Distribution and Antibiotic Resistance Profiling of Klebsiella Pneumoniae From Tertiary Care Hospital in Multan
Özet
Objective: The study was to determine distribution and antibiotic resistance profiling of MDR Klebsiella pneumoniae from patients admitted in intensive care unit (ICU) of Tertiary Care Hospital Multan. Methodology: Total 130 samples were collected from Nishtar Hospital Multan, Pakistan. Isolation and identification of all suspected samples were done on the basis of different standard microbiological procedures. Consequently, antibiotic susceptibility testing against different antibiotics was done through disc diffusion test. Furthermore, minimum inhibitory concentration was done to determine the in vitro activity of new antibiotics by Epsilometer strip testing (E-testing) according to CLSI 2018 guidelines. Results: Out of 130 samples, growth was observed on culture media in 63 (48.46%) samples and 67 (51.53%) cases showed no growth. Total 23 (34.32%) were confirmed as positive Klebsiella pneumoniae and remaining 40 (30.76%) were other gram-negative bacteria. According to the present study an increased resistance rate was observed against ceftriaxone, meropenem, levofloxacin and cefuroxime. Conclusion: The development of multi-drugs resistant K. pneumoniae is alarming in intensive care unit patients of southern Punjab, Pakistan. This data would be very helpful for the physician to alter the antibiotics recommendation against MDR K. pneumoniae. It will also reduce the burden of MDR K. pneumoniae mortality rate among ICU patients of Southern Punjab.
Referanslar
Decré D., Verdet C., Emirian A., Le Gourrierec T., Petit J C., Offenstadt G., et al. (2011). Emerging severe and fatal infections due to Klebsiella pneumoniae in two university hospitals in France. Journal of clinical microbiology, 49(8), 3012–3014
Dunn S J., Connor C., McNally A. (2019). The evolution and transmission of multi-drug-resistant Escherichia coli and Klebsiella pneumoniae: the complexity of clones and plasmids. Current opinion in microbiology, 51, 51–56
Giuffre M., Geraci D M., Bonura C., Saporito L., Graziano G., Insinga V., et al. (2016). The Increasing Challenge of Multidrug-Resistant Gram-Negative Bacilli: Results of a 5-Year Active Surveillance Program in a Neonatal Intensive Care Unit. Medicine (Baltimore), 95(10), e3016.
Hayat S., Siddique M H., Aslam B., Nadeem H., Ashraf A., Saqalein M., et al. (2019). Extended-Spectrum-β-Lactamase Producing Multidrug Resistant Klebsiella pneumoniae Isolates from Pediatrics. Proteus, 6, 5-6
Heidary M., Nasiri M J., Dabiri H., Tarashi S. (2018). Prevalence of drug-resistant Klebsiella pneumoniae in Iran: a review article. Iranian journal of public health, 47(3), 317
Infectious Diseases Society of America. (2004). Bad bugs, no drugs: as antibiotic discovery stagnates, a public health crisis brews. Alexandria, VA: Infectious Diseases Society of America.
Karlowsky J A., Lob S H., DeRyke C A., Siddiqui F., Young K., Motyl M R., et al. (2022). Prevalence of ESBL non-CRE Escherichia coli and Klebsiella pneumoniae among clinical isolates collected by the SMART global surveillance programme from 2015 to 2019. International Journal of Antimicrobial Agents, 59(3), 106535
Kotlovsky T., Shalginov R., Austin L., Sprecher H. (2009). Rapid detection of bla KPC-positive Klebsiella pneumoniae in a clinical setting. European journal of clinical microbiology & infectious diseases, 28(3), 309–311
Lee G.C., Burgess D.S. (2012). Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: a review of published case series and case reports. Annals of clinical microbiology and antimicrobials, 11(1), 1–9
Lledo W., Hernandez M., Lopez E., Molinari O., Soto R., Hernandez E., et al. (2009). Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. Morbidity and Mortality Weekly Report, 58(10), 256–258
Martellosio J P., Gastli N., Farhat R., Tazi A., Duraffour P., Rossi B., et al. (2022). Hypervirulent Klebsiella Pneumoniae, an Emerging Cause of Endogenous Endophthalmitis in A French Center: A Comparative Cohort Study. Ocular Immunology and Inflammation, 1–9
Siu L K., Fung C P., Chang F Y., Lee N., Yeh K M., Koh T H., et al. (2011). Molecular typing and virulence analysis of serotype K1 Klebsiella pneumoniae strains isolated from liver abscess patients and stool samples from noninfectious subjects in Hong Kong, Singapore, and Taiwan. Journal of clinical microbiology, 49(11), 3761–3765
Sligl W., Taylor G., Brindley P G. (2006). Five years of nosocomial Gram-negative bacteremia in a general intensive care unit: epidemiology, antimicrobial susceptibility patterns, and outcomes. International journal of infectious diseases, 10(4), 320–325
Snyder B.M., Montague B.T. (2019). Risk factors and epidemiologic predictors of blood stream infections with New Delhi Metallo-b-lactamase (NDM-1) producing Enterobacteriaceae. 147, e137
Yildirim S., Nursal T Z., Tarim A., Torer N., Noyan T., Demiroglu Y Z., et al. (2005). Bacteriological profile and antibiotic resistance: comparison of findings in a burn intensive care unit, other intensive care units, and the hospital services unit of a single center. The Journal of burn care & rehabilitation, 26(6), 488–492
Zhao D., Zuo Y., Wang Z., Li J. (2019). Characterize carbapenem-resistant Klebsiella pneumoniae isolates for nosocomial pneumonia and their Gram-negative bacteria neighbors in the respiratory tract. Molecular biology reports, 46(1), 609–616
Referanslar
Decré D., Verdet C., Emirian A., Le Gourrierec T., Petit J C., Offenstadt G., et al. (2011). Emerging severe and fatal infections due to Klebsiella pneumoniae in two university hospitals in France. Journal of clinical microbiology, 49(8), 3012–3014
Dunn S J., Connor C., McNally A. (2019). The evolution and transmission of multi-drug-resistant Escherichia coli and Klebsiella pneumoniae: the complexity of clones and plasmids. Current opinion in microbiology, 51, 51–56
Giuffre M., Geraci D M., Bonura C., Saporito L., Graziano G., Insinga V., et al. (2016). The Increasing Challenge of Multidrug-Resistant Gram-Negative Bacilli: Results of a 5-Year Active Surveillance Program in a Neonatal Intensive Care Unit. Medicine (Baltimore), 95(10), e3016.
Hayat S., Siddique M H., Aslam B., Nadeem H., Ashraf A., Saqalein M., et al. (2019). Extended-Spectrum-β-Lactamase Producing Multidrug Resistant Klebsiella pneumoniae Isolates from Pediatrics. Proteus, 6, 5-6
Heidary M., Nasiri M J., Dabiri H., Tarashi S. (2018). Prevalence of drug-resistant Klebsiella pneumoniae in Iran: a review article. Iranian journal of public health, 47(3), 317
Infectious Diseases Society of America. (2004). Bad bugs, no drugs: as antibiotic discovery stagnates, a public health crisis brews. Alexandria, VA: Infectious Diseases Society of America.
Karlowsky J A., Lob S H., DeRyke C A., Siddiqui F., Young K., Motyl M R., et al. (2022). Prevalence of ESBL non-CRE Escherichia coli and Klebsiella pneumoniae among clinical isolates collected by the SMART global surveillance programme from 2015 to 2019. International Journal of Antimicrobial Agents, 59(3), 106535
Kotlovsky T., Shalginov R., Austin L., Sprecher H. (2009). Rapid detection of bla KPC-positive Klebsiella pneumoniae in a clinical setting. European journal of clinical microbiology & infectious diseases, 28(3), 309–311
Lee G.C., Burgess D.S. (2012). Treatment of Klebsiella pneumoniae carbapenemase (KPC) infections: a review of published case series and case reports. Annals of clinical microbiology and antimicrobials, 11(1), 1–9
Lledo W., Hernandez M., Lopez E., Molinari O., Soto R., Hernandez E., et al. (2009). Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. Morbidity and Mortality Weekly Report, 58(10), 256–258
Martellosio J P., Gastli N., Farhat R., Tazi A., Duraffour P., Rossi B., et al. (2022). Hypervirulent Klebsiella Pneumoniae, an Emerging Cause of Endogenous Endophthalmitis in A French Center: A Comparative Cohort Study. Ocular Immunology and Inflammation, 1–9
Siu L K., Fung C P., Chang F Y., Lee N., Yeh K M., Koh T H., et al. (2011). Molecular typing and virulence analysis of serotype K1 Klebsiella pneumoniae strains isolated from liver abscess patients and stool samples from noninfectious subjects in Hong Kong, Singapore, and Taiwan. Journal of clinical microbiology, 49(11), 3761–3765
Sligl W., Taylor G., Brindley P G. (2006). Five years of nosocomial Gram-negative bacteremia in a general intensive care unit: epidemiology, antimicrobial susceptibility patterns, and outcomes. International journal of infectious diseases, 10(4), 320–325
Snyder B.M., Montague B.T. (2019). Risk factors and epidemiologic predictors of blood stream infections with New Delhi Metallo-b-lactamase (NDM-1) producing Enterobacteriaceae. 147, e137
Yildirim S., Nursal T Z., Tarim A., Torer N., Noyan T., Demiroglu Y Z., et al. (2005). Bacteriological profile and antibiotic resistance: comparison of findings in a burn intensive care unit, other intensive care units, and the hospital services unit of a single center. The Journal of burn care & rehabilitation, 26(6), 488–492
Zhao D., Zuo Y., Wang Z., Li J. (2019). Characterize carbapenem-resistant Klebsiella pneumoniae isolates for nosocomial pneumonia and their Gram-negative bacteria neighbors in the respiratory tract. Molecular biology reports, 46(1), 609–616
