Pathogens (Mar 2021)

Molecular Characterization of Carbapenem Resistant <i>Klebsiella pneumoniae</i> in Malaysia Hospital

  • Min Yi Lau,
  • Fui Enn Teng,
  • Kek Heng Chua,
  • Sasheela Ponnampalavanar,
  • Chun Wie Chong,
  • Kartini Abdul Jabar,
  • Cindy Shuan Ju Teh

DOI
https://doi.org/10.3390/pathogens10030279
Journal volume & issue
Vol. 10, no. 3
p. 279

Abstract

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The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is a great concern, as carbapenems are the last-line therapy for multidrug-resistant Gram-negative bacteria infections. This study aims to report the epidemiology of CRKP in a teaching hospital in Malaysia based on the molecular genotypic and clinical characteristics of the isolates. Sixty-three CRKP strains were isolated from a tertiary teaching hospital from January 2016 until August 2017. Carbapenemase genes were detected in 55 isolates, with blaOXA-48 (63.5%) as the predominant carbapenemase gene, followed by blaNDM (36.5%). At least one porin loss was detected in nine isolates. Overall, 63 isolates were divided into 30 clusters at similarity of 80% with PFGE analysis. Statistical analysis showed that in-hospital mortality was significantly associated with the usage of central venous catheter, infection or colonization by CRKP, particularly NDM-producers. In comparison, survival analysis using Cox proportional hazards regression identified a higher hazard ratio for patients with a stoma and patients treated with imipenem but a lower hazard ratio for patients with NDM-producing CRKP. OXA-48 carbapenemase gene was the predominant carbapenemase gene in this study. As CRKP infection could lead to a high rate of in-hospital mortality, early detection of the isolates was important to reduce their dissemination.

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