Prevalence and antimicrobial mechanism of carbapenem-resistant Klebsiella pneumoniae and its molecular properties

Abstract

Background: The carbapenem-resistant Klebsiella pneumoniae poses a serious threat to public health because carbapenems are used as a final resort to treat K. pneumoniae-mediated infections in humans. Methods: Samples were collected from various clinical specimens including skin swabs, anal swabs, wound swabs, oral swabs, and sputum by the standard method and K. pneumoniae strains were isolated. Biofilm-forming characters were determined. The antibiotic resistance pattern was analyzed by the Kirby–Bauer disk diffusion method. Carbapenem resistance properties were tested using the imipenem and meropenem antibiotics. The carbapenemase genes (blaKPC and blaNDM) were determined. Results: A total of 11 cephalosporin-resistant K. pneumoniae (CRKP) strains were isolated from the samples. The screened CRKP strains exhibited multi-drug resistance and non-susceptible to imipenem, ceftazidime, piperacillin, ceftriaxone, cefazolin, ampicillin, aztreonam, and cefotetan antibiotics. A total of 79.4 % K. pneumoniae isolates showed positive results on String-forming test. About 82.1 % of isolates showed mucoid colonies and 59 % of K. pneumoniae strains formed biofilm (p < 0.01). Out of 11 isolates, four strains exhibited Klebsiella pneumoniae carbapenemase type, three strains produced metallo-β-lactamases (MBL), and four strains exhibited as carbapenemase types. A total of 63.5 % Klebsiella pneumoniae carbapenemase-producing strains showed very low MIC value (<0.05 mg/L). Conclusions: Drug-resistance K. pneumoniae was isolated from clinical specimens that were screened. The continuous monitoring of drug-resistance genes are required to make policy decisions.

Keywords

• Klebsiella pneumoniae
• Carbapenem-resistant
• BlaKPC
• BlaNDM