Phenotypic and Genotypic Features of <i>Klebsiella pneumoniae</i> Harboring Carbapenemases in Egypt: OXA-48-Like Carbapenemases as an Investigated Model

• Main Authors: Suzan Mohammed Ragheb, Mahmoud Mohamed Tawfick, Amani Ali El-Kholy, Abeer Khairy Abdulall
• Format: Article
• Language: English
• Published: MDPI AG 2020-11-01
• Series: Antibiotics
• Subjects: <i>Klebsiella pneumoniae</i>; carbapenemases; <i>bla</i>_OXA-48; ERIC-PCR; plasmid profile analysis; biofilm formation
• Online Access: https://www.mdpi.com/2079-6382/9/12/852

This study aimed at the characterization of carbapenem-resistant <i>Klebsiella pneumoniae</i> isolates focusing on typing of the <i>bla</i>_OXA-48-like genes. Additionally, the correlation between the resistance pattern and biofilm formation capacity of the carbapenem-resistant <i>K. pneumoniae</i> isolates was studied. The collected isolates were assessed for their antimicrobial resistance and carbapenemases production by a modified Hodge test and inhibitor-based tests. The carbapenemases encoding genes (<i>bla</i>_KPC, <i>bla</i>_NDM, <i>bla</i>_VIM, <i>bla</i>_IMP, and <i>bla</i>_OXA-48-like) were detected by PCR. Isolates harboring <i>bla</i>_OXA-48-like genes were genotyped by Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction (ERIC-PCR) and plasmid profile analysis. The discriminatory power of the three typing methods (antibiogram, ERIC-PCR, and plasmid profile analysis) was compared by calculation of Simpson’s Diversity Index (SDI). The transferability of <i>bla</i>_OXA-48 gene was tested by chemical transformation. The biofilm formation capacity and the prevalence of the genes encoding the fimbrial adhesins <i>(fimH-1</i> and <i>mrkD</i>) were investigated. The isolates showed remarkable resistance to β-lactams and non-β-lactams antimicrobials. The coexistence of the investigated carbapenemases encoding genes was prevalent except for only 15 isolates. The plasmid profile analysis had the highest discriminatory power (SDI = 0.98) in comparison with ERIC-PCR (SDI = 0.89) and antibiogram (SDI = 0.78). The transferability of <i>bla</i>_OXA-48 gene was unsuccessful. All isolates were biofilm formers with the absence of a significant correlation between the biofilm formation capacity and resistance profile. The genes <i>fimH-1</i> and <i>mrkD</i> were prevalent among the isolates. The prevalence of carbapenemases encoding genes, especially <i>bla</i>_OXA-48-like genes in Egyptian healthcare settings, is worrisome and necessitates further strict dissemination control measures.