Molecular characterization of carbapenem resistant klebsiella pneumoniae in Malaysia hospital

Min Yi Lau, Fui Enn Teng, Kek Heng Chua, Sasheela Ponnampalavanar, Chun Wie Chong, Kartini Abdul Jabar, Cindy Shuan Ju Teh

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) is a great concern, as carbapenems are the last-line therapy for multidrug-resistant Gram-negative bacteria infections. This study aims to report the epidemiology of CRKP in a teaching hospital in Malaysia based on the molecular genotypic and clinical characteristics of the isolates. Sixty-three CRKP strains were isolated from a tertiary teaching hospital from January 2016 until August 2017. Carbapenemase genes were detected in 55 isolates, with blaOXA-48 (63.5%) as the predominant carbapenemase gene, followed by blaNDM (36.5%). At least one porin loss was detected in nine isolates. Overall, 63 isolates were divided into 30 clusters at similarity of 80% with PFGE analysis. Statistical analysis showed that in-hospital mortality was significantly associated with the usage of central venous catheter, infection or colonization by CRKP, particularly NDM-producers. In comparison, survival analysis using Cox proportional hazards regression identified a higher hazard ratio for patients with a stoma and patients treated with imipenem but a lower hazard ratio for patients with NDM-producing CRKP. OXA-48 carbapenemase gene was the predominant carbapenemase gene in this study. As CRKP infection could lead to a high rate of in-hospital mortality, early detection of the isolates was important to reduce their dissemination.

    Original languageEnglish
    Article number279
    Number of pages16
    JournalPathogens
    Volume10
    Issue number3
    DOIs
    Publication statusPublished - Mar 2021

    Keywords

    • Carbapenem-resistant Klebsiella pneumoniae
    • Carbapenemase
    • Enterobacteriaceae
    • NDM
    • OXA-48
    • PFGE

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