Journal of Angiotherapy
Angiogenesis, Inflammation & Therapeutics | Online ISSN  2207-872X
  1. You are here:
  2. Home
  3. Journals
  4. Biological Sciences
RESEARCH ARTICLE   (Open Access)
Contents Vol 8 (4)

A Molecular Resistance Mechanisms Detection in Klebsiella pneumoniae through Carbapenem Enzymatic Genes

Halah Raheem Mohammed Almidhatee 1*, Zainab Hayder Jaber Alkufaishi 2, Anwar Kadhim Hussein AL-saffar 3, Jwan Ahmed Ali Alhamawandi 4

+ Author Affiliations

Journal of Angiotherapy 8 (4) 1-8 https://doi.org/10.25163/angiotherapy.849602

Submitted: 05 February 2024 Revised: 02 April 2024  Published: 08 April 2024 

Abstract

Background: Klebsiella pneumoniae, a Gram-negative bacterium, shows significant challenges in healthcare due to its high virulence and antibiotic resistance. The spread of carbapenem resistance, particularly mediated by enzymes like Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-beta-lactamase (NDM), further complicates treatment options. Methods: Clinical specimens (n=300) were collected from Hilla Hospital in Iraq between March 2023 and September 2023. Klebsiella pneumoniae isolates were identified using culture methods and molecular techniques, followed by antimicrobial susceptibility testing (AST) using the Disk Diffusion Test (DDT) and genetic detection of resistance mechanisms through PCR. Results: In the study, among 25 Klebsiella pneumoniae isolates from clinical specimens, significant antibiotic resistance was observed, particularly against β-lactams, aminoglycosides, and fluoroquinolones. Piperacillin and carbenicillin exhibited the highest resistance rates at 80% and 81.2%, respectively. Resistance to imipenem and meropenem was 8.4% and 19.8%, respectively, while gentamicin (82%), amikacin (72.6%), cefepime (60.8%), cefotaxime (70.2%), ceftazidime (70.2%), and ceftriaxone (71.6%) also showed notable resistance. Molecular analysis via PCR revealed the presence of 16S rRNA gene in all isolates, indicating bacterial diagnosis. bla-NDM was the predominant MBL gene, present in 48% of isolates, followed by blaKPC in 72%, contributing to antibiotic resistance through beta-lactamase synthesis. Conclusion: Klebsiella pneumoniae strains, especially those carrying carbapenemase genes, exhibit widespread antibiotic resistance, limiting treatment options. Enhanced surveillance, molecular characterization, and infection control measures are essential for addressing the growing threat of antimicrobial resistance posed by Klebsiella pneumoniae, particularly strains producing blaKPC.

Keywords: Klebsiella pneumoniae, Carbapenem resistance, PCR detection, Antimicrobial susceptibility, Molecular characterization

References

Abdel-Halim, M. S., Askoura, M., Mansour, B., Yahya, G., & El-Ganiny, A. M. (2022). In vitro activity of celastrol in combination with thymol against carbapenem-resistant Klebsiella pneumoniae isolates. The Journal of Antibiotics, 75(12), 679-690.‏

Abdulah Y. Al-Mahdi, Alabed Ali A. Alabed, Mohammed Faez Baobaid et al., (2024). Antibacterial Activity of Herbal Essential Oils against Gram-positive and Gram-negative Bacteria with a Potential for Multidrug Resistance, Journal of Angiotherapy, 8(2), 1-7, 9517

Ahmadi, M., Ranjbar, R., Behzadi, P., & Mohammadian, T. (2022). Virulence factors, antibiotic resistance patterns, and molecular types of clinical isolates of Klebsiella Pneumoniae. Expert Review of Anti-infective Therapy, 20(3), 463-472.‏

Ahmadi, Z., Noormohammadi, Z., Ranjbar, R., & Behzadi, P. (2022). Prevalence of tetracycline resistance genes tet (A, B, C, 39) in Klebsiella pneumoniae isolated from Tehran, Iran. Iranian Journal of Medical Microbiology, 16(2), 141-147.‏

Ahmed Hasan, S., T Raheem, F., & Mohammed Abdulla, H. (2021). Phenotypic, antibiotyping, and molecular detection of Klebsiella pneumoniae isolates from clinical specimens in Kirkuk, Iraq. Archives of Razi Institute, 76(4), 1061-1067.‏

Al Balushi, M., Kumar, R., Al-Rashdi, A., Ratna, A., Al-Jabri, A., Al-Shekaili, N., ... & Al-Jardani, A. (2022). Genomic analysis of the emerging carbapenem-resistant Klebsiella pneumoniae sequence type 11 harbouring Klebsiella pneumoniae carbapenemase (KPC) in Oman. Journal of Infection and Public Health, 15(10), 1089-1096.‏

Aminul, P., Anwar, S., Molla, M. M. A., & Miah, M. R. A. (2021). Evaluation of antibiotic resistance patterns in clinical isolates of Klebsiella pneumoniae in Bangladesh. Biosafety and Health, 3(06), 301-306.‏

Ben Sallem, R., Laribi, B., Arfaoui, A., Ben Khelifa Melki, S., Ouzari, H. I., Ben Slama, K., ... & Klibi, N. (2022). Co-occurrence of genes encoding carbapenemase, ESBL, pAmpC and non-β-Lactam resistance among Klebsiella pneumonia and E. coli clinical isolates in Tunisia. Letters in Applied Microbiology, 74(5), 729-740.‏

Bunyan, I. A., & Al-Salem, H. L. (2022). Gene Sequencing of ENTB Gene Among Klebsiella Pneumonia Isolates from Different Site of Infection. Journal of Complementary Medicine Research, 13(1), 107-107.‏

Chew, K. L., Octavia, S., Lai, D., Lin, R. T., & Teo, J. W. (2021). Genomic characterization of Klebsiella quasipneumoniae from clinical specimens in Singapore. Antimicrobial Agents and Chemotherapy, 65(8), 10-1128.‏

El-Badawy, M. F., Tawakol, W. M., El-Far, S. W., Maghrabi, I. A., Al-Ghamdi, S. A., Mansy, M. S., ... & Shohayeb, M. M. (2017). Molecular identification of aminoglycoside-modifying enzymes and plasmid-mediated quinolone resistance genes among Klebsiella pneumoniae clinical isolates recovered from Egyptian patients. International journal of microbiology, 2017.‏

El-Domany, R. A., Awadalla, O. A., Shabana, S. A., El-Dardir, M. A., & Emara, M. (2021). Analysis of the correlation between antibiotic resistance patterns and virulence determinants in pathogenic Klebsiella pneumoniae isolates from Egypt. Microbial Drug Resistance, 27(6), 727-739.‏

El-Tawab, A., Soliman, E., El-Dahshan, E. S., & El-Bery, A. (2022). Molecular studies on some antibiotic-resistant genes of Klebsiella species isolated from chicken. Benha Veterinary Medical Journal, 41(2), 1-5.‏

Fatima, S., Liaqat, F., Akbar, A., Sahfee, M., Samad, A., Anwar, M., ... & Khan, A. (2021). Virulent and multidrug-resistant Klebsiella pneumoniae from clinical samples in Balochistan. International Wound Journal, 18(4), 510-518.‏

Güzel, M., Duygu, Ö. C. A. L., Önder, I. T., Akdogan, D., Erdem, G. B., & Akpinar, O. (2022). Comparison of in Vitro Antimicrobial Efficacy of Ceftolozane-Tazobactam and Ceftazidime-Avibactam Combination Against Carbapenem-Resistant Enterobacteriaceae Species Isolated from Various Clinical Specimens. Konuralp Medical Journal, 14(1), 75-80.‏

Hiba Ahmed Jawade, Zahraa Yosif Motaweq, Hawraa Dheyaa Rasool et al. (2024). Study of Antibiotic Resistance in ESKAPE Bacteria Using β-lactamase and ESBL Genes, Journal of Angiotherapy, 8(3), 1-8, 9618

Hussein, N. H., Mohammed Kareem, S., Hussein AL-Kakei, S. N., & Taha, B. M. (2022). The predominance of Klebsiella pneumoniae carbapenemase (KPC-type) gene among high-level carbapenem-resistant Klebsiella pneumoniae isolates in Baghdad, Iraq. Molecular Biology Reports, 49(6), 4653-4658.‏

Indrajith, S., Mukhopadhyay, A. K., Chowdhury, G., Al Farraj, D. A., Alkufeidy, R. M., Natesan, S., ... & Muthupandian, S. (2021). Molecular insights of carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples. Journal of Infection and Public Health, 14(1), 131-138.‏

Karampatakis, T., Tsergouli, K., & Behzadi, P. (2023). Carbapenem-resistant Klebsiella pneumoniae: virulence factors, molecular epidemiology and latest updates in treatment options. Antibiotics, 12(2), 234.‏

Khalifa, S. M., Abd El-Aziz, A. M., Hassan, R., & Abdelmegeed, E. S. (2021). β-lactam resistance associated with β-lactamase production and porin alteration in clinical isolates of E. coli and K. pneumoniae. PLoS One, 16(5), e0251594.‏

Kudaer, N. B., Risan, M. H., Yousif, E., Kadhom, M., Raheem, R., & Salman, I. (2022). Effect of zinc oxide nanoparticles on capsular gene expression in Klebsiella pneumoniae isolated from clinical samples. Biomimetics, 7(4), 180.‏

Lagha, R., Abdallah, F. B., ALKhammash, A. A., Amor, N., Hassan, M. M., Mabrouk, I., ... & Gaber, A. (2021). Molecular characterization of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from King Abdulaziz Specialist Hospital at Taif City, Saudi Arabia. Journal of Infection and Public Health, 14(1), 143-151.‏

Lau, M. Y., Teng, F. E., Chua, K. H., Ponnampalavanar, S., Chong, C. W., Abdul Jabar, K., & Teh, C. S. J. (2021). Molecular characterization of carbapenem resistant Klebsiella pneumoniae in Malaysia hospital. Pathogens, 10(3), 279.‏

Mariam Ayad Abd, Sawsan Q. T. Al-Quhli, Mahir Ali Jassim, (2024). Salmonella Biofilms And Antibiotic Resistance Determination From Different Patient Types, Journal of Angiotherapy, 8(2), 1-11, 9502

Muntaha R. Ibraheem, Dhafar N. Al-Ugaili. (2024). Nanoparticle-Mediated Plasmid Curing in Combating Antibiotic Resistance in Pathogenic Bacteria, Journal of Angiotherapy, 8(3), 1-8, 9495

Nigiz, S., Hazirolan, G., Köseoglu Eser, Ö., & Gür, D. (2022). First Detection of Klebsiella pneumoniae Isolate Co-Harboring Fosfomycin Resistance Gene fosA3 and bla ctx-m Among Gram Negative Urine Isolates in a Turkish Hospital. Microbial Drug Resistance, 28(3), 317-321.‏

Robatjazi, S., Nikkhahi, F., Niazadeh, M., Amin Marashi, S. M., Peymani, A., Javadi, A., & Kashani, A. H. (2021). Phenotypic identification and genotypic characterization of plasmid-mediated AmpC β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in Iran. Current Microbiology, 78, 2317-2323.‏

Silva-Sanchez, J., Barrios-Camacho, H., Hernández-Rodriguez, E., Duran-Bedolla, J., Sanchez-Perez, A., Martínez-Chavarría, L. C., ... & Garza-Ramos, U. (2021). Molecular characterization of KPC-2-producing Klebsiella pneumoniae ST258 isolated from bovine mastitis. Brazilian Journal of Microbiology, 52, 1029-1036.‏

Soltani, E., Hasani, A., Rezaee, M. A., Nahandi, M. Z., Hasani, A., & Gholizadeh, P. (2022). An alliance of carbapenem-resistant Klebsiella pneumoniae with precise capsular serotypes and clinical determinants: A disquietude in hospital setting. Canadian Journal of Infectious Diseases and Medical Microbiology, 2022.‏

Zhao, S., Qiu, X., Tan, Y., Xu, M., Xu, X., Ge, Y., ... & Wu, Q. (2022). Genomic analysis and molecular characteristics in carbapenem-resistant Klebsiella pneumoniae Strains. Current Microbiology, 79(12), 391.‏

PDF
Abstract
Export Citation

View Dimensions


View Plumx


View Altmetric




Save
0
Citation
454
View

Share