Department of Clinical Laboratory Sciences, College of Pharmacy, University of Anbar, Al-Anbar Governorate, Ramadi, Iraq.
Department of Microbiology, College of Medicine, University of Anbar, Al-Anbar Governorate, Ramadi, Iraq.
J Infect Public Health. 2024 Nov;17(11):102544. doi: 10.1016/j.jiph.2024.102544. Epub 2024 Sep 16.
An important chance of nosocomial acquired infections are caused by the opportunistic bacterium Klebsiella pneumoniae. Urine, wound, sputum, and blood samples were collected from all patients. This study aimed to detect the antibiotic resistance profile, the frequency of MDR, XDR, PDR, and detection of efflux pump and outer membrane permeability genes in K. pneumoniae isolates.
One hundred twenty samples were collected from patients who were admitted to the Ramadi Teaching Hospitals in Al-Anbar Governorate. Fifty five of K. pneumoniae strains were collected from patients. The VITEK®2 Compact B System was used to detect the antibiotic resistance pattern of studied bacteria. The isolates were classified as MDR, XDR, or PDR based on established guidelines. The data were analyzed using Clinical and Laboratory Standards Institute (CLSI) breakpoints. PCR was used to detect the efflux pumps and porins genes.
Out of the 120 samples studied, 45.83 % (55) tested positive for K. pneumoniae. The isolates displayed the greatest amount of resistance to cefazolin, ceftriaxone (98.2 %), ampicillin (100 %), and ceftazidime, cefepime (90.9 %). 20 % of the isolates were found to produce metallo-lactamases, and 41.81 % tested positive for extended-spectrum beta-lactamases. Overall, the rates of multi-drug resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) isolates were 57.2 %, 10.9 %, and 9.09 %, respectively. Additionally, the prevalence of efflux pump genes acrAB, mdtK, and tolC were 94.54 %, 14.54 %, and 89.09 %, respectively, while the porin-encoding genes ompK35 and ompK36 were found in 96.36 % and 98.18 % of the isolates.
This investigation concluded that the study isolates had a high degree of antibiotic resistance heterogenicity. High frequencies of resistance to ampicillin, cefazolin, and ceftriaxone are present in study isolates. Most strains were categorized as MDR strains, with six being XDR strains and five being PDR strains. One of the main routes of antibiotic resistance in multidrug-resistant K. pneumoniae strains is through the acrAB efflux system. The high prevalence of the acrAB, tolC, ompk35, and ompK36 genes were increases the ability of these isolates combat antimicrobial treatments.
机会致病菌肺炎克雷伯菌会导致医院获得性感染。从所有患者中采集尿液、伤口、痰液和血液样本。本研究旨在检测肺炎克雷伯菌分离株的抗生素耐药谱、MDR、XDR、PDR 频率以及外排泵和外膜通透性基因的检测。
从安巴尔省拉马迪教学医院住院患者中采集 120 份样本。从患者中采集了 55 株肺炎克雷伯菌。使用 VITEK®2 Compact B 系统检测研究细菌的抗生素耐药模式。根据既定指南将分离株分类为 MDR、XDR 或 PDR。使用临床和实验室标准协会 (CLSI) 临界点分析数据。使用 PCR 检测外排泵和孔蛋白基因。
在所研究的 120 个样本中，45.83%（55 个）检测出肺炎克雷伯菌阳性。分离株对头孢唑林、头孢曲松（98.2%）、氨苄西林（100%）和头孢他啶、头孢吡肟（90.9%）的耐药性最强。20%的分离株产生金属内酰胺酶，41.81%检测出超广谱β-内酰胺酶阳性。总体而言，多药耐药（MDR）、广泛耐药（XDR）和泛耐药（PDR）分离株的发生率分别为 57.2%、10.9%和 9.09%。此外，外排泵基因 acrAB、mdtK 和 tolC 的流行率分别为 94.54%、14.54%和 89.09%，而孔蛋白编码基因 ompK35 和 ompK36 在 96.36%和 98.18%的分离株中均有发现。
本研究表明，研究分离株具有高度的抗生素耐药异质性。研究分离株对氨苄西林、头孢唑林和头孢曲松的耐药率很高。大多数菌株被归类为 MDR 菌株，其中 6 株为 XDR 菌株，5 株为 PDR 菌株。多药耐药肺炎克雷伯菌菌株中抗生素耐药的主要途径之一是通过 acrAB 外排系统。acrAB、tolC、ompK35 和 ompK36 基因的高流行率增加了这些分离株对抗抗菌药物治疗的能力。
