Genotypic Characterization of Carbapenem-Resistant Klebsiella pneumoniae Isolated from an Egyptian University Hospital

Abstract

Globally, Klebsiella pneumoniae (K. pneumoniae) has been identified as a serious source of infections. The objectives of our study were to investigate the prevalence of multidrug-resistant (MDR) K. pneumoniae in Tanta University Hospitals, Gharbia Governorate, Egypt; characterize their carbapenem resistance profiles; and identify their different capsular serotypes. We identified and isolated 160 (32%) K. pneumoniae from 500 different clinical samples, performed antimicrobial susceptibility testing, and then used multiplex PCR to detect carbapenemase genes and capsular serotypes K1, K2, K3, K5, K20, K54, and K57. We detected phenotypic carbapenem resistance in 31.3% (50/160) of the isolates; however, molecular assays revealed that 38.75% (62/160) of isolates were carrying carbapenemase-encoding genes. Generally, blaOXA-48 was the prevalent gene (15.5%), followed by blaVIM (15%), blaIMP (7.5%), blaKPC (4%), and blaNDM (3.8%). BlaVIM and blaOXA-48 correlated with phenotypic resistance in 91.67% and 88% of the isolates that harbored them, respectively. Capsular typing showed that the most prevalent pathotype was K1 (30.6%), followed by K57 (24.2%), K54 (19.35%), K20 (9.67%), and K2 (6.45%). A critical risk to community health is posed by the high incidence of multidrug-resistant (MDR) virulent K. pneumoniae isolates from our hospital, and our study examines this pathogen’s public health and epidemiological risks.

Investigating the relationship between carbapenemase production and biofilm formation in Klebsiella pneumoniae clinical isolates

“…In this study, we found a low incidence (5.77%) of CP-Kp isolates that coharbored bla NDM-1 and bla KPC . These ndings are in accordance with previous studies conducted in Egypt, which report a low incidence (11.29%) (7 out of 62 isolates) [17] or absence [16] of the bla KPC gene in their CP-Kp isolates. This suggests that KPC is less prevalent in our geographic area.…”

“…These ndings are in line with other studies conducted in Egypt and other countries that reported the absence of these genes in their CP-Kp isolates [16,19]. However, in contrast to our ndings, some studies report a higher prevalence [17]. Here, we could not detect the presence of bla SPM in any isolate.…”

Molecular characterization of hypermucoviscous carbapenemase‐encoding Klebsiella pneumoniae isolates from an Egyptian hospital

“…The absence of such a correlation was discussed by Candan and Aksöz 90 in a study from Turkey. Furthermore, the absence of a correlation between the carbapenemases and capsular serotypes was documented by an Egyptian study of Taha et al 91 . Although Albasha et al 92 .…”

“…Furthermore, the absence of a correlation between the carbapenemases and capsular serotypes was documented by an Egyptian study of Taha et al 91 Although Albasha et al 92 found no association between antimicrobial resistance and virulence genes in K. pneumoniae isolated from Sudan, they identified a significant association between entB and bla NDM (p-value = 0.005).…”

Phenotypic, molecular, and in silico characterization of coumarin as carbapenemase inhibitor to fight carbapenem-resistant Klebsiella pneumoniae

“…Metallo β -lactamases (Class B) and oxacillinases (Class D) are considered the major contributors to carbapenem resistance [ 15 ]. In Egypt the most common carbapenemases are bla OXA followed by bla VIM and bla NDM [ 15 , 16 ]. The best way to overcome carbapenem resistance is to use combinations of carbapenem and β -lactamase inhibitors (BLI).…”