Epidemiological study of carbapenem-resistant Klebsiella pneumoniae

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_med-2018-0070_s_005_w2aab3b8d481b1b7b1aab1c16b1Aa"><jats:title>Background</jats:title><jats:p>This research is aimed to study the resistance and molecular epidemiological characteristics of carbapenem-resistant <jats:italic>Klebsiella pneumoniae</jats:italic> (CRKP).</jats:p></jats:sec><jats:sec id="j_med-2018-0070_s_006_w2aab3b8d481b1b7b1aab1c16b2Aa"><jats:title>Methodology</jats:title><jats:p>38 isolated CRKP strains were collected from clinical specimens.</jats:p></jats:sec><jats:sec id="j_med-2018-0070_s_007_w2aab3b8d481b1b7b1aab1c16b3Aa"><jats:title>Results</jats:title><jats:p>The resistance rates were more than 70.0%. Ampicillin had the highest rates among them (100.0%). 34 strains (89.5%) among the 38 CRKP strains carried <jats:italic>bla</jats:italic><jats:sub>KPC-2</jats:sub> gene, and 3 strains (7.9%) carried <jats:italic>bla</jats:italic><jats:sub>IMP-4</jats:sub> gene. 36 strains (94.7%) among the 38 CRKP strains carried <jats:italic>bla</jats:italic><jats:sub>SHV</jats:sub> gene, 29 strains (76.3%) carried <jats:italic>bla</jats:italic><jats:sub>TEM</jats:sub> gene, and 26 strains (68.4%) carried <jats:italic>bla</jats:italic><jats:sub>CT-M</jats:sub> gene. 7 strains (18.4%) among the 38 CRKP strains carried <jats:italic>bla</jats:italic><jats:sub>DHA-1</jats:sub> gene. 15 strains (39.5%) in 38 CRKP strains lost two fenestra proteins, ompK35 and ompK36, and the rest 23 strains carried ompK36 genes. 38 CRKP strains were divided into five kinds of ST types, with ST11 type as the most (86.8%, 33/38). The rest of the ST types included 2 strains of ST23 (5.3%, 2/38), one strain of ST15, ST1373 and ST1415 (2.6%, 1/38).</jats:p></jats:sec><jats:sec id="j_med-2018-0070_s_008_w2aab3b8d481b1b7b1aab1c16b4Aa"><jats:title>Conclusions</jats:title><jats:p>CRKP resistance is severe, and the mechanism of drug resistance has become increasingly complex. Various ST types and resistance genes are related to CRKP. The clinical prevention and control work is imminent.</jats:p></jats:sec>

Detection of plasmid-mediated colistin resistance in carbapenem-resistant Escherichia coli and Klebsiella pneumoniae isolates in Suez Canal University Hospitals

“…It showed 100% resistance to βlactam antibiotics due to ESBL production, while gentamycin, amikacin, levofloxacin and cefipime showed 51.3%, 63%, 79.5% and 87.7% resistance respectively. In a study done by Lin et al [22] antibiotic susceptibility to carbapenem-resistant isolates showed resistance to amikacin 55.3%, ciprofloxacin 84.2%, amoxicillin/Clavulanic acid 97.4% and cefipime 97.4% which showed accordance with our results. Also a study done in Egypt in El-Mansoura University by Moemen and Masallat [23] reported high resistance among the carbapenem-resistant isolates as it showed ESBL production in 97.6%, amikacin 52.4%, ciprofloxaxin 95.2%.…”

Detection of carbapenem resistant Klebsiella species isolated from clinical samples

“…Similar to our study, it was found in a research that all 38 experimental isolates have been resistant to beta-lactam antibiotics in which 37 strains out of 38 experimental isolates were resistant to imipenem which was also confirmed by genotypic characterization of carbapenemase gene. [14].…”

Prevalence of Carbapenem-Resistant Hypervirulent Klebsiella pneumoniae and Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae in China Determined via Mouse Lethality Tests

“…In this study, only two bla KPC (+)-HvKP strains, but no Hv- bla KPC (+)-KP strains, were eventually confirmed using a mouse lethality test, showing a rate of 0.5% (2/436) for CR-HvKP which was far lower than that reported in other studies ( Zhang et al, 2020 ; Hu et al, 2021 ). Owing to the predominance of KPC-induced carbapenem resistance ( Lin et al, 2018 ), the actual prevalence of CR-HvKP should be approximately 0.5–1.0% in mainland China in 2017. The considerable difference in prevalence rates determined between this study and other reports highlights the need to elucidate why such biomarkers are not reliable and the difference between mouse and G. mellonella lethality tests.…”

“…The frequent use of antimicrobials has resulted in the development of carbapenem-resistant K. pneumoniae (CRKP) strains which first emerged in 1996 ( Yigit et al., 2001 ). CRKP strains generally contain mobile genetic elements harbouring a variety of antimicrobial resistance genes, including beta-lactamase K. pneumoniae carbapenemase gene (bla KPC ), New Delhi metallo-β-lactamase gene ( bla NDM ), and oxacillinase-48 gene ( bla OXA-48 ) ( Lee et al, 2016 ; Zhang et al, 2015 ), among which bla KPC has been found to be shared in approximately 78.6% (44/56) ( Lin et al, 2020 ) and 89.5% (34/38) of isolates in two studies ( Lin et al, 2018 ). CRKP strains account for over 30.0% of K. pneumoniae strains and present great challenges in clinical practice ( Effah et al., 2020 ).…”