Association of Blaoxa-1 Gene with Multidrug Resistance in K. pneumoniae Clinical Isolates
DOI:
https://doi.org/10.37762/jgmds.10-4.444Keywords:
Klebsiella Pneumoniae, Gene, Antibiotics, Drug ResistanceAbstract
OBJECTIVES
This study aimed to isolate K. pneumoniae from patients samples and find an association of the plasmid-mediated bla-OXA-1 gene with multidrug-resistant K. pneumoniae.
METHODOLOGY
This cross-sectional study was conducted at Mardan Medical Complex and Khyber Medical University Peshawar. K. pneumoniae was isolated from pus, urine and blood samples by culture and confirmed by biochemical techniques. Antibiotic susceptibility was done by disc diffusion according to the CLSI 2022 guidelines. A polymerase chain reaction was done for the gene after extraction and amplification of plasmid DNA. Furthermore, an association of antibiotic resistance was confirmed with blaOXA-1.
RESULTS
A total of 160 K. pneumoniae isolates were cultured from the patient’s samples, including pus (135, 84.37%), urine (15, 9.37%) and blood (10, 6.26%). There were 154 (96.3%) isolates resistant to Penicillin-G, followed by Ceftriaxone 151 (94.4%), Cefepime 143 (89.4%), Amoxicillin 125 (78.1%), Tigecycline 110 (68.8%), Imipenem 92 (57.6%) and Ertapenem 75(49.9%). However, Tetracycline had 1.9% resistance. The blaOXA-1 gene was positive in 41(25.62%) isolates with a different pattern of antibiotics resistance to Penicillin-G, Ceftriaxone, Cefepime, Amoxicillin, Tigecycline, Imipenem and Ertapenem as compared to the negative isolates. Among the blaOXA-1 gene-positive K. pneumoniae isolates, resistance to Penicillin-G was 100%, followed by Ceftriaxone (92.7%), Cefepime and Amoxicillin (80.5%), respectively. However, resistance to Imipenem and Ertapenem was 46.3% and 41.5%, respectively, and Tetracycline was not resistant.
CONCLUSION
Our data suggest that the presence of plasmid associated blaOXA-1 gene in K. pneumoniae isolates may contribute to multidrug resistance in beta lactamase-containing antibiotics along with other internal mechanisms of resistance present in these bacteria.
Downloads
Metrics
References
Seco S. Towards glycoconjugate vaccines against carbapenem-resistance Klebsiella pneumoniae: Freie Universtitä Berlin. 2021
Khaertynov KS, Anokhin VA, Rizvanov AA, Davidyuk YN, Semyenova DR, Lubin SA, et al. Virulence factors and antibiotic resistance of Klebsiella pneumoniae strains isolated from neonates with sepsis. Front Med (Lausanne). 2018;5:225
Caneiras C, Lito L, Melo-Cristino J, Duarte A. Community-and hospital-acquired Klebsiella pneumoniae urinary tract infections in Portugal: virulence and antibiotic resistance. Microorganisms. 2019;7
Effah CY, Sun T, Liu S, Wu Y. Klebsiella pneumoniae: an increasing threat to public health. Ann Clin Microbiol Antimicrob. 2020;19(1):1
Cusack TP, Ashley EA, Ling CL, Roberts T, Turner P, Wangrangsimakul T, et al. Time to switch from CLSI to EUCAST? A Southeast Asian perspective. Clin Microbiol Infect. 2019;25(7):782-5
Yang Y, Yang Y, Chen G, Lin M, Chen Y, He R, et al. Molecular characterization of carbapenem-resistant and virulent plasmids in Klebsiella pneumoniae from patients with bloodstream infections in China. Emerg Microbes Infect. 2021;10(1):700-9
Bengoechea JA, Sa Pessoa J. Klebsiella pneumoniae infection biology: living to counteract host defences. FEMS Microbiol Rev. 2019;43(2):123-44
Baquero F, Levin BR. Proximate and ultimate causes of the bactericidal action of antibiotics. Nat Rev Microbiol. 2021;19(2):123-32.
Varela MF, Stephen J, Lekshmi M, Ojha M, Wenzel N, Sanford LM, et al. Bacterial resistance to antimicrobial agents. Antibiotics (Basel). 2021;10(5):593
Reygaert WC. An overview of the antimicrobial resistance mechanisms of bacteria. AIMS Microbiol. 2018;4(3):482-501
Gehlot P, P H. Computational and data mining studies to understand the distribution and dynamics of Temoneria (TEM) β-lactamase and their interaction with β-lactam and β-lactamase inhibitors. Environ Pollut. 2022;314(120289):120289
Baek E-H, Kim S-E, Kim S, Lee S, Cho O-H, In Hong S, et al. Successful control of an extended-spectrum beta-lactamase-producing Klebsiella pneumoniae ST307 outbreak in a neonatal intensive care unit. BMC Infect Dis. 2020;20(1):166
Crellen T, Turner P, Pol S, Baker S, Nguyen Thi Nguyen T, Stoesser N, et al. Transmission dynamics and control of multidrug-resistant Klebsiella pneumoniae in neonates in a developing country. Elife. 2019;8
Santos B, Cabudoy R, Balolong MP. Pacheco2. Cornista JC, de Jesus ER, Noriel RA, editors
Fmb A-S. Urinary Tract Infections; Role of Extended Spectrum Beta-Lactamase (ESBL+) of Escherichia coli. KING ABDULAZIZ UNIVERSITY JEDDAH; 2020
Performance standards for antimicrobial Disk susceptibility tests,M100. CLSI 32nd Edition. 2022
Koch R. Prevention and control of multidrug resistant bacteria in the Netherland and Germany.The impact of healthcare structures. Int J Environ Res Public Health. 2020;17(17)
Palmeiro JK, de Souza RF, Schörner MA, Passarelli-Araujo H, Grazziotin AL, Vidal NM, et al. Molecular epidemiology of multidrug-resistant Klebsiella pneumoniae isolates in a Brazilian tertiary hospital. Front Microbiol. 2019;10:1669
Barros HDWea. synthesis and self asembly of curcumin modified amphilhic polymeric micelles with antibacterial activity. JNanobiotechnol. 2021;19
Nirwati H, Sinanjung K, Fahrunissa F, Wijaya F, Napitupulu S, Hati VP, et al. Biofilm formation and antibiotic resistance of Klebsiella pneumoniae isolated from clinical samples in a tertiary care hospital, Klaten, Indonesia. BMC Proc. 2019;13(Suppl 11):20
Ballén V, Gabasa Y, Ratia C, Ortega R, Tejero M, Soto S. Antibiotic resistance and virulence profiles of Klebsiella pneumoniae strains isolated from different clinical sources. Front Cell Infect Microbiol. 2021;11:738223
Kumari N, Kumar M, Katiyar A, Kumar A, Priya P, Kumar B, et al. Genome-wide identification of carbapenem-resistant Gram-negative bacterial (CR-GNB) isolates retrieved from hospitalized patients in Bihar, India. Sci Rep. 2022;12(1):8477
Maajae A. Antimicrobial therapeutic drug mointoring in critically ill adult patients Intensive care Med. Intensive care Med. 2020;46:1127-53
Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. 2019;11:1756287219832172
Hao J, Zeng Z, Xiao X, Ding Y, Deng J, Wei Y. Genomic and Phenotypic Characterization of a Colistin-Resistant Escherichia coli Isolate Co-Harboring bla (NDM-5), bla (OXA-1,) and bla (CTX-M-55) Isolated from Urine. Infect Drug Resist. 2022;15:1329–43. 26. Tsilipounidaki K, Athanasakopoulou Z, Müller E, Burgold-Voigt S, Florou Z, Braun SD, et al. Plethora of resistance genes in carbapenem-resistant Gram-negative bacteria in Greece: No end to a continuous genetic evolution Microorganisms. 2022;10(1):159
Liu M, Ma J, Jia W, Li W. Antimicrobial resistance and molecular characterization of gene cassettes from class 1 integrons in Pseudomonas aeruginosa strains. Microb Drug Resist. 2020;26(6):670-6
Huang J, Ma S, Yu Q, Fu M, Shao L, Shan X, et al. Whole genome sequence of an Escherichia coli ST410 isolate co-harbouring blaNDM-5, blaOXA-1, blaCTX-M-15, blaCMY-2, aac(3)-IIa and aac(6’)-Ib-cr genes isolated from a patient with bloodstream infection in China. J Glob Antimicrob Resist. 2019;19:354-5
Kang Q, Wang X, Zhao J, Liu Z, Ji F, Chang H, et al. Multidrug-resistant Proteus mirabilis isolates carrying blaOXA-1 and blaNDM-1 from wildlife in China: increasing public health risk. Integr Zool. 2021;16(6):798-809
Cepas V. Relationship between biofilm formation and Antimicrobial resistance in Gram Negative Bacteria. Microb drug Resist. 2019;25:72-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Aisha Gohar, Ihsan Ullah, Abdullah, Taj Ali Khan
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
