Prevalence of antibiotic resistance and biofilm formation in Klebsiella pneumoniae carrying fimbrial genes in Egypt

Abstract

Biofilm formation is closely related to the pathogenic processes of Klebsiella pneumoniae, which frequently causes infections that are difficult to treat with antimicrobial agents. The aim of this study was to evaluate biofilm formation ability among clinical Klebsiella pneumoniae isolates from Egypt, and to study its antibiotic resistance, extended spectrum β-lactamases (ESBLs) production and fimbrial genes occurrence. A total of 90 clinical Klebsiella pneumoniae isolates were collected from different sources. Antimicrobial susceptibility, phenotypic and genotypic detection of ESBLs and biofilm assay were determined. SEM was applied to confirm K. pneumoniae biofilm formation. PCR assay was performed to investigate the distribution of fimbrial, as well as β-lactamases genes which were further confirmed by DNA sequencing. The results reveal high prevalence of multidrug resistance (86.66%) and biofilm formation ability (51%) among Klebsiella pneumoniae isolates. Furthermore, ESBL producing Klebsiella pneumoniae isolates had a higher ability to form a biofilm compared to non-ESBL forming ones. The occurrence of blaCTX-M and blaTEM among ESBLs-biofilm producers demonstrated high predominance of isolates harboring blaCTX-M. The distribution of fimbrial (mrkD and fimH) among biofilm former isolates were 100% and 86.95% respectively. The present study revealed high prevalence of multi-drug resistance (MDR) among Klebsiella pneumoniae in Egypt, in addition to biofilm formation, and also conclude that ESBL producing Klebsiella pneumoniae isolates had a higher ability to form a biofilm in comparison with non-ESBL forming ones. In addition, our study strongly supports that type 3 fimbriae strongly promote biofilm formation in Klebsiella pneumoniae.