Assessment of the activity of tigecycline and colistin on biofilm producer Klebsiella pneumoniae isolated from COVID-19 patients, Iran

Abstract

Abstract Background Pneumonia caused by β-lactamase-producing Klebsiella pneumoniae is encountered in hospitals. We aimed to investigate the activity of tigecycline, colistin and other selected antibiotics against 27 β-lactamase-producing Klebsiella pneumonia isolated from bronchoalveolar lavage (BAL) in COVID-19 patients. Methods In the current survey phenotypic screening of ESBL, AmpC, and carbapenemase enzymes was carried out. Detection of ESBL, AmpC, and carbapenemase genes was also performed by the PCR method. Biofilm formation was assessed by staining with 1% crystal violet. Finally, a set of the virulence-encoding genes were detected by the PCR method. Results This study demonstrated the high percentage of ESBL and carbapenemase-producing Klebsiella pneumoniae among COVID-19 patients. Tigecycline and colistin were more effective against these isolates. ESBL associated genes were detected in (18 (66.7%) blaTEM, 27 (100%) blaSHV, and 18 (66.7%) blaCTX−M) isolates. Also, carbapenemase-related genes were detected in 16 (59.3%) isolates. The prevalence of these genes were blaOXA−48−like 14(51.9%), and blaNDM1 2 (7.4%). Twenty-seven isolates exhibited biofilm formation. Molecular distribution of virulence genes revealed that 92.59%, 92.5%, 88.88%, 11.11% and 18.5% of the isolates carried entB, mrkD, Irp2, fimH and magA genes, respectively. MLST results for four colistin-resistant isolates showed three different sequence types-ST: ST3500, ST273, and 2 cases of ST2558. Conclusion The results of this study demonstrated the prevalence of infections caused by β-lactamase-producing Klebsiella pneumoniae, which are biofilm producers among respiratory hospitalized Patients. The effective antimicrobial activity of tigecycline to the bacteria that produce these enzymes may be efficient in faster and better treating COVID-19 patients which are hospitalized.