A Study on Carbapenemase Producing Klebsiella Pneumoniae In Beni Suef University Hospital

Abstract

Background: Widespread dissemination of Klebsiella pneumoniae carbapenemase (KPC) is of major concern in healthcare settings. Resistance to carbapenems involves multiple mechanisms such as the production of carbapenemases, impermeability of outer membrane and efflux pump mechanism. Objective: The aim of this study was to evaluate the prevalence of carbapenemase-producing K. pneumoniae strains among various clinical specimens obtained from different wards and to detect KPC as a mechanism of resistance. Methods: 100 samples of urine and sputum (55 urine and 45sputum) were collected from outpatients and inpatients attending urology and chest departments in Beni Suef University Hospital aiming to isolate K.pneumniae during the period of December 2016 through January 2018. The isolates were tested for susceptability to ertapenem using E test. Resistant isolates were subjected to phenotypic detection of carbapenemase production by MHT and molecular assessment of KPC gene by PCR. Phylogentic tree was used to detect their relationship. Results: K.pneumonia were isolated from 31(31%) of the samples taken. Out of them 19(61.8%) were resistant to ertapenem. By MHT,17/19 (89.4%) were positive for carbapenemase; and only 13 out of them (76.4%) were confirmed as KPC by PCR. Conclusion: High rate of carbapenem- resistance in K. pneumoniae by both phenotypic and molecular methods. Initiating appropriate infection control measures along with a strictly implemented antibiotic stewardship program are necessary to prevent their spread.