Multidrug‐resistant Klebsiella pneumoniae in hospital‐acquired infections: Concomitant analysis of antimicrobial resistant strains

Abstract

Background Hospital‐acquired infections caused by K pneumoniae are difficult to eradicate since K pneumoniae carries resistance genes for many antimicrobials, including carbapenems. The study aimed to determine the prevalence of hospital‐acquired infections caused by multiple drug‐resistant K pneumoniae and identify carbapenem and fluoroquinolone resistance by phenotypic and genotypic methods amongst hospitalised patients. Methods Two hundred and fifty samples from patients with hospital‐acquired infections were included. Identification and susceptibility testing for K pneumoniae isolates was performed by standard methods. The detection of carbapenemase resistance (blaKPC, blaVIM‐1 and blaOXA‐48) and plasmid‐mediated quinolone resistance (PMQR; qnrA, qnrB and qnrS) genes was performed using PCR assay. Results Out of 250 samples, 42 (16.8%) were multiple drug‐resistant K pneumoniae, and the frequency of K Pneumoniae isolation was higher in urine samples, in the age group (<10 years), in ICU and in patients with longer hospital stay. Twenty‐four (57%) of the isolates were resistant to Meropenem, 13 (31%) were resistant to Imipenem and 35 (83.3%) were resistant to Ciprofloxacin. blaOXA‐48 gene was detected in 9 (21.4%) of isolates, and blaVIM‐1 gene was detected in 6 (14.3%) of isolates. However, no isolate harboured blaKPC gene. PMQR genes were detected in 100% of ciprofloxacin resistant isolates, and qnrS was the dominant. Conclusion Multidrug‐resistant K pneumoniae isolates harbouring blaOXA‐48, blaVIM‐1 and PMQR genes are emerging in hospitals particularly with long hospital stays.

Prevalence and molecular characteristics of ESBL and AmpC β -lactamase producing Enterobacteriaceae strains isolated from UTIs in Egypt

“…ESBL producing Enterobacteriaceae isolates showed higher rates of resistance to all studied antimicrobials compared to the non-ESBL-producing isolates except for imipenem, where all tested isolates were imipenem-sensitive, that agrees with other Egyptian studies [30,33]. On the other context, a recent study from our region reported that, (31%) of K. pneumoniae isolated from hospital infections were resistant to imipenem [41]. Although MDR rate among ESBL producers in the current study (28.5%) was lower than that reported in previous studies; (96.3%) [36] and (77.6%) [40], there was statistically significant increase in MDR rate reported in the ESBL-producers (28.5%) than that reported in the non-ESBL-producers (1.5%) (p value = 0.04).…”

Characteristics of Carbapenem-Resistant Gram-Negative Bacilli in Patients with Ventilator-Associated Pneumonia

“…However, our findings were higher than the incidence observed by Khairy et al in Minia, Egypt. Their study showed that (37.5%) of patients were reported with a length of hospital stay (LOS) >10 days, followed by (28.2%) with 8–10 days [ 18 ]. This may be attributable to the spread of resistant strains of K. pneumonia among VAP patients and the improper use of combined antibiotics as empirical treatment.…”

Emergence of Hypervirulent Carbapenem-Resistant Klebsiella pneumoniae Coharboring a bla NDM-1 -Carrying Virulent Plasmid and a bla KPC-2 -Carrying Plasmid in an Egyptian Hospital

“…KEYWORDS Klebsiella pneumoniae, NDM-1, KPC-2, hybrid plasmid, virulent plasmid, Egypt S everal studies have reported the emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in Egyptian hospitals (1)(2)(3)(4); however, to the best of our knowledge, the genetic basis and analysis of the plasmids associated with CR-hypervirulent K. pneumoniae (CR-HvKP) in Egypt have not been presented. Furthermore, carbapenem resistance has been reported to be associated with increased length of hospital stay and mortality of bloodstream infection (BSI) patients in low-and middle-income countries (5).…”