Prevalence of Extended Spectrum β-Lactamases Klebsiella pneumoniae in various Clinical Samples and Characterization of the bla Genes in a Tertiary Care Hospital of Western Maharashtra

Abstract

Introduction: This study was carried out to determine the presence of blaTEM, blaSHV, and blaCTX-M genes in extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae at a tertiary care hospital of western Maharashtra. Materials and Methods: A total of 2312 clinically significant, non-repetitive isolates of K. pneumoniae isolated from outpatient and inpatients attending the hospital were included in the study. An antibiotic susceptibility test, screening, and phenotypic confirmation for ESBLs producers were performed to check for the presence of ESBL enzymes. A polymerase chain reaction was carried out for the detection of ESBL-producing genes CTX-M-15, TEM, and SHV. Results: Non-repetitive clinical specimens processed for culture and identification in our hospital revealed 931 (40.26%) were ESBL-producing K. pneumoniae. A total of 45 bacterial isolates were subjected to molecular genotyping for the production of extended broad spectrum β-lactamases. Of the 45 samples, 40 (88.9%) were positive for blaCTX-M gene, and 44 (97.8%) were positive for blaTEM and blaSHV genes. ESBL production in these samples is largely found to be contributed by CTX-M, TEM, and SHV genes as the prevalence for these genes was higher. Conclusion: This is among the premier report describing the simultaneous occurrence of blaTEM, blaSHV, and blaCTX-M genes and their dissemination. This raises concern and emphasizes a need for more molecular studies to search for the presence of these gene pools in this locality.