Makled Amal F, Labeeb Azza Z, Moaz Heba M, Sleem Asmaa S
Department of Medical Microbiology & Immunology, Faculty of Medicine, Menoufia University, Shibīn al Kom, Egypt.
BMC Infect Dis. 2025 May 7;25(1):670. doi: 10.1186/s12879-025-10980-w.
Hospital-acquired infections caused by multidrug resistant (MDR) Klebsiella pneumoniae pose a significant global health threat. Effective antisepsis and disinfection protocols are mandatory to prevent these infections. This study aimed to isolate Klebsiella pneumoniae, evaluate antimicrobial susceptibility, and assess the efficacy of selected biocides.
Fifty clinical MDR Klebsiella pneumoniae isolates were collected from various hospital departments. Antimicrobial susceptibility was determined using the disc diffusion method. Minimum inhibitory concentrations (MICs) of chlorhexidine and benzalkonium chloride were measured via agar dilution. Conventional PCR was employed to detect biocide resistance genes (qacE∆1 and cepA).
Klebsiella pneumoniae was identified in 19.16% of cases. All isolates exhibited multidrug resistance, with multiple antimicrobial resistance indices ranging from 0.24 to 0.92, reaching up to 1. Benzalkonium chloride MICs significantly increased with resistance, reaching up to 64 µg/mL, while chlorhexidine MICs were consistent across isolates. The qacE∆1 and cepA genes were detected in 62% and 72% of isolates, respectively, with a significant association between qacE∆1 and cephalosporin resistance. No significant correlation was found between biocide MICs and clinical specimen types or hospital units.
The cepA gene is closely associated with extensive drug resistance in Klebsiella pneumoniae, emphasizing its role in antimicrobial resistance. Optimized biocide formulations, when properly developed and applied, can play a crucial role in combating and preventing infections caused by multidrug-resistant Klebsiella pneumoniae.
多重耐药（MDR）肺炎克雷伯菌引起的医院获得性感染对全球健康构成重大威胁。有效的防腐和消毒方案对于预防这些感染至关重要。本研究旨在分离肺炎克雷伯菌、评估抗菌药物敏感性，并评估所选杀菌剂的效果。
从医院各科室收集了50株临床多重耐药肺炎克雷伯菌分离株。采用纸片扩散法测定抗菌药物敏感性。通过琼脂稀释法测定洗必泰和苯扎氯铵的最低抑菌浓度（MIC）。采用常规PCR检测杀菌剂耐药基因（qacE∆1和cepA）。
在19.16%的病例中鉴定出肺炎克雷伯菌。所有分离株均表现出多重耐药性，多重抗菌药物耐药指数范围为0.24至0.92，最高可达1。苯扎氯铵的MIC随耐药性显著增加，最高可达64μg/mL，而洗必泰的MIC在各分离株中保持一致。分别在62%和72%的分离株中检测到qacE∆1和cepA基因，qacE∆1与头孢菌素耐药性之间存在显著关联。未发现杀菌剂MIC与临床标本类型或医院科室之间存在显著相关性。
cepA基因与肺炎克雷伯菌的广泛耐药密切相关，强调了其在抗菌药物耐药性中的作用。优化的杀菌剂配方，在正确开发和应用时，可在对抗和预防多重耐药肺炎克雷伯菌引起的感染中发挥关键作用。
