The Situation of Antibiotic Resistance in Klebsiella Pneumoniae and Carbapenemase-Producing Klebsiella Pneumoniae in Vietnam: A Cross-Sectional Study

Abstract

Objective: Klebsiella pneumoniae (K. pneumoniae) is one of the most prevalent human pathogens. Carbapenemaseproducing klebsiella pneumoniae (CPKP) has recently developed significant antibiotic resistance, not just to carbapenem antibiotics but also to the majority of other currently available antibiotics. Prior to this point, there have been few international studies or publications on the situation of CPKP in Vietnam. Hence, this study was conducted to determine the antibiotic resistance of K. pneumoniae and CPKP strains in Can Tho, Vietnam. Material and Methods: In total, 345 K. pneumoniae strains were isolated. Antibiotic susceptibility was assessed via an automated microbiological system. A modified carbapenem inactivation assay was applied to identify CPKP strains, followed by the use of the MASTDISCS combi Carba plus disc system to classify certain carbapenemases. Results: Of the 345 K. pneumoniae strains, 110 represented an isolation rate of 31.9%. There was a significant correlation (p-value<0.05) between the specimen type, hospital unit and CPKP ratio. All the examined CPKP strains exhibited complete resistance to penicillin and cefazolin. The CPKP strains were also significantly more resistant to PTZ, cefepime, ciprofloxacin and imipenem than the non-CPKP strains (p-value<0.05). Amikacin, gentamicin and TMP/SMX have been shown to be effective in treating patients infected with CPKP strains. Conclusion: CPKP accounts for 31.9% of all K. pneumoniae infections. K. pneumoniae and CPKP exhibited the highest levels of resistance to ampicillin, cefazoline, ciprofloxacin, ceftriaxone and ceftazidime. Amikacin, gentamicin and TMP/ SMX were the least resistant antibiotics tested.

Keywords

• antibiotic resistance
• carbapenem resistance
• carbapenemase-producing klebsiella pneumoniae
• klebsiella pneumoniae
• vietnam