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

Identifying carbapenem resistance mechanisms in Klebsiella pneumoniae might be a treatment strategies against the rising antibiotic resistance globally.

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

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