Emergence of CTX-M Group 1-ESBL producing Klebsiella pneumonia from a tertiary care centre in Karachi, Pakistan

  • Erum Khan Department of Pathology/Microbiolog, Aga Khan University Hospital, Karachi, Pakistan
  • Thamarai Schneiders Queen's University Belfast Northern Ireland
  • Afia Zafar Aga Khan University Hospital, Karachi
  • Erum Aziz Aga Khan University Hospital
  • Asra Parekh Aga Khan University Hospital
  • Rumina Hasan Aga Khan University Hospital, Karachi

Abstract

Background: Extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae have been reported previously from Pakistan but the genotypic characteristics of these enzymes is not known. Hence the aim of the study was first to characterise the genotypic content of these beta-lactamases and secondly to assess the clonal relationship of these isolates.

Methodology: We analysed 65 non-duplicate ESBL positive, K. pneumoniae isolates prospectively collected based on phenotype as detected using the two-disc method. Isolates were collected from different sources: blood cultures (46.15%; n = 30); tracheal aspirates (24.6%; n = 16); urine (10.7%; n = 7); wound swabs, pus and tissue (18.4%; n = 12). ESBL production was confirmed by the ESBL E-test method and the presence of the blaCTX-M encoding genes was confirmed by polymerase chain reaction. The clonal relationship of clinical isolates was studied by Pulsed Field Gel Electrophoresis.

Results: The results showed that 93.84% (n = 61) isolates of K. pneumoniae were positive for the blaCTX-M-1 group. One isolate showed PCR signals for blaCTX-M-25 group. None of our isolates were positive for CTX-M groups 2, 8 and 9. The majority of blaCTX-M positive isolates were genetically unrelated and no epidemic clones were identified. Conclusion: This study reports the emergence of CTX-M groups 1 and 25 producing isolates of K. pneumoniae with genetic diversity in Karachi, Pakistan.

Author Biographies

Erum Khan, Department of Pathology/Microbiolog, Aga Khan University Hospital, Karachi, Pakistan

Assistant Professor,

Department of Pathology and Microbiology

Thamarai Schneiders, Queen's University Belfast Northern Ireland

Centre for infection and Immunity

Afia Zafar, Aga Khan University Hospital, Karachi
Associatate Professor, Department of Pathology and Microbiology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
Erum Aziz, Aga Khan University Hospital
Research Assistant, Department of Pathology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
Asra Parekh, Aga Khan University Hospital
Research Assistant, Department of Pathology and Microbiology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan
Rumina Hasan, Aga Khan University Hospital, Karachi
Professor, Department of Pathology and Microbiology, Aga Khan University Hospital, Stadium Road Karachi, Pakistan
Published
2010-05-09
How to Cite
Khan E, Schneiders T, Zafar A, Aziz E, Parekh A, Hasan R (2010) Emergence of CTX-M Group 1-ESBL producing Klebsiella pneumonia from a tertiary care centre in Karachi, Pakistan. The Journal Of Infection In Developing Countries 4 (08): 472-476. https://doi.org/10.3855/jidc.674
Section
Original Articles

Keywords

Gram negative, extended spectrum beta lactamases, multidrug resistance, hospital acquired infections, non-clonal isolates, carbapenam resistance.