Molecular Detection of bla OXA-48 Carbapenemase in Uropathogenic Klebsiella pneumoniae Strains from Suez Canal University Hospital

Abstract

The emergence of multidrug resistant Klebsiella pneumoniae (K. pneumoniae) is a new storm of antibiotic resistant threats. With the rise of resistance to carbapenems, antibiotics of last choice, the problem is reaching life-threatening scopes. Objective: our aim of this study was to make recommendations for the identification and detection of Klebsiella Producing Carbapenemases (KPC) to improve patient management and antimicrobial stewardship. Methodology: this study included 120 consecutive and non-duplicate clinical strains of K. pneumonia isolated from cases of urinary tract infections. Phenotypic detection of ESBL and Carbapenemases production were performed. Identification of class D carbapenemases by 16S rRNA gene sequence was done. Carbapenem resistance bla OXA-48 gene was detected using conventional PCR. Results: Phenotypic tests show 57 strains (47.5%) were carbapenem resistance (p value = 0.002) and 47 strains (39.1%) were ESBL producers (p value = 0.001). By 16S rRNA sequencing analysis, most of class D carbapenemases were K. pneumonia (17 strains out of 20 strains). Two strains were K. oxytoca and the other strain was Bacillus cereus. Among class D carbapenemase resistant K. pneumonia identified by 16S rRNA sequencing, PCR for bla OXA-48 gene produced amplified product of 744 bp and was positive in 10 isolates (58.8%). All these isolates were ESBL producers by phenotypic tests and resistant to ciprofloxacin, levofloxacin, gentamycin and amikacin. Conclusion: There are high frequencies of both carbapenem resistance (47.5%) and ESBL production (39.1%) among K. pneumoniae isolates. Effective infection control and strict antimicrobial stewardship are decisive basics to limit the spread of resentence genes.

Phenotypic methods for detection of Beta Lactam resistance in Klebsiella pneumoniae

“…On the other hand this disagreed with other Egyption studies conducted at Suez canal university. 33 and at Mansoura university 34 .…”