Publication Details
Abstract
Background: Klebsiella pneumoniae is a leading cause of multidrug-resistant infections, particularly in intensive care settings1,2, and represents a major challenge in healthcare-associated infection (HAI) management due to its capacity to horizontally acquire carbapenem resistance genes. Many studies shed light on antibiotic resistance genes, particularly those of the blaNDM and blaKPC genes in Klebsiella pneumoniae. Objective: This study aimed to analyze the genetic variation of Klebsiella pneumoniae isolates using the blaNDM and blaKPC genes obtained from ICU patients in Babylon Governorate, Iraq. Methods: A total of 200 clinical samples were collected from intensive care unit (ICU) patients, and 95 isolates were confirmed as carbapenem resistant (CRKP). Results: PCR results revealed that blaNDM was present in 73.7% of the isolates and blaKPC in 61.1% and both genes were present in 45.3% of the isolates. Our sequencing analysis showed various mutations at positions 70 (A → T) and 150 (C→G) were strongly associated with higher levels of resistance. High levels of expression of these genes were correlated with increased carbapenem resistance based on qPCR analysis. Clinical data also indicated that patients whose isolates contained both genes had a 50% higher mortality rate and an 18-day median hospital stay. Conclusion: The otcomes of the present study indicate the necessity for stronger implementation of molecular surveillance programs and strict infection control measures, as well as the need for the development of new therapeutic strategies in order to reduce CRKP transmission originating from hospitalized patients and subsequently imported into the ICU.