Investigation of Antibiotic Resistance and Biofilm Formation in Clinical Isolates of Klebsiella pneumoniae.

Kiana Karimi,Parinaz Sedighi,Leili Shokoohizadeh,Amin Doosti-Irani,Omid Zarei,Mohammad Taheri,Clemencia Chaves Lopez

doi:10.1155/2021/5573388

Abstract

Aim Klebsiella pneumoniae (K. pneumoniae) is an encapsulated Gram-negative bacterium that can lead to 14–20% of nosocomial infections. The ability of biofilm formation in this bacterium decreases the host immune response and antibiotic efficacy. This may impose a huge impact on patients and healthcare settings. This study aimed to evaluate the antibiotic resistance pattern and biofilm formation in K. pneumoniae strains isolated from two major Hamadan hospitals, west of Iran. Methods A total of 83 K. pneumoniae strains were isolated from clinical samples of patients in different wards of Hamadan hospitals from September 2018 to March 2019. Determination of antimicrobial susceptibility was performed using the disk diffusion method. Biofilm formation was evaluated by the crystal violet method. Data were analyzed by the SPSS software and chi-square test. Results The results showed that clinical samples included 18 urinary tract samples (22%), 6 wound samples (7%), 6 blood samples (7%), 17 tracheal tube aspiration samples (20%), 32 throat cultures (38%), 2 sputum samples (2.5%), and 2 abscess drain cultures (2.5%). High-level resistance to cefotaxime was detected in 92%, and all of isolates were susceptible to colistin. Biofilm formation was seen in 62 (75%) isolates. Strong biofilm formation was observed in 17 (20%) strains. A significant correlation was seen between biofilm formation and antibiotic resistance (P value <0.05). Conclusion Our findings emphasize the need for proper diagnosis, control, and treatment of infections caused by K. pneumoniae especially in respiratory tract infections due to the strong biofilm formation and high antibiotic resistance in these strains.

Highlights

Klebsiella pneumoniae (K. pneumoniae) is a Gram-negative, encapsulated, nonmotile, rod-shaped bacterium and an important member of Enterobacteriaceae which can lead to various infections including gastrointestinal, skin, nasopharyngeal, osteomyelitis, biliary and urinary tract infections, and bacteremia
K. pneumoniae, the highest antibiotic resistance was related to cefotaxime (92%), and all isolates were susceptible to colistin
Different antibiotic resistance patterns were detected in various clinical samples, for example, the highest resistance to amikacin, ceftazidime, and gentamicin was found in wound and blood samples and the highest antibiotic resistance to trimethoprim-sulfamethoxazole, tobramycin, cefotaxime, piperacillin-tazobactam, ampicillin-sulbactam, and meropenem was observed in urine samples

Summary

Introduction

Klebsiella pneumoniae (K. pneumoniae) is a Gram-negative, encapsulated, nonmotile, rod-shaped bacterium and an important member of Enterobacteriaceae which can lead to various infections including gastrointestinal, skin, nasopharyngeal, osteomyelitis, biliary and urinary tract infections, and bacteremia. Urinary tract infection (UTI) is known to be the most prevalent type of nosocomial infection, and. K. pneumonia is the second cause of urinary tract infections among other Gram-negative bacteria [4]. Extended-spectrum β-lactamase (ESBLs), part of group A beta-lactamases, can lead to the hydrolysis of broad-spectrum cephalosporin and lead to resistance to penicillin and cephalosporins. They can be inhibited by beta-lactamase inhibitors such as clavulanic acid [9, 10].

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