Nosocomial infections by Klebsiella pneumoniae carbapenemase producing enterobacteria in a teaching hospital (original) (raw)
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Microbes and Infectious Diseases, 2020
Background: Carbapenem-resistant Enterobacteriaceae (CRE) pose a great threat to the public health sector as a result of its high communicability, high morbidity and mortality rates. This study investigated the occurrence of carbapenem resistant Enterobacteriaceae and the prevalence of Klebsiella pneumoniae carbapenemase (KPC) producing Klebsiella pneumoniae as a mechanism of resistance. Method: One hundred and ten Enterobacteriaceae isolates were cultured from different samples of patients in Intensive Care Units of two hospitals. Using Clinical and Laboratory Standards Institute (CLSI) Guidelines of 2017. Carbapenemase production was determined phenotypically using Brilliance CRE agar, Carbapenem inactivation method and confirmed with Modified Hodge test (MHT). Modified Hodge test positive isolates were screened for KPC-producing Klebsiella pneumoniae using boronic acid-based inhibition test. Result: Phenotypic results revealed an occurrence of 10.9% (12/110) isolates for carbapenem resistant Enterobacteriaceae while KPC-producing Klebsiella pneumoniae prevalence was 3.6% contributing 33.3% to the burden of carbapenem production. The occurrence of carbapenem-resistant Enterobacteriaceae in this study was relatively high and KPC-Klebsiella pneumoniae had a significant contribution to the burden of CRE. Conclusion: Hence, a sinewy antibiotic stewardship is needed in this regard.
Microbiology Research, 2019
The emergence of Klebsiella pneumoniae carbapenemase (KPC) resistance has led to the countdown of activity of carbapenems, which were considered as drugs of last resort for infections caused by Enterobacteriaceae. The aims of the present study were the detection of KPC-production among K. pneumoniae isolates, select the appropriate method for its detection and assess the consequence of KPC production on the antibiotics susceptibility. One hundred and four non-duplicated K. pneumoniae isolates were collected from University teaching hospitals of Tabriz, Iran. The disk diffusion, E-test, and Modified Hodge test were performed for the determination of antibiotic susceptibility pattern, Minimum Inhibitory Concentrations (MICs) determination and the production of carbapenemase, respectively. BlaKPC-2 gene was detected by using PCR. High levels of resistance were observed towards co-trimoxazole (69.2%), followed by cefazolin (66.3%), ceftriaxone (65.4%), ofloxacin and ciprofloxacin (54.8%...
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Carbapenemases are one of the common β-lactamases seen in Klebsiella pneumoniae that are responsible for multi drug resistance. Detection of resistance in these bacteria is necessary for formulation of infection control policies. The hidden resistance of this bacteria is critical to diagnose. To address this problem, the present study aims to detect Carbapenemase production and antimicrobial susceptibility patterns in clinical isolates of Klebsiella pneumoniae at the present setting. Materials and Method: A total of 438 strains of Klebsiella pneumoniae were isolated and subjected to Carbapenemase detection by Screening method using Imepenem (10 µg) disc. Modified Hodge test and Combined disc diffusion test along with E-test was done to confirm carbapenemase production followed by antimicrobial susceptibility testing. E-test was considered to be gold standard. Results: Total 34/438 (7.76%) carbapenem resistant isolates were obtained. The carbapenemase positive isolates were predominantly isolated from Burns wards (14.61%). E-test considering it as gold standard test confirmed all 34 of these as carbapenemase producers. Out of 34, MHT detected 31and CDT detected 32 isolates as positive for carbapenemase production. They were highly resistant to cefotaxime, and ceftazidime (91.18%). Conclusion: Screening for Carbapenemase production needs to be carried out routinely in every clinical diagnostic facility. There is a need for rational use and strict adherence to the concept of " reserve drugs " to minimize the misuse of available antimicrobials. The findings of this study emphasize the need for a continuous surveillance in the ICUs and different hospital wards to detect the resistant strains.
A Study on Carbapenemase Producing Klebsiella Pneumoniae In Beni Suef University Hospital
International Journal of Scientific Research in Science and Technology, 2022
Background: Widespread dissemination of Klebsiella pneumoniae carbapenemase (KPC) is of major concern in healthcare settings. Resistance to carbapenems involves multiple mechanisms such as the production of carbapenemases, impermeability of outer membrane and efflux pump mechanism. Objective: The aim of this study was to evaluate the prevalence of carbapenemase-producing K. pneumoniae strains among various clinical specimens obtained from different wards and to detect KPC as a mechanism of resistance. Methods: 100 samples of urine and sputum (55 urine and 45sputum) were collected from outpatients and inpatients attending urology and chest departments in Beni Suef University Hospital aiming to isolate K.pneumniae during the period of December 2016 through January 2018. The isolates were tested for susceptability to ertapenem using E test. Resistant isolates were subjected to phenotypic detection of carbapenemase production by MHT and molecular assessment of KPC gene by PCR. Phylogentic tree was used to detect their relationship. Results: K.pneumonia were isolated from 31(31%) of the samples taken. Out of them 19(61.8%) were resistant to ertapenem. By MHT,17/19 (89.4%) were positive for carbapenemase; and only 13 out of them (76.4%) were confirmed as KPC by PCR. Conclusion: High rate of carbapenem- resistance in K. pneumoniae by both phenotypic and molecular methods. Initiating appropriate infection control measures along with a strictly implemented antibiotic stewardship program are necessary to prevent their spread.
2020
Background: The emergence of carbapenem-resistant Enterobacteriaceae made the treatment difficult, which has become a major issue of public health. A sharp increase of carbapenem-resistance rate in Klebsiella pneumoniae was observed in a maternity and child health care hospital in Zunyi, China, in 2014.To investigate the cause and epidemiology of the carbapenem-resistant Klebsiella pneumoniae (CRKp) in the affected hospital.Methods: In 2015-2016, CRKp isolated from all the clinical samples were analyzed to identify the carbapenem-resistance genes. They were then fingerprinted in order to determine their genetic relationship. Clinical data such as usage of imipenem in 2012-2016 and the nosocomial infection surveillance data were analyzedResults: Thirty five isolates of CRKp out of 4328 various pathogens were obtained and blaNDM-1 was identified to be the most common resistant gene present in the CRKp isolates. The fingerprint analysis identified 15 major clusters of CRKp isolates. Th...
Journal of Medical Microbiology, 2016
Resistance patterns and carbapenemase gene presence among Klebsiella pneumoniae isolates from the University General Hospital of Patras, Greece during a ten-year period were analysed under a surveillance programme for multi-drug-resistant bacteria. From 2005 to 2014, K. pneumoniae isolates from clinically significant specimens were identified by the Vitek 2 Advanced Expert System. Antibiotic susceptibility testing was performed by the agar disc diffusion method and Etest. The strains were tested for the presence of bla VIM , bla IMP , bla KPC , bla NDM and bla OXA-48 genes by PCR. PFGE of chromosomal Xbal DNA digests was performed. A total of 3449 K. pneumoniae isolates were recovered during the last decade. Among them, 1668 (48 %) were carbapenemase-producing: 1333 (80 %) K. pneumoniae carbapenemase (KPC)-, 286 (17 %) Verona imipenemase (VIM), 45 (3 %) KPC-and VIM-, and four New Delhi metallo-beta-lactamase (NDM)-producing. Their resistance rates to gentamicin, colistin and tigecycline were 41 %, 23 % and 16 %, respectively. VIM-producing K. pneumoniae were isolated in 2005 and since 2008 have been endemic. KPC-producing K. pneumoniae (KPC-Kp) isolates were introduced in 2008 and until now represent the predominant carbapenemase-producing K. pneumoniae in our institution. PFGE of 97 KPC-Kp strains identified three types: A, 84 (87 %); B, 11 (11 %); and E, two (2 %). Eleven co-producing KPC and VIM K. pneumoniae isolates belonged to PFGE B. The four NDM-positives were classified to type F. The number of K. pneumoniae bacteraemias increased during the study period, which may be solely attributed to the increase of carbapenemase-producing isolates. The threat of carbapenemase-producing K. pneumoniae emphasizes the urgent need for implementation of infection control measures and budgetary allocations to infection control.