Molecular Epidemiological Surveillance of CTX-M-15-producing Klebsiella pneumoniae from the patients of a teaching hospital in Sindh, Pakistan.

Abstract

Background The presence of Extended-spectrum β-lactamase positive bacteria in hospital setting is an aggravating influential factor for hospitalized patients, and its consequences may be hazardous. Therefore, there is a need for rapid detection methods for newly emerging drug-resistant bacteria. This study was aimed at the molecular characterization of Extended-spectrum β-lactamase -positive Klebsiella pneumoniae isolates recovered from the patients of a teaching hospital in Sindh, Pakistan. Methods A total of 513 K. pneumoniae isolates were obtained from various clinical samples during June 2019 to May 2020. The collected isolates were investigated for antimicrobial susceptibility (antibiogram), and PCR and DNA sequencing were performed to analyse the ESBL genes. Results Among the 513 isolates, as many as 359 (69.9%) were Extended-spectrum β-lactamase producers and 87.5% were multi-drug resistant, while none had resistance to imipenem. PCR scored 3% blaTEM, 3% blaSHV, and 60% blaCTX-M-15 genes for the tested isolates. Conclusion The study showed that CTX-M-15 was the major prevalent Extended-spectrum β-lactamase type among the isolates. Additionally, all the isolates were susceptible to carbapenems. Screening and detection of Extended-spectrum β-lactamase tests are necessary among all isolates from the enterobacteriaceae family in routine microbiology laboratory to prevent associated nosocomial infections. A larger study is essential to understand molecular epidemiology of Extended-spectrum β-lactamase producing organisms to minimize morbidities due to these multidrug resistant organisms.

The Rising Tide of Antibiotic Resistance: A Study on Extended‐Spectrum Beta‐Lactamase and Carbapenem‐Resistant Escherichia coli and Klebsiella pneumoniae

“…This increase was observed in urine samples, with a prevalence of 31.8–62.9%, and in pus samples, with a prevalence of 55.5% [ 30 ]. Several studies on ESBL‐producing Enterobacterales from various cities in Pakistan have reported findings similar to this study [ 31 , 32 , 33 ].…”

In Vitro Susceptibility of Colistin Against Multidrug Resistant Klebsiella Pneumoniae Clinical Isolates

“…European Committee for Antimicrobial Susceptibility Testing (EUCAST) breaking points were used for Tigecycline (TGC) and Colistin susceptibility. 14 AST was done using different antimicrobial disks including Ampicillin (AMP) 10 μg, Gentamicin (CN) 10 μg, Ciprofloxacin (CIP) 5 μg, Levofloxacin (LEV) 5 μg, Amikacin (AK) 30 μg, Cotrimoxazole (SXT) 25 μg, Ceftriaxone (CRO) 30 μg, Ceftazidime (CAZ) 30 μg, Cefipime (FEP) 30 μg, Imipenem (IMP)10 μg, Merope-nem (MEM) 10 μg, Ampicillin+sulbactam (SAM) 20 μg, Piperacillin +Tazobactam (TZP) 110 μg, Coamoxiclav (AMC) 30 μg, Aztreonam (ATM) 30 μg, Minocycline (MIN) 30 μg, Doxycycline(DOX) 30 μg, Chloram-phenicol (CAP) 30 μg, Tigecycline (TGC) 15 μg. ATCC (American Type Culture Collection, Rockville, MD) of Escherichia coli was used for quality control of AST.…”

Nanopore sequencing of antibiotic-resistantKlebsiella pneumoniaeJRCGR1 isolate from Pakistan and country scale pan-genomics

“…SHV-28, rsmA, aadA2, AAC(6')-Ib-cr6, eptB and gyrA were unique to JRCGR1 compared to the studied genomes, while CRP, eptB, EF-Tu and UhpT were shared with core genome. However CTX-M-15 and SHV-28 beta-lactamases, present in JRCGR1 (which render resistance to cephalosporins and work by antibiotic inactivation), have already been reported in some areas of Pakistan via PCR tests [35,36] or genome [37] not listed in the PATRIC database (from where we picked our data). S83I mutation in gyrA gene conferring resistance to ciprofloxacin has been previously detected in Pakistani isolates [38], which is common to global lineage.…”