Molecular detection and antimicrobial resistance pattern of carbapenem-resistant Klebsiella pneumoniae isolated from patients with lower respiratory tract infections
Jul 2026· International Journal of Research in Medical Sciences· Vol 14, pp. 3207-3211· 0 citations· 14 references
TL;DR
One in every fourth KP isolate was CRKP, which highlighted the need for careful prescription of carbapenems for the therapy of infectious diseases with ESBL-producing KP.
Abstract
Background: Recently worldwide, carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has attracted a lot of attention because of the scarcity of effective drugs and the severity of the illness as well as the high death rate. This study was conducted to assess the antimicrobial susceptibility profiles and the molecular identification of CRKP isolates that were obtained from patients with lower respiratory tract infection (LRTI) at a tertiary care hospital in Sylhet, Bangladesh.
Methods: This cross-sectional study was conducted in the Department of Microbiology at Sylhet MAG Osmani Medical College, Sylhet, from July 2021 to June 2022. A total of 153 sputum samples were collected from adult patients (≥18 years) clinically diagnosed with LRTIs. Data were analyzed using SPSS version 26.
Result: Among 153 sputum samples from LRTI patients, 66.0% showed bacterial growth, with Klebsiella pneumoniae accounting for 20.9% of isolates. The mean age was 52.43±17.12 years with male predominance (69.3%). Of the Klebsiella pneumoniae isolates, 25.0% were carbapenem-resistant (CRKP), among which 75.0% produced carbapenemase and 50.0% harbored the KPC gene. Overall isolates showed high resistance to cephalosporins (up to 81.2%) and moderate sensitivity to carbapenems (around 72–75%) and amikacin (56.2%). CRKP isolates demonstrated marked multidrug resistance, with high resistance to most antibiotics, including carbapenems (75.0%).
Conclusion: In conclusion, one in every fourth KP isolate was CRKP, which highlighted the need for careful prescription of carbapenems for the therapy of infectious diseases with ESBL-producing KP. Among different genes conferring resistance to carbapenems, only the blaKPC gene was investigated in this study.
Background: Klebsiella pneumoniae is a major opportunistic pathogen responsible for a wide range of severe nosocomial and community-acquired infections. The rapid global dissemination of multidrug-resistant (MDR) and carbapenem-resistant K. pneumoniae (CRKP) strains severely restricts therapeutic alternatives and significantly raises patient mortality rates.
AIM: This study aimed to evaluate the antibiotic susceptibility pattern of K. pneumoniae from clinical isolates and evaluate the carbapenemase-producing strains using the rapid Carba NP test within a tertiary care hospital.
Materials & Methods: An observational cross-sectional study was conducted from May 2024 to July 2025 at the Department of Medical Microbiology, Santosh Medical College and Hospital (Ghaziabad) and Rama Medical College (Harpur). A total of 335 non-duplicated K. pneumoniae isolates collected from various clinical specimens (including urine, sputum, pus, and blood) across all age groups and genders were included. Bacterial identification was achieved through standard cultural characteristics and biochemical profiling. Antibiotic susceptibility testing (AST) was performed on Muller-Hinton agar using the Kirby-Bauer disc diffusion method, and phenotypic validation of carbapenemase production was executed using the Carba NP test in strict accordance with CLSI guidelines.
Results: Out of 335 isolates, the highest rate was retrieved from urine samples (40.3%), followed by sputum (26.6%) and pus (14.0%). The General Medicine ward presented the heaviest burden (54.43%), followed by Surgery (20.30%). The highest incidence occurred within the 51–60 age group (73 cases), demonstrating an overall male predominance in older populations, while a female predominance was isolated among young adults aged 21–30 years. In sensitivity pattern. Alarming rates of resistance were observed for ampicillin (>80% across sputum, pus, and blood) and early-to-late-generation cephalosporins. Carbapenems (meropenem and imipenem) sustained solid sensitivity in blood (84.4%) and urine (73.3% meropenem, 79.3% imipenem), but critical reduction in pus samples, where resistance rates were between 36.2% and 40.4%.
The Carba NP test successfully identified 45 phenotypic carbapenemase-producing isolates (yielding an overall positivity rate of 13.43%). Proportional carbapenemase positivity was most concentrated in endotracheal (ET) tube specimens (36.36%) and pus samples (31.91%).
Conclusions: The study shows an alarming level of multidrug resistance and a significant rise in carbapenemase producing K. pneumoniae isolates, particularly within device-associated (ET tube) and wound (pus) environments.
Zenab Naseem, A. Rawat, Muzaffari Yasmeen· Adolescência e Saúde· 0 citations
Background: Klebsiella pneumoniae is a critical contributor to both community- and hospital-acquired infections, with rising multidrug resistance (MDR) posing serious therapeutic challenges.
Objective: This study assessed the prevalence of K. pneumoniae and its antimicrobial susceptibility patterns among clinical specimens collected at Chittagong Medical College, Bangladesh.
Methodology: This cross-sectional study was conducted from July 2022 to June 2023 in Chittagong Medical College, Chattogram. A total of 320 clinical specimens (urine, wound swabs, sputum, blood) from inpatients and outpatients were subjected to culture and sensitivity. Conventional microbiological identification was confirmed by 16S rRNA PCR. Antimicrobial susceptibility (excluding colistin) was tested via the Modified Kirby–Bauer disk diffusion method (CLSI 2022). Colistin resistance was assessed using the colistin agar test, applying CLSI breakpoints.
Results: Overall culture positivity was 63.4% (203/320). Klebsiella pneumoniae was confirmed in 16.9% (54/320) of samples, most commonly isolated from sputum (51.4%), followed by wound swabs (17.1%), urine (11.8%), and blood (6.5%). Among the 54 Klebsiella pneumoniae isolates, resistance rates were highest against amoxiclav (94.4%), with lower resistance observed for aminoglycosides (amikacin, 24.1%) and meropenem (31.5%). Colistin resistance was detected in 12.9% (7/54) of Klebsiella pneumoniae isolates.
Conclusion: The prominence of Klebsiella pneumoniae and its variable degree of resistance to multiple antibiotics, underscores an urgent need for enhanced antimicrobial stewardship, accurate diagnostics, and robust surveillance in Bangladesh.
Bangladesh Journal of Medical Microbiology, January 2026;20 (1):3-9
D. Chowdhury, Sahed Uddin, Pompy Dey et al.· Bangladesh Journal of Medica...· 0 citations
A high resistance rate in K. pneumoniae to a widely used antibiotic is found and the presence of blaNDM is confirmed, highlighting the need for antimicrobial stewardship and strengthened local surveillance.
I. Nzabanterura, Samson Adewale Oyebadejo, Djibril Mbarushimana et al.· American Journal of Tropical...· 0 citations
Urinary tract infection is among the most common infectious disease ranking next to upper respiratory tract infection. Therefore, studying bacterial pathogens causing urinary tract infection and their antimicrobials susceptibility patterns are of the highest priority. Infections caused by Klebsiella pneumoniae have become a significant worldwide public health problem. This study was aimed at phenotypic characterization of extended spectrum beta-lactamase (ESBL)-and carbapenemase producing Klebsiella pneumoniae from urinary tract infection in a secondary health facility in Calabar, Southern Nigeria. One hundred and fifty (150) urine samples were collected, and analyze using standard microbiological techniques on chromogenic agar. A total number of 21 non repetitive clinical bacterial strains were isolated, out of which (9/12; 42.85%) isolation rate falls in the age range greater than 60 years significantly higher at p>0.05 than that recorded for age range 21-31 years (1/21; 5.56%). The female gender showed high 58% isolation rate. Results for the screening of Klebsiella pneumoniae isolates for ESBL- and carbapenemase production revealed (5/21; 23.80%) to be ESBL-producers and (1/5;20%) to be resistant to imipenem antibiotics and were characterized and identified as strains of Klebsiella pneumoniae. Antimicrobials susceptibility profile of ESBL-and carbapenemase producers showed them to be susceptible to streptomycin, imipenem and, sulfonamide, ofloxacin respectively. The findings in this study indicate that age group of over 60 years are prone to urinary tract infection cause by Klebsiella pneumoniae and that one has more of it in the female gender.
Effiom E. Henshaw, J. Lennox· Global Journal of Pure and A...· 0 citations
Gut colonization with multidrug-resistant (MDR) Klebsiella pneumoniae is commonly associated with an increased risk of extraintestinal infections among hospitalized patients. Extensive antibiotic exposure during the COVID-19 pandemic, is a critical contributing factor for the emergence of resistant strains. This investigation sought to elucidate the phenotypic and molecular resistance traits of carbapenem-resistant K. pneumoniae (CRKP) and extended-spectrum β-lactamase–producing K. pneumoniae (ESBL-KP) colonizing the gut of pediatric patients with confirmed COVID-19. A cross-sectional study was conducted from October 2020 to March 2022 at a tertiary pediatric hospital in Fayoum, Egypt. Fecal samples were collected from hospitalized pediatric COVID-19 patients. K. pneumoniae isolates were identified using standard microbiological methods. Antimicrobial susceptibility testing was carried out in accordance with the CLSI guidelines. ESBL and carbapenemase production were assessed phenotypically, while resistance genes were detected by multiplex and uniplex PCR. Microtiter plate method was used to assess biofilm formation. K. pneumoniae was detected in 36 of 71 patients (50.7%) using antibiotic-supplemented selective culture. The isolated strains were exclusively resistant, including 22 CRKP and 14 ESBL-KP. Colistin susceptibility was maintained in all isolates. CRKP strains showed significantly increased rate of resistance to fluoroquinolones and amikacin compared with ESBL-KP. BlaNDM gene (54.5%) and blaKPC (45.5%) were detected among CRKP isolates. ESBL-associated genes blaCTX-M, blaTEM, and blaSHV were prevalent in both groups. Biofilm formation was common and comparable between CRKP and ESBL-KP isolates. A high prevalence of fecal carriage of MDR K. pneumoniae, driven by carbapenemase-producing strains, was observed among hospitalized pediatric COVID-19 patients. These outcomes highlight the necessity for routine colonization surveillance, optimized antimicrobial stewardship, and strengthened infection control strategies in pediatric settings.
M. Khalil, M. El-Ansary, Sara I. AboElnour et al.· BMC Microbiology· 1 citation
Antibiotic resistance in
Klebsiella pneumoniae
is a major threat to global health. Despite its clinical importance, regional data from Saudi Arabia remain limited. This study analyzed the resistance patterns of
K. pneumoniae
isolates collected from the King Fahad Specialist Hospital in Al-Qassim between January 2015 and December 2023.
A retrospective cross-sectional analysis was conducted on 3,838 confirmed
K. pneumoniae
cases. Data were extracted from hospital electronic records and analyzed using R software. Descriptive and inferential statistics were used to examine resistance patterns by specimen type, age, sex, and hospital department.
High resistance rates were observed to first-line antibiotics, particularly third-generation cephalosporins (59.18%–68.69%), amoxicillin-clavulanate (58.38%), and piperacillin-tazobactam (52.81%). Resistance to fluoroquinolones ranged from 53.85% to 56.36%. In contrast, higher susceptibility was observed for aminoglycosides and carbapenems. Resistance was more frequent in ESBL-producing strains, with limited presence of MDR strains. Age and sex were associated with an increased risk of resistance.
The
Klebsiella pneumoniae
isolates in this study demonstrated significant resistance to commonly prescribed antibiotics. ESBL production substantially contributed to resistance patterns. Although aminoglycosides and carbapenems have shown relative effectiveness, emerging resistance trends underscore the need for continuous monitoring and strict antibiotic stewardship in hospital settings.
Not applicable.
N. Al‐Sowayan, Farah Al-masoud, Manal Almutari et al.· BMC Infectious Diseases· 0 citations
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