RESISTANCE PHENOTYPE AND MOLECULAR EPIDEMIOLOGY OF CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE ISOLATES IN KING ABDUALLAH MEDICAL COMPLEX, JEDDAH
Main Article Content
Keywords
Molecular Epidemiology, Resistance Phenotype, CRKP, Antibiotic resistance, pert Carba-R assay, blaNDM, blaOXA-48
Abstract
Although amikacin, meropenem, and colistin are options that still can be used, but the spread of CRKP has become a big problem all over the world, especially because this type of bacteria is resistant to most wide-spread antibiotics being used. Several studies have shown that the CRKP strains have been identified with these technology-based designs that are applied retrospectively. While the function of the molecular epidemiology and the influence of CRKP on outcomes were precisely outlined, a relevant paragraph explaining this phenomenon is still not available. Moreover, the existing options for therapy of CRKP are not efficient and this area still awaits a breakthrough. Consequently, the objective of the research study is to perform the molecular analysis of CRKP and the resistance patterns in the King Abdullah Medical Complex (KAMCJ), Jeddah. In this study the strain was subjected to growing in colonies during January 2022- August 2023 for a total of 260 CRKP isolates. An antimicrobial susceptibility test has been performed through these advanced techniques with VITEK-2 automated microbiology analyzer platform as well as broth microdilution approach. Then, to detect the carbapenemase and drug resistance genes, the XpertCarba-R assay and modified carbenem acid inactivation method have been conducted. The finding of this study indicated that the blaOXA-48 and blaNDM genes resulted in the transmission of K. pneumonia in patients' admissions at the intensive care unit. In the study, it was found out that patients who had CRKP were statistically related to their gender and chronic obstructive pulmonary disease. Besides that, CRKP dispersal would be limited and the performance of infection control measures supervised through CRKP strains surveillance.
References
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2. Al-Zahrani, I.A. and Alasiri, B.A. (2018) ‘The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir) Province, Saudi Arabia’, Saudi Medical Journal, 39(1), pp. 23–30. Available at: https://doi.org/10.1 5537/smj.2018.1.21094.
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5. Alshahrani, A.M. et al. (2022) ‘Molecular Epidemiology of Carbapenem-Resistant K. pneumoniae Clinical Isolates from the Adult Patients with Comorbidities in a Tertiary Hospital, Southern Saudi Arabia’, Antibiotics, 11(12), pp. 1–13. Available at: https://doi.org /10.3390/antibiotics11121697.
6. Brek, T. et al. (2023) ‘Prevalence and molecular determinants of carbapenemase-producing Klebsiella pneumoniae isolated from Jazan, Saudi Arabia’, Journal of Infection in Developing Countries, 17(10), pp. 1420–1429. Available at: https://doi.org/10.3855/jidc.17662.
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11. Gandor, N.H.M. et al. (2022) ‘Characterization of Carbapenem-Resistant K. Pneumoniae Isolated from Intensive Care Units of Zagazig University Hospitals’, Antibiotics, 11(8), pp. 1–14. Available at: https://doi.org/10.3390/antibiotics11081108.
12. Gong, Y. et al. (2022) ‘Emergence of a Carbapenem-Resistant Klebsiella pneumoniae Isolate Co-harbouring Dual blaNDM– 6-Carrying Plasmids in China’, Frontiers in Microbiology, 13, pp. 1–8. Available at: https://doi.org/10.3389/fmicb.2022.900831.
13. Granov, D., Dedeic-Ljubovic, A. and Salimovic-Besic, I. (2020) ‘Characterization of Carbapenemase-Producing Klebsiella pneumoniae in Clinical Center University of Sarajevo, Bosnia and Herzegovina’, Microbial Drug Resistance, 26(9), pp. 1038–1045. Available at: https://doi.org/10.1089/mdr.2019.0188.
14. Guo, H. et al. (2023) ‘Global emergence of carbapenem-resistant Klebsiella pneumoniae co-carrying multiple carbapenemases’, Computational and Structural Biotechnology Journal, 21, pp. 3557–3563. Available at: https://doi.org/10.1016/j.csbj.2023.07.013.
15. Guo, Y. et al. (2023) ‘Virulence, antimicrobial resistance, and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae in a hospital in Shijiazhuang City from China’, International Microbiology, 26(4), pp. 1073–1085. Available at: https://doi.org/10.1007/s10123-023-00357-x.
16. Hafiz, T.A. et al. (2023) ‘Klebsiella pneumoniae bacteraemia epidemiology: resistance profiles and clinical outcome of King Fahad Medical City isolates, Riyadh, Saudi Arabia’, BMC Infectious Diseases, 23(1), pp. 1–9. Available at: https://doi.org/10.1186/s12879-023-08563-8.
17. Hazirolan, G. and Karagoz, A. (2020) ‘Emergence of carbapenemase-producing and colistin resistant Klebsiella pneumoniae ST101 high-risk clone in Turkey’, Acta Microbiologica et Immunologica Hungarica, 67(4), pp. 216–221. Available at: https://doi.org/10.1 556/030.2020.01275.
18. Hu, F. et al. (2023) ‘Molecular and Clinical Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Isolates at a Tertiary Hospital in Wuhan, China’, Infection and Drug Resistance, 16, pp. 65–76. Available at: https://doi.org/10.2147/IDR.S397975.
19. Huang, W. et al. (2022) ‘Carbapenemase Production and Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumoniae in Western Chongqing, China’, Frontiers in Cellular and Infection Microbiology, 11, pp. 1–11. Available at: https://doi.org/10.3389/fcimb.2021.775740.
20. Indrajith, S. et al. (2021) ‘Molecular insights of Carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples’, Journal of Infection and Public Health, 14(1), pp. 131–138. Available at: https://doi.org/10.1016/j.jiph.2020.09.018.
21. Kang, H. et al. (2020) ‘Disease burden and molecular epidemiology of carbapenem- resistant Klebsiella pneumonia infection in a tertiary hospital in China’, Annals of Translational Medicine, 8(9), pp. 1–10. Available at: https://doi.org/10.21037/atm.2020.03.122.
22. Kuzina, E.S. et al. (2023) ‘High-Molecular-Weight Plasmids Carrying Carbapenemase Genes blaNDM-1, blaKPC-2, and blaOXA-48 Coexisting in Clinical Klebsiella pneumoniae Strains of ST39’, Microorganisms, 11(2), pp. 1–16. Available at: https://doi.org/10.3390/microorganisms11020459.
23. Lalaoui, R. et al. (2018) ‘Spread of Carbapenem and Colistin-Resistant Klebsiella pneumoniae ST512 Clinical Isolates in Israel: A Cause for Vigilance’, Microbial Drug Resistance, 25(1), pp. 63–71. Available at: https://doi.org/10.1089/mdr.2018.0014.
24. Lau, M.Y. et al. (2021) ‘Molecular characterization of carbapenem resistant klebsiella pneumoniae in Malaysia hospital’, Pathogens, 10(3), pp. 1–15. Available at: https://doi.org/10.3390/pathogens10030279.
25. Lee, Y.Q. et al. (2022) ‘Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant Klebsiella pneumoniae Based on Their Clinical and Molecular Profile in Malaysia’, Antibiotics, 11(11), pp. 1–20. Available at: https://doi.org/10.3390/antibiotics11111670.
26. Li, Z. et al. (2021) ‘Carbapenem-Resistant Klebsiella pneumoniae in southwest China: Molecular characteristics and risk factors caused by KPC and NDM producers’, Infection and Drug Resistance, 14, pp. 3145–3158. Available at: https://doi.org/10.2147/IDR.S324244.
27. Liao, Y. et al. (2023) ‘Drug Resistance Genes and Molecular Epidemiological Characteristics of Carbapenem-Resistant Klebsiella pneumonia’, Infection and Drug Resistance, 16, pp. 1511–1519. Available at: https://doi.org/10.2147/IDR.S399142.
28. Lin, X.C. et al. (2024) ‘The Global and Regional Prevalence of Hospital-Acquired Carbapenem-Resistant Klebsiella pneumoniae Infection: A Systematic Review and Meta-analysis’, Open Forum Infectious Diseases, 11(2), pp. 1–15. Available at: https://doi.org/10.1093/ofid/ofad649.
29. Liu, S. et al. (2023) ‘Retracted: Analysis of Carbapenemase-Resistant Genotypes of Highly Virulent Klebsiella pneumoniae and Clinical Infection Characteristics of Different MLST Types’, Evidence-Based Complementary and Alternative Medicine, 2021, pp. 1–9. Available at: https://doi.org/10.1155/2023/9838103.
30. Lynch, J.P., Clark, N.M. and Zhanel, G.G. (2021) ‘Escalating antimicrobial resistance among Enterobacteriaceae: focus on carbapenemases’, Expert Opinion on Pharmacotherapy, 22(11), pp. 1455–1473. Available at: https://doi.org/10.1080/14656566.2021.1904891.
31. Mirzaie, A. and Ranjbar, R. (2021) ‘Antibiotic resistance, virulence-associated genes analysis and molecular typing of Klebsiella pneumoniae strains recovered from clinical samples’, AMB Express, 11(1), pp. 1–11. Available at: https://doi.org/10.1186/s13568-021-01282-w.
32. Mouftah, S.F. et al. (2021) ‘Diversity of carbapenem-resistant Klebsiella pneumoniae ST14 and emergence of a subgroup with KL64 capsular locus in the Arabian Peninsula’, European Journal of Clinical Microbiology and Infectious Diseases, pp. 1–9. Available at: https://doi.org/10.1007/s10096-021-04384-2.
33. Pattolath, A., Adhikari, P. and Pai, V. (2023) ‘Clinical and Molecular Profile of Carbapenem Resistant Klebsiella pneumoniae Infections in a Tertiary Care Hospital –Mangalore’, Infection and Drug Resistance, 16, pp. 4335–4348. Available at: https://doi.org/10.2147/IDR.S411056.
34. Puente, F. Del et al. (2019) ‘Epidemiology and outcome of Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-KP) infections in cardiac surgery patients: a brief narrative review’, Journal of Chemotherapy, 31(7–8), pp. 359–366. Available at: https://doi.org/10.1080/1120009X.2019.1685794.
35. Samadi, N. et al. (2024) ‘Phenotypic and Molecular Detection of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Patients Admitted to Teaching Hospitals in Shiraz, Iran’, Jundishapur Journal of Microbiology, 16(12), pp. 1–9. Available at: https://doi.org/10.5812/jjm-142449.
36. Shaidullina, E. et al. (2020) ‘Antimicrobial resistance and genomic characterization of OXA-48-and CTX-M-15-co-producing hypervirulent Klebsiella pneumoniae st23 recovered from nosocomial outbreak’, Antibiotics, 9(12), pp. 1–9. Available at: https://doi.org/10.339 0/antibiotics9120862.
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Published
Feb 10, 2023
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Suhailah Khalil Abdulhalim, Ohoud suliman mannaa, Almontaserbellah Abdulhadi Suror, Ghazwah Rehim Aljadany, Noha khalid mohammed Nouh, Ala helyyel alharbi, Dr. Abdulaziz Mohammed Felemban, & Bayan Sagga. (2023). RESISTANCE PHENOTYPE AND MOLECULAR EPIDEMIOLOGY OF CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE ISOLATES IN KING ABDUALLAH MEDICAL COMPLEX, JEDDAH. Journal of Population Therapeutics and Clinical Pharmacology, 30(2), 838–854. https://doi.org/10.53555/jptcp.v30i2.4866
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Author Biographies
Suhailah Khalil Abdulhalim
Senior Specialist Genetics at King Abdullah Medical Complex, Ministry of Health, Jeddah Saudi Arabia
Ohoud suliman mannaa
King Abdullah Medical Complex, Ministry of Health, Jeddah Saudi Arabia
Almontaserbellah Abdulhadi Suror
King Abdullah Medical Complex, Ministry of Health, Jeddah Saudi Arabia
Ghazwah Rehim Aljadany
King Abdullah Medical Complex, Ministry of Health, Jeddah Saudi Arabia
Noha khalid mohammed Nouh
King Abdullah Medical Complex, Ministry of Health, Jeddah Saudi Arabia
Ala helyyel alharbi
Maternity & Children's Hospital in the north, Ministry of Health, Jeddah Saudi Arabia
Dr. Abdulaziz Mohammed Felemban
King abdullah medical complex – Jeddah
Bayan Sagga
Ministry of health, Jeddah Saudi Arabia