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Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance

BACKGROUND: Klebsiella pneumoniae (K. pneumoniae) is one of the most important pathogens in nosocomial infections. It has resistance to most antibiotics, even carbapenem, resulting in restricted therapeutic options. PURPOSE: We tried to assess the antimicrobial resistance and virulence fitness of ca...

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Autores principales: Elmanakhly, Arwa R, Bendary, Mahmoud M, Safwat, Nesreen A, Awad, Eman Abu-Elnasr, Alhomrani, Majid, Alamri, Abdulhakeem S, Khafagy, El-Sayed, Alotaibi, Hadil Faris, Abou-Elazm, Fatma I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9597670/
https://www.ncbi.nlm.nih.gov/pubmed/36312437
http://dx.doi.org/10.2147/IDR.S387742
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author Elmanakhly, Arwa R
Bendary, Mahmoud M
Safwat, Nesreen A
Awad, Eman Abu-Elnasr
Alhomrani, Majid
Alamri, Abdulhakeem S
Khafagy, El-Sayed
Alotaibi, Hadil Faris
Abou-Elazm, Fatma I
author_facet Elmanakhly, Arwa R
Bendary, Mahmoud M
Safwat, Nesreen A
Awad, Eman Abu-Elnasr
Alhomrani, Majid
Alamri, Abdulhakeem S
Khafagy, El-Sayed
Alotaibi, Hadil Faris
Abou-Elazm, Fatma I
author_sort Elmanakhly, Arwa R
collection PubMed
description BACKGROUND: Klebsiella pneumoniae (K. pneumoniae) is one of the most important pathogens in nosocomial infections. It has resistance to most antibiotics, even carbapenem, resulting in restricted therapeutic options. PURPOSE: We tried to assess the antimicrobial resistance and virulence fitness of carbapenem-resistant K. pneumoniae (CRKP) in addition to their phenotypic and genotypic diversity. MATERIALS AND METHODS: The conventional methods, automated Vitek-32 system, and antimicrobial susceptibility pattern were used to detect CRKP isolates. Virulence and resistance genes profiles were created by using PCR technique. The correlation analysis was done by using R-program. RESULTS: The antimicrobial resistance profile for all our K. pneumoniae isolates was shocking as the MDR and CRKP were the most prominent phenotypes. Unfortunately, high degrees of heterogeneity among our CRKP isolates were recorded, as 97.5% of them were differentiated into different clusters. We found a negative correlation between the existence of virulence and antimicrobial resistance genes. In contrast to sputum and urine CRPK isolates, the blood isolates showed high antimicrobial resistance and low virulence fitness. Finally, K. pneumoniae creates several outbreaks and crises in Egypt owing to the highly heterogeneity and the wide spread of multidrug-resistant (MDR) and multi-virulent CRKP phenotypes. CONCLUSION: Our results are significant and alarming to health organizations throughout the world for the severity and heterogeneity of K. pneumoniae infections. Therefore, the traditional method for treatment of CRKP infections must be renewed. Additionally, the treatment protocols must be well correlated with the site of infections, phenotypes, and genotypes of CRKP strains.
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spelling pubmed-95976702022-10-27 Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance Elmanakhly, Arwa R Bendary, Mahmoud M Safwat, Nesreen A Awad, Eman Abu-Elnasr Alhomrani, Majid Alamri, Abdulhakeem S Khafagy, El-Sayed Alotaibi, Hadil Faris Abou-Elazm, Fatma I Infect Drug Resist Original Research BACKGROUND: Klebsiella pneumoniae (K. pneumoniae) is one of the most important pathogens in nosocomial infections. It has resistance to most antibiotics, even carbapenem, resulting in restricted therapeutic options. PURPOSE: We tried to assess the antimicrobial resistance and virulence fitness of carbapenem-resistant K. pneumoniae (CRKP) in addition to their phenotypic and genotypic diversity. MATERIALS AND METHODS: The conventional methods, automated Vitek-32 system, and antimicrobial susceptibility pattern were used to detect CRKP isolates. Virulence and resistance genes profiles were created by using PCR technique. The correlation analysis was done by using R-program. RESULTS: The antimicrobial resistance profile for all our K. pneumoniae isolates was shocking as the MDR and CRKP were the most prominent phenotypes. Unfortunately, high degrees of heterogeneity among our CRKP isolates were recorded, as 97.5% of them were differentiated into different clusters. We found a negative correlation between the existence of virulence and antimicrobial resistance genes. In contrast to sputum and urine CRPK isolates, the blood isolates showed high antimicrobial resistance and low virulence fitness. Finally, K. pneumoniae creates several outbreaks and crises in Egypt owing to the highly heterogeneity and the wide spread of multidrug-resistant (MDR) and multi-virulent CRKP phenotypes. CONCLUSION: Our results are significant and alarming to health organizations throughout the world for the severity and heterogeneity of K. pneumoniae infections. Therefore, the traditional method for treatment of CRKP infections must be renewed. Additionally, the treatment protocols must be well correlated with the site of infections, phenotypes, and genotypes of CRKP strains. Dove 2022-10-26 /pmc/articles/PMC9597670/ /pubmed/36312437 http://dx.doi.org/10.2147/IDR.S387742 Text en © 2022 Elmanakhly et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Elmanakhly, Arwa R
Bendary, Mahmoud M
Safwat, Nesreen A
Awad, Eman Abu-Elnasr
Alhomrani, Majid
Alamri, Abdulhakeem S
Khafagy, El-Sayed
Alotaibi, Hadil Faris
Abou-Elazm, Fatma I
Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance
title Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance
title_full Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance
title_fullStr Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance
title_full_unstemmed Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance
title_short Carbapenem-Resistant Klebsiella pneumoniae: Diversity, Virulence, and Antimicrobial Resistance
title_sort carbapenem-resistant klebsiella pneumoniae: diversity, virulence, and antimicrobial resistance
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9597670/
https://www.ncbi.nlm.nih.gov/pubmed/36312437
http://dx.doi.org/10.2147/IDR.S387742
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