Resistance Profile and Molecular Insights of Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates: A Preliminary Experience from a Tertiary Care Hospital

Abstract

Carbapenems are the last-line antibiotic defense against gram-negative extended spectrum β-lactamase producers. Carbapenem-resistant Enterobacteriaceae, especially carbapenem-resistant Klebsiella pneumoniae (CRKP), is recognized as one of the well-known public health problems, which is increasingly being reported around the world. The present study focused on analyzing the carbapenemase-producing K. pneumoniae isolates obtained from patients admitted to the intensive care unit of a tertiary care hospital in Western Uttar Pradesh, India, and the results confirmed the presence of resistant genes using real-time polymerase chain reaction (PCR). A total of 103 K. pneumoniae isolates were screened for carbapenem resistance using the VITEK 2 compact system (bioMérieux SA, Marcy-l'Étoile, France). Carbapenemase was detected using genotypic characterization by real-time PCR; 49.5% of isolates were confirmed as K. pneumoniae, including 64.7% CRKP. The most common carbapenemase genes identified were New Delhi metallo-β-lactamase (bla_NDM; 93.9%), followed by bla_OXA-48 (90.9%) and bla_OXA-23 (69.7%). In conclusion, our study results depict a high prevalence of carbapenemase-producing K. pneumoniae. In conclusion, our findings demonstrate a high prevalence of carbapenemase-producing K. pneumoniae in critically ill patients. As there are no new drugs available and the prevalence varies regionally, real-time PCR probe-based detection of these genes is beneficial for early detection, developing infection control protocols, and promoting appropriate antibiotic use.