Unveiling Efflux Pump-Mediated Antibiotic Resistance in Klebsiella pneumoniae Clinical Isolates: A Call for Strategic Intervention

Abstract

Introduction: Klebsiella pneumoniae stands as a significant opportunistic pathogen, often implicated in hospital-acquired infections. The escalating levels of antibiotic resistance, propelled by novel bacterial survival mechanisms, present a dire challenge, leading to treatment failures and amplified mortality rates. Efflux pump systems which play a pivotal role in antibiotic resistance actively expel toxic compounds, thereby fostering bacterial survival and the emergence of resilient strains. This study endeavored to examine the frequency of efflux genes in clinical isolates of K. pneumoniae. Methods: Ninety-six non-repetitive clinical isolates of K. pneumoniae were obtained from patients attending Khatam-Al-Anbeya hospital in Zahedan, Iran. Standard biochemical laboratory methods were employed to identify all bacterial isolates. Furthermore, genomic DNA extraction was performed using the boiling method, followed by multiplex polymerase chain reaction (PCR) targeting the AcrAB, MdtK, and TolC efflux pump genes. Results: Our findings revealed high prevalence rates: 94 (97.91%) for AcrAB, 92 (95.83%) for TolC, and 43(44.79%) for MdtK genes, indicating the widespread presence of efflux pump coding genes in K. pneumoniae isolates. Moreover, 92 isolates contained multiple studied genes. Conclusion: Efflux pump-mediated antibiotic resistance represents a significant challenge in the treatment of K. pneumoniae infections. This study highlights the urgent need for strategies to combat efflux pump-mediated resistance and preserve the efficacy of antibiotic therapies against this clinically important pathogen.