Detection of carbapenem resistant Klebsiella species isolated from clinical samples

Abstract

The dissemination of carbapenem resistance among the family of Enterobacteriaceae is one of the most potent intimidation to an individual's health nowadays. In this research, the foremost focus is on carbapenemase-producing Klebsiella species. Carbapenems are a genre of betalactam ring containing antibiotics which includes meropenem imipenem, ertapenem, biapenem, doripenem & panipenem. Carbapenems are highly effective antibiotics as they arrest the cell wall of bacteria so if the resistance against carbapenem emerges than it will subsequently lead to narrow therapeutic options. The foremost purpose of this research is the determination of carbapenem resistance among Klebsiella species. Fifty (n=50) gram-negative samples were collected from the Centralized Diagnostic Laboratory of Karachi, Pakistan. All the samples were sub-cultured on EMB (eosin methylene blue) agar to differentiate them from other Enterobacteriaceaes. MacConkey agar was used to check lactose fermentation. Gram staining and capsule staining for morphological identification, biochemical tests (Indole, Methyl red, Voges Proskauer, Citrate, (IMViC), Triple Sugar Iron (TSI)) were carried out to differentiate among Klebsiella species. Carbapenem resistance against Imipenem and Meropenem was identified by the disc diffusion method based on the Clinical Laboratory Standard Institute (CLSI) guidelines. Out of which 26 isolates were identified as Klebsiella spp. In these 26 isolates, 10 isolates were identified as Klebsiella pneumoniae. Further results showed that K. pneumoniae isolates were more resistant to Meropenem as compared to the Imipenem. All ten isolates of K. pneumoniae were found resistant to Meropenem while only two isolates of K. pneumoniae were resistant to Imipenem. This study was done to determine the carbapenem resistance among Klebsiella so that data can be provided which will help in rapid and appropriate treatment of patients so that in the future we can use alternative drugs or cocktail of drugs to treat infections caused by Klebsiella.

Molecular Characterization of Multidrug-Resistant Klebsiella pneumoniae Isolated from Some Hospitals in Benghazi, Libya

“…Up to 10% of nosocomial infections are caused by the Gram-negative encapsulated bacteria Klebsiella pneumoniae, or KP. It is increasingly linked to invasive infections that have significant morbidity and mortality rates [1]. The opportunistic pathogen; k. pneumoniae is a member of the Enterobacteriaceae family, that has emerged as major clinical problem causing both hospital-associated and community -acquired infections due to the rising prevalence of multidrugresistant strains(MDR) [2,3].…”

“…One pathway involves the expression of (ESBLs) that contributes to produce resistance in K. pneumoniae against cephalosporin and monobactam. Another extremely worse resistance mechanism is that the expression of carbapenemases by K. pneumoniae, which contribute to resistance of K. pneumoniae against most offered β-lactams as well as the carbapenems [1]. In addition, K. pneumoniae has been reported to be the most common pathogenic bacteria to develop resistance to broad-spectrum beta-lactam antibiotics via (ESBL).…”