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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
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Carbapenem and Colistin Resistance, Integrons and Plasmid Replicon Types in Multi-Drug Resistant Klebsiella Strains

Fatma Kalayci-Yuksek, Defne Gumus, Aysun Uyanik-Ocal

    Clinical Laboratory
    |March 13, 2023
    PubMed
    Abstract

    Insights

    This study found high rates of carbapenemase genes blaNDM and blaOXA-48, along with Class I and II integrons, in multidrug-resistant Klebsiella strains. These findings emphasize the need for ongoing surveillance of emerging antibiotic resistance.

    Area of Science:

    • Microbiology
    • Infectious Diseases
    • Molecular Biology

    Background:

    • Multidrug-resistant (MDR) Klebsiella is a significant cause of hospital-acquired infections.
    • This study investigated 101 MDR Klebsiella strains from clinical specimens in Turkey.
    • The research focused on the prevalence of carbapenemase genes, mobile colistin resistance genes, and integrons.

    Purpose of the Study:

    • To determine the prevalence of specific carbapenemase genes (blaOXA-48, blaNDM, blaIMP, blaVIM, blaKPC).
    • To identify the presence of mobile colistin resistance genes (mcr-1, mcr-2).
    • To examine the occurrence of integrons (Class I, II, and III) in MDR Klebsiella.

    Main Methods:

    • Antibiotic susceptibility testing using Kirby Bauer disc-diffusion and colistin minimum inhibitory concentrations.
    • Polymerase chain reaction (PCR) was employed to detect carbapenemase genes, mobile colistin resistance genes, and integrons.
    • Plasmid replicon typing was performed on strains harboring both blaNDM and blaOXA-48.

    Main Results:

    • All 101 strains exhibited resistance to beta-lactams, carbapenems, and quinolones; only 8.9% were resistant to colistin.
    • The most prevalent carbapenemase genes were blaNDM (64.3%) and blaOXA-48 (53.5%), with 27.7% co-harboring both.
    • Class I and Class II integrons were found in 83.2% and 63.3% of strains, respectively. Notably, co-presence of blaNDM, blaOXA-48, and both integron classes was reported for the first time in a human isolate from Turkey.

    Conclusions:

    • The study highlights the widespread dissemination of carbapenemases and integrons among MDR Klebsiella in Turkey.
    • The findings underscore the critical need for continuous surveillance of emerging antibiotic resistance mechanisms.
    • Effective infection control strategies are essential to combat the spread of these resistant pathogens in healthcare settings.

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