Association of Blaoxa-1 Gene with Multidrug Resistance in K. pneumoniae Clinical Isolates

Abstract

OBJECTIVES This study aimed to isolate K. pneumoniae from patients samples and find an association of the plasmid-mediated bla-OXA-1 gene with multidrug-resistant K. pneumoniae. METHODOLOGY This cross-sectional study was conducted at Mardan Medical Complex and Khyber Medical University Peshawar. K. pneumoniae was isolated from pus, urine and blood samples by culture and confirmed by biochemical techniques. Antibiotic susceptibility was done by disc diffusion according to the CLSI 2022 guidelines. A polymerase chain reaction was done for the gene after extraction and amplification of plasmid DNA. Furthermore, an association of antibiotic resistance was confirmed with blaOXA-1. RESULTSA total of 160 K. pneumoniae isolates were cultured from the patient’s samples, including pus (135, 84.37%), urine (15, 9.37%) and blood (10, 6.26%). There were 154 (96.3%) isolates resistant to Penicillin-G, followed by Ceftriaxone 151 (94.4%), Cefepime 143 (89.4%), Amoxicillin 125 (78.1%), Tigecycline 110 (68.8%), Imipenem 92 (57.6%) and Ertapenem 75(49.9%). However, Tetracycline had 1.9% resistance. The blaOXA-1 gene was positive in 41(25.62%) isolates with a different pattern of antibiotics resistance to Penicillin-G, Ceftriaxone, Cefepime, Amoxicillin, Tigecycline, Imipenem and Ertapenem as compared to the negative isolates. Among the blaOXA-1 gene-positive K. pneumoniae isolates, resistance to Penicillin-G was 100%, followed by Ceftriaxone (92.7%), Cefepime and Amoxicillin (80.5%), respectively. However, resistance to Imipenem and Ertapenem was 46.3% and 41.5%, respectively, and Tetracycline was not resistant. CONCLUSION Our data suggest that the presence of plasmid associated blaOXA-1 gene in K. pneumoniae isolates may contribute to multidrug resistance in beta lactamase-containing antibiotics along with other internal mechanisms of resistance present in these bacteria.