Molecular insights of Carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples

Indrajith, Sureka; Mukhopadhyay, Asish K.; Chowdhury, Goutam; Farraj, Dunia A. Al; Alkufeidy, Roua M.; Sivakumar, N.; Meghanathan, Velmurugan; Selvakumar, Gopal; Saravanan, Muthupandian

doi:10.1016/j.jiph.2020.09.018

Cited by 48 publications

(27 citation statements)

References 33 publications

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“…Yang et al reported that the highest multidrug resistance rate was detected in human strains of K. pneumoniae strains (90.4%). Highest resistance to imipenem 38% (34/89), meropenem 31% (n = 28/89) among K. pneumoniae strains was reported by Indrajitha et al ( 2021 ) which is less than the resistance rates seen in our K. pneumoniae strains.…”

Section: Discussioncontrasting

confidence: 46%

Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples

Mirzaie

Ranjbar

2021

AMB Expr

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Klebsiella pneumoniae is a multidrug-resistant (MDR) opportunistic pathogen that causes nosocomial infections. Virulence analysis and molecular typing as powerful approaches can provide relevant information on K. pneumoniae infection. In the current study, antibiotic resistance, virulence-associated genes analysis, as well as molecular typing of K. pneumoniae strains were investigated. Out of 505 clinical samples collected from hospitalized patients, 100 K. pneumoniae strains were isolated by standard microbiological methods and subjected to the phenotypic and genotyping analysis. The highest prevalence of resistance was observed against ciprofloxacin (75%), trimethoprim–sulfamethoxazole (73%) and nitrofurantoin (68%). Virulence associated genes including entB, traT, ybts, magA, iucC, htrA and rmpA were found in 80%, 62%, 75%, 5%, 30%, 72% and 48%, of the isolates, respectively. The prevalence of biofilm-associated genes including mrkA, fimH, and mrkD were equally 88% for all tested isolates. Moreover, the efflux pump genes including AcrAB, TolC and mdtK were observed in 41 (41%), 33 (33%) and 26 (26%) of the strains respectively. A significant statistical association was observed between MDR strains and high expression of efflux pump and biofilm genes. The K. pneumoniae strains were differentiated into 11 different genetic patterns using the repetitive element sequence-based PCR (rep-PCR) technique. High prevalence of resistance, presence of various virulence factors, high level of efflux pump, and biofilm gene expression in diverse clones of K. pneumoniae strains pose an important health issue in clinical settings.

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Section: Discussioncontrasting

confidence: 46%

Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples

Mirzaie

Ranjbar

2021

AMB Expr

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“…The prevalence of the bla NDM gene varies in different parts of the world depending on the level of health and overuse of antibiotics. In the current study, the bla IMP gene was observed in 17.5% of the isolates, which is not consistent with studies conducted in South India (8%) (28), China (36.5%) (29), and Egypt (15.2%) (30). In the present study, the prevalence of the bla VIM gene was 75%.…”

Section: Discussioncontrasting

confidence: 99%

Prevalence of Metallo-β-Lactamase Genes in Clinical Isolates of Klebsiella pneumoniae in Health Care Centers in Mazandaran Province

Alizadeh

Alipour

Rezaee

2021

Avicenna J Clin Microbiol Infect

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Background: Klebsiella pneumoniae is one of the most important causes of opportunistic infections, including lobar pneumonia, urinary tract infection (UTIs), and wound infection. Treatment of disease caused by this bacterium has also become a challenge, as many strains are resistant to all β-lactam antibiotics. Metallo-β-lactamases hydrolyze most β-lactam antibiotics, especially carbapenems, but cannot inactivate monobactams. This study aimed to determine the prevalence of Metallo-β-lactamase genes (blaIMP, blaVIM, and blaNDM) in K. pneumoniae isolated from clinical specimens. Methods: Clinical samples were collected from hospitals of Mazandaran province. Among 500 clinical samples collected, only 40 Klebsiella pneumoniae isolates were detected by culture and biochemical tests. Antimicrobial susceptibility testing was performed on all isolates by the Kirby-Bauer method. The polymerase chain reaction (PCR) technique was used for the identification of blaIMP, blaVIM, and blaNDM genes. Results: Antibiogram by disk diffusion method showed that 21 (52%) and 19 (48%) isolates were classified as imipenem resistant and sensitive, respectively. Of all the samples, 30 (75%), 7 (17.5%), and 36 (90%) contained blaVIM, blaIMP, and blaNDM genes, respectively. The co-existence of the blaVIM and blaNDM genes was observed in 22 (55%) isolates. The presence of both blaIMP and blaNDM genes was confirmed in 2 (5%) of the isolates. Four isolates (10%) had blaNDM, blaIMP, and blaVIM genes simultaneously, but none of these genes were present in one isolate (2.5%). Conclusions: This study showed that the prevalence of metallo-β-lactamase genes in K. pneumoniae isolated from clinical specimens is very high, so it is recommended that physicians treat patients based on phenotypic and genotypic characteristics.

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“…In contrast, Abbas et al, 2019 reported that two E. coli (0.6%) and 15 Klebsiella pneumoniae (5%) out of 300 clinical isolates were carbapenem-resistant [26]. The increased resistance to cephalosporins may be attributed to the worldwide use of this class of antibiotics while carbapenems are still active in the treatment of serious infections [27].…”

Section: Discussionmentioning

confidence: 98%

Genetic characterization of extended-spectrum β-Lactamase- and carbapenemase-producing Escherichia coli isolated from Egyptian hospitals and environments

et al. 2021

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Over the past decades, Escherichia coli (E. coli) have acquired extensive resistance to antibiotics; especially β- lactams. This study aimed to investigate the frequency of Extended-spectrum β-lactamase (ESBL) and carbapenemase producers among E. coli isolates and their correlation with serotypes, phylogenetic background, and pathogenicity associated islands. A total of 105 E. coli strains were isolated and subjected to antimicrobial susceptibility testing against β-lactam antibiotics. All isolates showed a high resistance profile. Resistant isolates were tested for ESBL and carbapenemase production. Fifty-three and 18 isolates were positive for ESBL and carbapenemase producers, respectively. ESBL and carbapenemase genes were detected by PCR. TEM gene was the most prevalent gene among all isolates followed by SHV and CTX-M15. In carbapenemase-producers, OXA-48 and IMP were the predominant genes. Enteropathogenic E. coli (EPEC) and Enterohemorrhagic E. coli (EHEC) were the major producers of ESBL and carbapenemase, respectively as indicated by serodiagnosis. They were further assessed for the presence of pathogenicity islands (PAIs) and phylogenetic background. The most predominant DEC PAI and ExPEC PAI were HPI and IICFT073. Most clinically ESBL-producers were group D and B2 while environmentally ones were group B1 and A. On contrary, clinically carbapenemase-producers belonged to group C and D. In conclusion, our study confirms the importance of phylogenetic group D, B2, and C origin for antibiotic resistance in E. coli. Ultimately, our findings support the fact that environmental isolates contribute to the local spread of E. coli pathogenicity in Egypt and these isolates maybe serve as reservoirs for transmission of resistance.

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Molecular insights of Carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples

Cited by 48 publications

References 33 publications

Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples

Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples

Prevalence of Metallo-β-Lactamase Genes in Clinical Isolates of Klebsiella pneumoniae in Health Care Centers in Mazandaran Province

Genetic characterization of extended-spectrum β-Lactamase- and carbapenemase-producing Escherichia coli isolated from Egyptian hospitals and environments

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