Phenotypic and Genotypic Profiles of Extended-Spectrum Beta-Lactamase-Producing Multidrug-Resistant <i>Klebsiella pneumoniae</i> in Northeastern Thailand

• Main Authors: Sumontha Chaisaeng (Author), Nattamol Phetburom (Author), Pachara Kasemsiri (Author), Nuntiput Putthanachote (Author), Naowarut Wangnadee (Author), Parichart Boueroy (Author), Anusak Kerdsin (Author), Peechanika Chopjitt (Author)
• Format: Book
• Published: MDPI AG, 2024-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

The global emergence of extended-spectrum beta-lactamase (ESBL)-producing <i>Klebsiella pneumoniae</i> presents a significant public health threat and complicates antibiotic treatment for infections. This study aimed to determine the prevalence of ESBL-producing <i>K. pneumoniae</i> in a clinical setting, analyze their antimicrobial susceptibility profiles, and characterize both phenotypic and genetic determinants. A total of 507 non-duplicate clinical isolates of <i>Enterobacterales</i> were collected between 2019 and 2020, and third-generation cephalosporin resistance was screened by disk diffusion. Identification of <i>K. pneumoniae</i> was confirmed using biochemical tests and PCR with species-specific primers. Antimicrobial susceptibility testing was conducted using disk diffusion, and phenotypic ESBL production was confirmed using the combined disk method. Multiplex PCR detected ESBL genes (<i>bla</i>_TEM, <i>bla</i>_SHV, and <i>bla</i>_CTX-M) and identified <i>bla</i>_CTX-M groups. The genetic relatedness of ESBL-producing strains was assessed using the ERIC-PCR approach. Fitty-four isolates were confirmed as ESBL producers, all classified as multidrug-resistant (MDR). All ESBL-producing <i>K. pneumoniae</i> isolates exhibited resistance to ampicillin and cefotaxime, with high resistance rates for ciprofloxacin (98.2%), azithromycin (94.4%), piperacillin-tazobactam (88.9%), and trimethoprim (83.3%). Genotypic analysis revealed <i>bla</i>_CTX-M was present in 94.4% of isolates, <i>bla</i>_SHV in 87%, and <i>bla</i>_TEM in 55.5%. The <i>bla</i>_CTX-M-1 group was the most prevalent, accounting for 96.1% of isolates. Co-harboring of <i>bla</i>_CTX-M, <i>bla</i>_SHV, and <i>bla</i>_TEM occurred in 42.6% of isolates, with co-carrying of <i>bla</i>_CTX-M, and <i>bla</i>_SHV was observed in 23/54 isolates. The ERIC-PCR analysis revealed 15 distinct types, indicating high genetic diversity. These findings highlight the urgent need for ongoing monitoring to control the spread of ESBL among <i>K. pneumoniae</i> and emphasize the importance of early detection and appropriate antibiotic selection for effectively treating infection caused by these pathogens.

Item Description

10.3390/antibiotics13100917
2079-6382