The prevalence of antibiotic resistance genes of carbopenemases of the metallo-β-lactamase group in enterobacteria strains isolated from patients of a multidisciplinary hospital in a region with a developed petrochemical industry

Abstract

The research work included strains of Klebsiella pneumonaie (n = 128) isolated from patients of a multidisciplinary hospital in a large industrial city. The antibiotic sensitivity of the isolated pure cultures was studied in relation to the most popular antibacterial drugs in clinical practice (in the amount of 21), by the standard disco-diffusion method. Identification of resistance genes was carried out by PCR using commercial reagent kits «AmpliSens MDR-MBL-FL», «AmpliSens MDR-KPC/OXA-48‑FL». The results of determining the sensitivity of isolates isolated from the lower respiratory tract revealed low activity of amoxicillin/clavulanic acid, cephalosparins of the III and IV generation (ceftazidim, cefotaxime, cefepim). 86.7 % of isolates are resistant to the aminoglycoside group — amikacin, and 100 % are resistant to gentamicin. Meropenem was the most active of the carbapenem group — 26.6 %, about 7 % are sensitive to ertapenem. From the group of fluoroquinolones, the sensitivity varied from 20 to 30 %. The greatest activity of all drugs was shown by ticarcillin / clavulanate — 33.3 %. A high proportion of strains of Kl. pneumoniae with a phenotype of multiple resistance has been established. The identification of resistance genes made it possible to establish their diversity in antibiotic-resistant isolates, a high proportion (26.6 %) of multi-resistant strains with the absence of the studied genes, and the combination of VIM + NDM + OXA-48 genes, identified in every second studied strain, prevails. Thus, the analysis of the prevalence of antibiotic resistance genes of carbopenemases of the metallo- β-lactamase group in enterobacteria strains isolated from patients of a multidisciplinary hospital in a region with a developed petrochemical industry showed the predominance of isolates (53.9 %) with the production of a combination of three antibiotic resistance genes (VIM + NDM + OXA-48). Isolates containing two genes simultaneously (NDM + OXA-48 and VIM + OXA-48) identified in 7.8 and 6.3 %. Isolates containing a single gene (carbapenemase Kl. Pneumoniae) amounted to 5.4 %.