²,

Kafil³

et al. 2020

IDR

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“…Bhaskar et al 33 treated Klebsiella pneumoniae with Cefotaxime (30 µg). He found wrinkled with roughsurfaced bacterial cells when examining with SEM.…”

Section: Discussionmentioning

confidence: 99%

Detection and Control of Biofilm Formation by Staphylococcus aureus from Febrile Neutropenic Patient

Elnagdy

Abdel-Fattah

Emarah

2020

IDR

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Introduction Febrile neutropenia (FN) is the evolution of fever in a patient with neutropenia over 38.0°C. Neutropenia is diagnosed when absolute neutrophil count (ANC) <1500 cells/µL. FN represents a common complication of cancer treatment. Hence, it is featured to be a major cause of morbidity and mortality in cancer patients. Staphylococcus aureus is one of the most important microorganisms isolated from the blood of febrile neutropenic patients. Infections caused by S. aureus range from mild to life-threatening diseases. Biofilm production by S. aureus is one of the most significant virulence factors of the bacterium as it prevents the penetration of antibiotics. Recently, it has been shown that S. aureus carries the ica operon responsible for biofilm production. The aim of the work is to determine a genotypic characterization that includes not only the detection of icaA and icaD genes in S. aureus but also the determination of their relation to clinical and microbiological features. Empiric antibacterial treatment was recommended for cancer patients receiving chemotherapy. Materials and Methods The relation between the presence of icaA and icaD and biofilm production was determined in a collection of 66 S. aureus samples from febrile neutropenic patients. Biofilm-forming ability was tested on Congo Red agar plates. Also, the effect of the most sensitive antibiotics on the bacterial cells was determined by an electron microscope. Results Of the bacterial samples, 48 were biofilm-productive and 18 were non-biofilm productive. For the biofilm productive bacteria, 37.5% were positive for icaA , 22.9% were positive for icaD and 10.4% were positive for both. Linezolid was the most effective antibiotic and it is highly recommended for the treatment of febrile neutropenia caused by biofilm-productive S. aureus . Severe changes were found on the bacterial cell after being treated with Linezolid. The icaA and icaD genes were present in only 50% of biofilm-productive bacteria. Conclusion The ica operon is present in only 50% of biofilm-productive S. aureus and Linezolid is the best antibiotic against these bacteria.

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“…K. pneumoniae have acquired carbapenemases, which are capable of breaking down most β-lactams, including carbapenems, and confer resistance to these drugs. Reports indicate that carbapenemase- producing Enterobacteriaceae isolates are increasing in number in the last few years [39].…”

Section: Discussionmentioning

confidence: 99%

Genes Conferring Antimicrobial-Resistance Among Klebsiella Pneumoniae in the Arabian Gulf Countries: A Systematic Review and Meta-Analysis

Bindayna

Joji

Ezzat

et al. 2021

Asian J Pharm Clin Res

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Objective: The objective of the study was to look on the prevalence of six AMR genes (CTX-M, TEM, SHV, NDM-1, OXA-48, and VIM genes) in the province of the Arabian Gulf. We performed a systematic review and meta-analysis of the published studies from the Arabian Gulf countries and analyzed the antimicrobial resistance (AMR) genes pattern present in Klebsiella pneumoniae. Methods: The present study used the Meta-analysis Of Observational Studies in Epidemiology as a guideline for reporting findings. An electronic search was conducted in online databases such as PubMed/MEDLINE, EMBASE, Scopus, Google Scholar, Science Direct, and Web of Science from January 2014 to June 2020 following the inclusion and exclusion criteria. Articles published were included in the study resistance pattern among 2036 isolates were analyzed. These isolates conferred the AMR genes including OXA-48 (n=500), CTX-M (n= 1796), SHV (n=1637), TEM (n=1492), NDM-1 (n=500), and VIM (n=302). Results: Of 160 initially searched studies, 28 entries met the inclusion criteria and were subjected to meta-analysis. Critical appraisal of studies or quality assessment revealed a mean quality score was 4.2, with an SD of 1.6. The analysis revealed predominant AMR genes wereOXA-48 followed by CTX-M, SHV, TEM, NDM-1, and VIM in the Arabian Gulf region. Conclusion: The Arabian Gulf countries share a high prevalence of OXA-48, CTX-M followed by SHV, TEM, NDM-1, and VIM genes. Antimicrobial-resistant in K. pneumoniae is a threat to public health and this needs strong surveillance to curb this threat.

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Molecular Characterization of Extended Spectrum â-lactamase and Carbapenemase Producing Klebsiella pneumoniae from a Tertiary Care Hospital

Cited by 17 publications

References 44 publications

<p>Evaluation of Resistance Mechanisms in Carbapenem-Resistant <em>Enterobacteriaceae</em></p>

<p>Evaluation of Resistance Mechanisms in Carbapenem-Resistant <em>Enterobacteriaceae</em></p>

<p>Detection and Control of Biofilm Formation by <em>Staphylococcus aureus</em> from Febrile Neutropenic Patient</p>

Genes Conferring Antimicrobial-Resistance Among Klebsiella Pneumoniae in the Arabian Gulf Countries: A Systematic Review and Meta-Analysis

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