Abstract
Klebsiella pneumoniae has been identified as an opportunistic pathogen associated with both community-acquired and nosocomial infections mainly among patients admitted to the Intensive care units (ICUs). Some resistant genes were transferred vertically or horizontally within many microbial communities, directly between bacteria through plasmids or integrin. Different techniques including; phenotypic and genetic ones were used to evaluate the presence of β-lactamases among the isolated strains of K. pneumoniae. This bacterial species is the most commonly isolated pathogen (95 isolates) from all the examined samples (51.35%). Current results revealed that 30 and 14 strains of K. pneumoniae are positive to Extended spectrum β-lactamase (ESBL) production, and AmpC β-lactamase producers, respectively. On the other hand, modified carbapenem inactivation and modified Hodge test (MHT) were used to assess the carbapenem resistant strains. It is observed that all the β-lactamase producers’ strains are also carbapenemase producers, whereas only nine strains (30%) are MHT positive. The Polymerase Chain Reaction (PCR) technique revealed that TEM, BETA, NDM and IPM genes are found on the bacterial plasmid (100%). However the presence of the β-lactamase genes on the bacterial DNA varied among the different strains. The presence of the resistance genes on the bacterial plasmid may signify the resistance acquired upon the previous exposure of this bacterium to the different antibiotics. The aims of the current work were to isolate K. pneumonia from Al-Shatby hospital ICUs, to determine the incidence of its β-lactamases, and to decide the frequency of acquisition of 12 different genes among ESBL K. pneumoniae isolates.
Highlights
During the past decades, the emerging problem of ESBL producing bacteria has received a great attention
This study aimed to evaluate the incidences of the resistant Multi drug resistant (MDR), ESBL, and carbapenem-resistant Klebsiella pneumoniae (CRKP) genes of the K. pneumoniae isolates recovered from the Intensive care units (ICUs) of AlShatby Pediatric Hospital, Alexandria, Egypt
The Vitek 2 and RapIDTM one systems were used for identification of Klebsiella sp., and they confirmed their identification as K. pneumoniae with > 99.9% confidence level
Summary
The emerging problem of ESBL producing bacteria has received a great attention. Doi et al, (2013) reported that the most commonly important ways by which the Gramnegative bacteria can resist β-lactam antibiotics are through the production of enzymes (β-lactamase enzymes) capable of hydrolyzing the β-lactam ring of the antibiotics. Lutgring and Limbago, (2016) study revealed that the mechanisms of carbapenem resistance in the family Enterobacteriaceae are multifarious. They consist of βlactamases carbapenem hydrolyzing enzymes construction, and resistance in line for the combination of other factors including ESBLs or AmpC βlactamases hyper-production. The Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) can spread rapidly, and their detection may warrant implementation of more-intensive infection control interventions than would be employed for none-CP-CRE The Gram-negative βlactamases are regulated by several genes such as; blaCTX-M, blaTEM and blaSHV (Monstein et al, 2007)
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