Assessment of carbapenem-resistant Klebsiella pneumoniae from clinical isolates of hospitalized patients
DOI:
https://doi.org/10.61529/idjp.v34i3.414Abstract
Objective: Klebsiella pneumoniae, a non-motile, Gram-negative rod of the Enterobacteriaceae family, is an opportunistic pathogen commonly associated with nosocomial infections and community-acquired diseases in both patients and healthy individuals. The aim of this study is to assess the carbapenem resistance and alternative antibiotic options in clinical isolates of Klebsiella pneumoniae.
Materials and Methods: The present study was conducted in CMH, Multan, for 3-5 months. One hundred various clinical samples (blood, BAL, urine, pus, sputum, tissue, and wound fluids) that were received in microbiology laboratory of the hospital were processed for bacterial growth on blood and MacConkey agar plates. The clinical isolates of Klebsiella pneumoniae were identified, and their antibiogram profiles were studied. Isolates resistant to Imipenem, meropenem alone or both were considered carbapenem resistant.
Results: Of 110 clinical samples, 50% yielded Klebsiella pneumoniae, of which 67.3% were carbapenem resistant. Most patients were aged 50–70 years (mean 58.04 ± 17.31); 65.5% isolates were from males. Strains were mainly recovered from blood (38.2%), pus (27.3%), and sputum (12.7%). High resistance was observed to imipenem (69.1%) and meropenem (47.3%), while sensitivity to colistin and tigecycline was 100% and 72.7%, respectively.
Conclusion: In conclusion, carbapenem resistance was frequent among clinical isolates of Klebsiella pneumoniae, and there should be combination therapy of colistin, tigecycline, and meropenem against infections of carbapenem-resistant Klebsiella pneumoniae.
Keywords: Carbapenem-resistant, Colistin, Klebsiella pneumoniae, Meropenem, Tigecycline
References
Mustafa U, Ashraf A, Ali G, Wadood HZ, Ali M, Yousaf S. Identification and characterization of Klebsiella Pneumoniae in different clinical samples at tertiary care hospital, Lahore. Pak J Med Health Sci. 2023; 17(06): 66- DOI: https://doi.org/10.53350/pjmhs202317666
Patel SS, Chauhan HC, Patel AC, Shrimali MD, Patel KB, Prajapati BI, et al. Isolation and identification of Klebsiella pneumoniae from sheep-case report. Int J Curr Microbiol App Sci. 2017;6(5):331-4. Available from: https://www.ijcmas.com/6-5-2017/S.S.%20Patel,%20et% 20al.pdf
Zhu J, Wang T, Chen L, Du H. Virulence factors in hypervirulent Klebsiella pneumoniae. Front in Microbiol. 2021; 12: 642484. DOI: https://doi.org/10.3389/fmicb.2021.642484
Ali S, Alam M, Hasan GM, Hassan MI. Potential therapeutic targets of Klebsiella pneumoniae: A multi-omics review perspective. Brief Funct Genomics. 2022; 21(2): 63-77. DOI: https://doi.org/10.1093/bfgp/elab038
Hesse S, Malachowa N, Porter AR, Freedman B, Kobayashi SD, Gardner DJ, et al. Bacteriophage treatment rescues mice infected with multidrug-resistant Klebsiella pneumoniae ST258. MBio. 2021; 12(1): 10-128. DOI: https://doi.org/10.1128/mbio.00034-21
Larsson DJ, Flach CF. Antibiotic resistance in the environment. Nat Rev Microbiol. 2022; 20(5): 257-69.
DOI: https://doi.org/10.1038/s41579-021-00649-x
Chokshi A, Sifri Z, Cennimo D, Horng H. Global contributors to antibiotic resistance. J Global Infect Dis. 2019; 11(1): 36-42. DOI: https://doi.org/10.4103/jgid.jgid_110_18
Ayobami O, Brinkwirth S, Eckmanns T, Markwart R. Antibiotic resistance in hospital-acquired ESKAPE-E infections in low-and lower-middle-income countries: A systematic review and meta-analysis. Emerg Microbes Infect. 2022; 11(1): 443-51. DOI: https://doi.org/10.1080/22221751.2022.2030196
Indrajith S, Mukhopadhyay AK, Chowdhury G, Al Farraj DA, Alkufeidy RM, Natesan S, et al. Molecular insights of carbapenem resistance Klebsiella pneumoniae isolates with focus on multidrug resistance from clinical samples. J Infect Public Health. 2021;14(1): 131-8. DOI: https://doi.org/10.1016/j.jiph.2020.09.018
Durante-Mangoni E, Andini R, Zampino RJ. Management of carbapenem-resistant Enterobacteriaceae infections. Clin Microbiol Infect. 2019; 25(8): 943-50. DOI: https://doi.org/10.1016/j.cmi.2019.04.013
Tilahun M, Kassa Y, Gedefie A, Ashagire M. Emerging carbapenem-resistant Enterobacteriaceae infection, its epidemiology and novel treatment options: A review. Infect Drug Resist. 2021: 4363-74. DOI: https://doi.org/10.2147/idr.s337611
Alizadeh N, Rezaee AM, Kafil SH, Hasani A, Barhaghi SMH, Milani M, et al. Evaluation of resistance mechanisms in carbapenem-resistant Enterobacteriaceae. Infect Drug Resist. 2020: 1377-85. DOI: https://doi.org/10.2147/idr.s244357
Sheu CC, Chang YT, Lin SY, Chen YH, Hsueh PR. Infections caused by carbapenem-resistant Enterobacteriaceae: An update on therapeutic options. Front Microbiol. 2019; 10: 80. DOI: https://doi.org/10.3389/fmicb.2019.00080
Girlich D, Grosperrin V, Naas T, Dortet L. CHROMagar™ ESBL/mSuperCARBA bi-plate medium for detection of ESBL-and carbapenemase-producing Enterobacteriaceae from spiked stools. Diagn Microbiol Infect Dis. 2019; 95(2): 107-12. DOI: https://doi.org/10.1016/j.diagmicrobio.2019.05.002
Humayun A, Siddiqui FM, Akram N, Saleem S, Ali A, Iqbal T. Incidence of metallo-beta-lactamase-producing Klebsiella pneumoniae isolates from hospital setting in Pakistan. Int Microbiol. 2018; 21: 73-8.
DOI: https://doi.org/10.1007/s10123-018-0006-1
Hussain W, Zahra FT, Farman S, Tayyab N, Zaman G, Khadim MT. Carbapenem resistance and antimicrobial options in Klebsiella pneumoniae isolated from clinical specimens of ICU patients. Pak J Pathol. 2019; 30(1): 13-6. Available from: https://pakjpath.com/index.php/Pak-J-Pathol/article/view/501/436
Ugrakli S, Dogan M. Growing threat increased carbapenem-resistance among Klebsiella pneumoniae; antibiotic susceptibility pattern of Klebsiella pneumoniae in a tertiary care hospital. Int J Clin Microbiol. 2020; 1(2): 1-7. DOI: https://openaccesspub.org/article/1251/ijcm-19-3154.pdf
Negm EM, Mowafy SM, Mohammed AA, Amer MG, Tawfik AE, Ibrahim AE, et al. Antibiograms of intensive care units at an Egyptian tertiary care hospital. The Egyptian J Bronchol. 2021; 15: 1-5. DOI: https://doi.org/10.1186/s43168-021-00059-w
Al-Baz AA, Maarouf A, Marei A, Abdallah AL. Prevalence and antibiotic resistance profiles of carbapenem-resistant Klebsiella pneumoniae isolated from Tertiary Care Hospital, Egypt. Egyptian J Hospital Med. 2022; 88(1): 2883-90.
DOI: https://doi.org/10.21608/ejhm.2022.242765
Ali SE, Mahmoud NA, Elamin MM, Amr GE, Mahrous HK. Assessment of carbapenem-resistant Klebsiella pneumoniae in the intensive care unit of Zagazig University Hospitals. Microb Infect Dis. 2024; 5(1): 282-94. DOI: https://doi.org/10.21608/mid.2024.245531.1645
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mehreen Afzal

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
