Emergence of multidrug-resistant ST11 blaKPC-2 producing Klebsiella pneumoniae coharboring blaCTX-M and blaSHV in Pakistan

Aamir Jamal Gondal; Sidrah Saleem; Nakhshab Choudhry; Fridoon Jawad Ahmad; Hina Bukhari; Nighat Yasmin; Shah Jahan

doi:10.3855/jidc.17041

Emergence of multidrug-resistant ST11 blaKPC-2 producing Klebsiella pneumoniae coharboring blaCTX-M and blaSHV in Pakistan

Authors

Aamir Jamal Gondal Department of Microbiology, University of Health Sciences, Lahore, Pakistan https://orcid.org/0000-0003-4379-0578
Sidrah Saleem Department of Microbiology, University of Health Sciences, Lahore, Pakistan https://orcid.org/0000-0002-1730-5025
Nakhshab Choudhry Department of Biochemistry, King Edward Medical University, Lahore, Pakistan.
Fridoon Jawad Ahmad Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan https://orcid.org/0000-0002-7456-6643
Hina Bukhari Department of Pathology, King Edward Medical University, Lahore, Pakistan
Nighat Yasmin Department of Biomedical Sciences, King Edward Medical University, Lahore, Pakistan https://orcid.org/0000-0002-3783-6093
Shah Jahan Department of Immunology, University of Health Sciences, Lahore, Pakistan https://orcid.org/0000-0002-1730-5025

DOI:

https://doi.org/10.3855/jidc.17041

Keywords:

ST11, K. pneumoniae, Multilocus sequence typing, ST147

Abstract

Introduction: Carbapenemases are primarily responsible for the intensified spread of multidrug-resistant (MDR) K. pneumoniae by virtue of antibiotics overuse. Therefore, frequent investigation of high-risk clones especially from developing world is crucial to curtail global spread.

Methodology: In this observational study, 107 K. pneumoniae were retrieved and confirmed genotypically from April 2018 to March 2020 from tertiary care hospitals in Lahore, Pakistan. Carbapenemases and extended-spectrum β-lactamases were verified by Polymerase Chain Reaction and Sanger sequencing. Multilocus sequence typing and plasmid replicon typing were used to assign clonal lineages and plasmid replicons.

Results: Among the K. pneumoniae, 72.9% (78/107) strains were carbapenem resistant (CR) with 65.4% (51/78) exhibiting carbapenemase producing phenotype. Among CR K. pneumoniae 38.5% (30/78) strains exhibited the following carbapenemase genotypes: bla_NDM-1 (26.7%, 8/30), bla_OXA-48 (26.7%, 8/30), bla_KPC-2 (20.0%, 6/30), bla_VIM (10.0%, 3/30), bla_NDM-1/bla_OXA-48 (10.0%, 3/30), bla_OXA-48/bla_VIM (3.3%, 1/30) and bla_OXA-48/bla_IMP (3.3%, 1/30). Tigecycline and polymyxin-B retained susceptible profile. β-lactam drugs showed intermediate to high resistance. The occurrence of CR K. pneumoniae infections was significantly associated with wound (39.7%, p = 0.0007), pus (38.5%, p = 0.009), general surgery (34.6%, p = 0.002) and intensive-care unit (26.9%, p = 0.04). bla_KPC-2 producing K. pneumoniae coharboring bla_CTX-M/bla_SHV (66.7%) and bla_CTX-M (33.3%) exhibited sequence type (ST) 258 (n = 4) and ST11 (n = 2) sequence types with IncFII, IncN, IncFIIA, IncL/M and IncFIIK plasmids.

Conclusions: This is the first report describing the emergence of MDR bla_KPC-2producing K. pneumoniae ST11 coharboring bla_CTX-M and bla_SHV in Pakistan.

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Published

2023-02-28

How to Cite

Jamal Gondal A, Saleem S, Choudhry N, Jawad Ahmad F, Bukhari H, Yasmin N, Jahan S (2023) Emergence of multidrug-resistant ST11 blaKPC-2 producing Klebsiella pneumoniae coharboring blaCTX-M and blaSHV in Pakistan. J Infect Dev Ctries 17:210–217. doi: 10.3855/jidc.17041

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Issue

Vol. 17 No. 02: February 2023

Section

Original Articles

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