VIM IgG (Human) ELISA Kit

Purpose: The emergence of multidrug-resistant Klebsiella pneumoniae (K. pneumoniae) is associated with the acquisition of multiple carbapenemases. Their clonal spread is a worldwide concern due to their critical role in nosocomial infections. Therefore, the identification of high-risk clones with antibiotic resistance genes is very crucial for controlling its global spread. Materials and Methods: A total of 227 K. pneumoniae strains collected during April 2018 to November 2019 were confirmed by PCR. Carbapenemases and extended-spectrum beta-lactamases (ESBL) were detected phenotypically. Confirmation of carbapenemases was carried out by PCR and Sanger sequencing. The clonal lineages were assigned to selected isolates by multilocus sequence typing (MLST), and the plasmid analysis was done by PCR-based detection of the plasmid replicon typing. Results: Of the total K. pneumoniae, 117 (51.5%) were carbapenem resistant (CRKP) and 140 (61.7%) were identified as ESBL producers. Intermediate to high resistance was detected in the tested beta-lactam drugs while polymyxin-B and tigecycline were found to be susceptible. Among CRKP, 91 (77.8%) isolates were detected as carbapenemase producing, while 55 (47%) were positive for bla(NDM-1) 23.9% (n=28), bla(OXA-48) 22.2% (n=26) and bla(VIM) 0.85% (n=1) while 12.7% (n=7) carried both bla(NDM-1) and bla(OXA-48) genes. The CRKP coharboring bla(NDM-1) and bla(OXA-48) genes (n=7) were positive for bla(CTX-M) bla(SHV) (n=3), bla(SHV) (n=1) and bla(CTX-M) (n=3). The novel CRKP with the coexistence of bla(NDM-1), bla(OXA-48), bla(CTX-M) and bla(SHV) genes were associated with the high-risk clone ST147 (n=5) and ST11 (n=2). The assigned replicon types were IncL/M, IncFII, IncA/C and IncH1. Conclusion: This is the first report of the coexistence of bla(NDM-1), bla(OXA-48), bla(CTX-M) and bla(SHV) genes on a high-risk lineage ST147 from Pakistan. This study highlights the successful dissemination of carbapenemase resistance genes in the high-risk clones that emphasizes the importance of monitoring and controlling the spread of these diverse clones globally.

Klebsiella pneumoniae infections have always been an important problem in public health, but today, the increasing resistance of these bacteria to antibiotics due to beta-lactamases production has renewed interest in K. pneumoniae infections. The aim of the study was to present a case of a neurosurgical patient with multidrug-resistant K. pneumoniae ST11 infection after craniectomy. Four K. pneumoniae isolates from various clinical materials of the patient undergone identification and susceptibility testing with the Vitek2 system. Tests for beta-lactamases production were performed according to EUCAST guidelines. Strains were analyzed for bla genes responsible for beta-lactamase production (bla(TEM), bla(SHV), bla(CTX-M), bla(VIM), bla(IMP), bla(NDM), bla(KPC), bla(OXA-48)) using PCR. Moreover, the genetic relatedness of these isolates was determined by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). All tested strain presented multidrug resistance. The highest susceptibility was observed for imipenem, meropenem, and ertapenem. The strain isolated from the nervous system was ESBL-positive with bla(SHV-11), bla(TEM-1), and bla(CTX-M-15) genes. Additionally, the strain from urine was bla(KPC-3)-positive. Molecular typing revealed that all strains belonged to the same clone and identified two PFGE profiles. The analysis of MLST allelic profile showed that tested K. pneumoniae strains belonged to ST11. Identification of ST11 K. pneumoniae as etiological factor of infection unfavorably impacts on prognosis among neurosurgical patient after craniectomy.