Detection and distribution of carbapenemase-encoding genes in clinical Klebsiella pneumoniae isolates from Kayseri, Türkiye

Thowiba Yousif  Jameel; Abdurrahman  Ayvaz; Pınar  Sağıroğlu; Mustafa Altay  Atalay

doi:10.18502/ijm.v18i1.20903

Thowiba Yousif Jameel Department of Biology, Graduate School of Natural and Applied Science, Erciyes University, Kayseri, Türkiye
Abdurrahman Ayvaz Department of Biology, Faculty of Science, Erciyes University, Kayseri, Türkiye
Pınar Sağıroğlu Department of Medical Microbiology, School of Medicine, Erciyes University, Kayseri, Türkiye
Mustafa Altay Atalay Department of Medical Microbiology, School of Medicine, Erciyes University, Kayseri, Türkiye

DOI: https://doi.org/10.18502/ijm.v18i1.20903

Keywords: Carbapenems; Carbapenemases; Genes; Klebsiella pneumoniae

Abstract

Background and Objectives: Carbapenem Resistance Klebsiella pneumonia (CRKP ), mostly caused by carbapenemase enzymes, poses a serious public health threat due to limited treatment options. This study aimed to genotypically identify carbapenemase-encoding genes in CRKP isolates recovered from fecal swabs and to correlate these genotypes with pheno- typic antibiotic resistance profiles.

Materials and Methods: In this study, fecal samples from 150 hospitalized patients were screened for K. pneumoniae. Phenotypic testing included the Phoenix automated system, CHROMagar KPC, biochemical tests, and disk diffusion assays. Genotypic analysis was performed using the BD MAX Checkpoint CPO PCR test, marking its first use in Kayseri, Türkiye, to detect carbapenemase genes in this pathogen.

Results: Out of 150 fecal samples, 47 tested positive for K. pneumoniae, with 28 (59.6%) identified as carbapenem-resistant(CRKP). Molecular analysis identified five distinct carbapenemase gene patterns among these resistant isolates. The mostprevalent gene, blaOXA-48, was found alone in 60.7% of CRKP isolates, followed by blaOXA-48 NDMin 3.6%; blaKPCwas not detect-OXA-48 Co-occurrence of genes was observed as follows: bla/blaNDM(14.3%), blawith blaVIM/blaIMP(10.7%), andblaOXA-48with blaNDMand blaVIM/blaIMP(10.7%) in CRKP clinical isolates.

Conclusion: The study found that blaKPCwas consistently absent, while blaOXA-48was highly prevalent and exhibited co-oc-currences of carbapenemase genes. It underscored the need for strict hospital surveillance and effective infection control to prevent the spread of CRKP strains. Rapid molecular methods, such as the BD MAX multiplex PCR, have shown promise in accurately and efficiently identifying carbapenemase genes.