Work

Phenotypic characteristics and carbapenemase genes in Klebsiella pneumoniae from patients at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal

Year: 2025

Type: article

Abstract: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as a critical nosocomial pathogen, associated with a substantial rise in morbidity and mortality. Phenotypic and molecular characterization of key carbapenemase genes in K. pneumoniae isolates is essential for understanding resistance mechanisms, guiding effective antibiotic stewardship and infection control strategies. This cross-sectional study was conducted from November 2023 to April 2024 at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu. Various types of clinical specimens were collected and processed for bacterial isolation and identification. Antimicrobial susceptibility testing was performed, isolates were screened for β-lactamase production. Carbapenem-resistant isolates were subjected to mCIM and eCIM tests to detect carbapenemase. The presence of bla KPC , bla NDM-1 , bla VIM , bla IMP and bla OXA-48-like genes was confirmed by polymerase chain reaction. Data were analyzed using Statistical Package for Social Sciences (SPSS). Out of total 812 samples, 21.2% (172/812) were culture positive. K. pneumoniae accounted for 28.5% (49/172) of isolates. More than half of the K. pneumoniae isolates were resistant to carbapenems, fluoroquinolones, aminoglycosides, nitrofurantoin and cotrimoxazole . Multidrug resistance (MDR) was observed in 73.5% (36/49) of isolates. ESBL and AmpC production were detected in 73.5% (36/49) and 44.9% (22/49) of isolates, respectively. Among 29 CRKP isolates, 62% (18/29) and 34.5% (10/29) were MBL and KPC producers respectively. Carbapenemase production was confirmed in 58.6% (17/29), while metallo-carbapenemase activity was seen in 55.1% (16/29) of CRKP isolates. The prevalence of bla NDM-1 , bla VIM and bla OXA-48-like were 58.6%, 10.3% and 6.9% in respective CRKP isolates. Co-existence of bla NDM-1 and bla VIM was observed in 6.9% (2/29), while bla NDM-1 and bla OXA-48-like in 3.4% (1/29) of the isolates. The study highlights the concerning prevalence of carbapenem-resistant K. pneumoniae in clinical settings, underscoring its role as a significant public health threat. Strengthening antimicrobial stewardship and implementing strict infection control measures are crucial to curb the spread of CRKP.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-025-11530-0

Authors: Babita Neupane, Madhu Dixit Devkota, Bharat Mani Pokhrel, Sandesh Rimal, Megha Raj Banjara

Institution: Tribhuvan University

Language: English

Topic: Antibiotic Resistance in Bacteria

Subfield: Molecular Medicine

Field: Biochemistry, Genetics and Molecular Biology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090