Genetic Insights on Meropenem Resistance Concerning Klebsiella pneumoniae Clinical Isolates

Area of Science:

• Microbiology
• Genetics
• Infectious Diseases

Background:

• Transferable genetic elements facilitate the spread of virulence factors in Klebsiella pneumoniae.
• Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant global health challenge.
• Understanding antimicrobial resistance (AMR) mechanisms in CRKP is crucial for effective treatment.

Purpose of the Study:

• To assess correlated antimicrobial resistance in carbapenem-resistant Klebsiella pneumoniae clinical isolates.
• To investigate the prevalence of biofilm biosynthesis, carbapenemase, and extended-spectrum beta-lactamase (ESBL) production.
• To screen for genotypic correlations of AMR, including biofilm, outer membrane porin, and plasmid-associated genes.

Main Methods:

• Phenotypic characterization of biofilm production, carbapenemase, and ESBL.
• Genotypic screening for specific AMR genes, including those for adhesins, carbapenemases, ESBLs, and other resistance mechanisms.
• Analysis of the co-occurrence of AMR genes and their association with multidrug resistance (MDR) phenotypes.

Main Results:

• High prevalence of MDR (50%), ESBL production (98.4%), and carbapenem resistance (89.3%) observed.
• A significant proportion of MDR isolates (93.1%) exhibited biofilm production.
• Detection of key resistance genes: blaKPC (16.1%), blaOXA-48-like (53.6%), blaNDM (55.4%), blaSHV (95.2%), blaCTX-M (61.3%), aac(3)IIa (38.1%), qnrB (46%), and tetB (7.9%).

Conclusions:

• Elevated prevalence of diverse AMR-associated genes in Klebsiella pneumoniae clinical isolates.
• Co-transfer of plasmid-encoding AMR genes likely contributes to the acquisition of MDR phenotypes.
• The findings highlight the urgent need for strategies to combat the dissemination of AMR in Klebsiella pneumoniae.