Evaluation of antibiotic resistance patterns in clinical isolates of Klebsiella pneumoniae in Bangladesh

Aminul, Parama; Anwar, Shaheda; Molla, Md. Maruf Ahmed; Miah, Md. Ruhul Amin

doi:10.1016/j.bsheal.2021.11.001

Cited by 18 publications

(8 citation statements)

References 33 publications

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“…A nationwide AMR surveillance study in Bangladesh reported K. pneumoniae to be the third most abundant organism recovered from the clinical specimens, preceded by E. coli and pseudomonas species ( Habib et al, 2021 ). Other in-country reports suggest the proportion of MDR K. pneumoniae has increased to over 80% ( Ahmed et al, 2019 ; Aminul et al, 2021 ; Habib et al, 2021 ); this has driven the use of carbapenem as a drug of choice for treating MDR K. pneumoniae infections ( Habib et al, 2021 ). Consequently, high carbapenem resistance rates were also reported from Bangladesh ( Habib et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Genome dynamics of high-risk resistant and hypervirulent Klebsiella pneumoniae clones in Dhaka, Bangladesh

et al. 2023

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Klebsiella pneumoniae is recognized as an urgent public health threat because of the emergence of difficult-to-treat (DTR) strains and hypervirulent clones, resulting in infections with high morbidity and mortality rates. Despite its prominence, little is known about the genomic epidemiology of K. pneumoniae in resource-limited settings like Bangladesh. We sequenced genomes of 32 K. pneumoniae strains isolated from patient samples at the International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b). Genome sequences were examined for their diversity, population structure, resistome, virulome, MLST, O and K antigens and plasmids. Our results revealed the presence of two K. pneumoniae phylogroups, namely KpI (K. pneumoniae) (97%) and KpII (K. quasipneumoniae) (3%). The genomic characterization revealed that 25% (8/32) of isolates were associated with high-risk multidrug-resistant clones, including ST11, ST14, ST15, ST307, ST231 and ST147. The virulome analysis confirmed the presence of six (19%) hypervirulent K. pneumoniae (hvKp) and 26 (81%) classical K. pneumoniae (cKp) strains. The most common ESBL gene identified was blaCTX-M-15 (50%). Around 9% (3/32) isolates exhibited a difficult-to-treat phenotype, harboring carbapenem resistance genes (2 strains harbored blaNDM-5 plus blaOXA-232, one isolate blaOXA-181). The most prevalent O antigen was O1 (56%). The capsular polysaccharides K2, K20, K16 and K62 were enriched in the K. pneumoniae population. This study suggests the circulation of the major international high-risk multidrug-resistant and hypervirulent (hvKp) K. pneumoniae clones in Dhaka, Bangladesh. These findings warrant immediate appropriate interventions, which would otherwise lead to a high burden of untreatable life-threatening infections locally.

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Section: Introductionmentioning

confidence: 99%

Genome dynamics of high-risk resistant and hypervirulent Klebsiella pneumoniae clones in Dhaka, Bangladesh

et al. 2023

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“…was most prominent in urine, sputum, and throat and was resistant to Doxycycline (27.3%), Cefixime (13.6%), Cefuroxime (13.6%), Ceftazidime (13.6%), Ciprofloxacin (13.6%), Levofloxacin (13.6%), Ampicillin (13.6%), Imipenem (13.6%), and Meropenem (13.6%). Aminul et al (2021) stated Klebsiella isolates from clinical specimens exhibited significant resistance against aminoglycosides, β-lactam antibiotics, Carbapenem, Ciprofloxacin, Cotrimoxazole, Piperacillin, and Tazobactam [17]. Clinical Klebsiella isolates were found to be resistant, ranging from 65 to 79%, against Cefepime, Cefixime, Cefuroxime, Cefotaxime, Ceftazidime, and Ceftriaxone by Tanniet al (2021) [18].…”

Section: Discussionmentioning

confidence: 99%

Isolation, Identification and Antibiotic Resistance of Different Clinical Isolates in Savar Area, Bangladesh

Fayez Ahmed,

Najmun Nahar,

Tanvir Ahmed

et al. 2023

biosight

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Introduction: The rise of multidrug-resistant (MDR) microorganisms, which pose a grave threat, has made choosing antibiotics to treat bacterial infections incredibly challenging. The prescription antibiotics have to consistently be effective against the identified related infections. Thus the research team wanted to find the antibiotic sensitivity profiles and pathogenic bacterial isolates in various patient specimens. Methods: The collection of 403 clinical samples of throat swabs, sputum, blood, stool, and urine from people of both genders and various ages was performed aseptically. Identification was carried out by microscopic, cultural, biochemical, and serological analysis. Finally, the disk diffusion method by Kirby-Bauer was employed to determine antibiotic responsiveness profiling. Results: A total of 93 samples (23.08%) were identified as positive isolates comprising 28.74% (25/87) of urine culture, followed by 24.32% (27/111) of blood, 23.08% (15/65) of stool, 20% (07/35) of throat swabs, and 18.1% (19/105) of sputum culture. Gram-negative bacteria 81(87.1%) showed more prevalence than Gram-positive bacteria 12 (12.90%). The most frequently identified isolates were Klebsiella spp. (24%), Salmonella spp. (23%), E. coli (17%), Pseudomonas spp. (5%), and Enterococcus spp. (3%). The infections showed more prevalence within the age group of 16-46 years (60.2%) and among males (48%) than females (46%). Conclusions: It was found that E. coli was the most abundant bacteria isolated from urine, Klebsiella spp. was the most abundant bacteria isolated from sputum and throat swabs, and Shiga toxin-producing Escherichia coli was the most abundant bacteria isolated from stool. Amikacin, Ciprofloxacin, Gentamicin, Imipenem, and Levofloxacin were considerably effective antibiotics, whereas Cefotaxime, Ceftazidime, Cefuroxime, Mecillinam, and Meropenem were least effective.

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“…Recently, K. pneumoniae of MDR as well as those with carbapenem-resistance have developed as main public health dilemma in the world [24]. The pathogenicity of K. pneumoniae is attributed to numerous virulence factors, such as its capability to readily acquire multiple antibiotics resistance [25]. This bacterium has evolved many mechanisms to avoid β-lactam drugs, including cephalosporins, penicillins and carbapenems.…”

Section: Sadeq and Laftamentioning

confidence: 99%

Tigecycline is the Most Effective against Multi-Drug Resistant Klebsiella pneumoniae Recovered from Burn Wound Infections in Two Hospitals in Al-Kut City, Iraq

Sadeq,

Lafta

2024

Iraqi Journal of Science

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Klebsiella pneumoniae is among the most frequent microorganisms isolated from infections of burn wounds. This cross-sectional study aimed to investigate the distribution of multi-drug resistant (MDR) K. pneumoniae in two burn hospitals and the antibiotic resistance profile in different burn regions of the same patient. It was performed in two hospitals (Al-Zahraa and Al-Karama) in Al-Kut, Iraq, between January and May 2022. Totally, 100 burn swabs were collected from 40 patients of both genders suffering from burn wound infections, with ages ranging between 3 and 50 years. Klebsiella pneumoniae were isolated and identified using conventional methods followed by VITEK®2 system and confirmed via polymerase chain reaction targeting the gapA gene. Then, the antimicrobial susceptibility pattern was studied by the VITEK®2 system. Of the 100 burn wound swabs, 20 isolates were K. pneumoniae. Fifty five percent (11 out of 20) of K. pneumoniae isolated in the current study were MDR and 35% of the isolates had the extended spectrum beta-lactamase (ESBL) which is the main antibiotic resistance mechanism. Furthermore, the bacteria isolated from different burned areas of the same patient showed variable pattern of antibiotic susceptibility. To conclude, K. pneumoniae contaminating the burn wards in the Iraqi hospitals are mostly MDR, against which tigecycline is the most effective antibiotic.

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Evaluation of antibiotic resistance patterns in clinical isolates of Klebsiella pneumoniae in Bangladesh

Cited by 18 publications

References 33 publications

Genome dynamics of high-risk resistant and hypervirulent Klebsiella pneumoniae clones in Dhaka, Bangladesh

Genome dynamics of high-risk resistant and hypervirulent Klebsiella pneumoniae clones in Dhaka, Bangladesh

Isolation, Identification and Antibiotic Resistance of Different Clinical Isolates in Savar Area, Bangladesh

Tigecycline is the Most Effective against Multi-Drug Resistant Klebsiella pneumoniae Recovered from Burn Wound Infections in Two Hospitals in Al-Kut City, Iraq

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