Scholarlink

Objective <p><i>Klebsiella pneumoniae,</i> a major nosocomial pathogen, is increasingly associated with multidrug resistance and carbapenem production, posing a significant therapeutic challenge on a global scale. The study aimed to determine the distribution, antimicrobial susceptibility pattern, and molecular identification of <i>bla</i><sub>KPC−2</sub> and <i>bla</i><sub>VIM</sub> genes among carbapenem-resistant <i>K. pneumoniae</i> isolated from clinical specimens.</p> Methods <p>Between January and June 2024, a hospital-based cross-sectional study was carried out at Kirtipur Hospital in Nepal. Standard microbiological protocols were adopted for the processing of 5002 clinical samples. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method following CLSI guidelines. The modified carbapenem inactivation method (mCIM) and the EDTA-modified carbapenem inactivation method (eCIM) were used to confirm carbapenemase production phenotypically, and the polymerase chain reaction (PCR) was used to detect the <i>bla</i><sub>KPC−2</sub> and <i>bla</i><sub>VIM</sub> genes at the molecular level.</p> Results <p>Of the total samples, 18.3% (917) showed bacterial growth, with <i>K. pneumoniae</i> accounting for 7.6% (<i>n</i> = 70) of isolates, predominantly from wound/pus (35.7%), urine (32.8%), and blood (17.1%) specimens. High resistance was observed against imipenem (68.6%), ceftazidime (64.3%), and ceftriaxone (62.9%), whereas tigecycline and doxycycline remained the most effective ones. Twelve (30.8%) of the 39 carbapenem-resistant isolates were determined to be carbapenemases producers, all harboring <i>bla</i><sub><i>KPC−2</i></sub> (100%) and three (25%) additionally carrying <i>bla</i><sub><i>VIM</i></sub>.</p> Conclusion <p>The dominance of KPC-mediated resistance among the hospitalized patients, underscores the need for rigorous infection control, ongoing molecular surveillance, and prudent antimicrobial stewardship to stop the spread of high-risk <i>K. pneumoniae</i> strains in healthcare environments.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

High burden of blaKPC−2–positive carbapenem-resistant Klebsiella pneumoniae among inpatients in a Tertiary Care Hospital in Kathmandu

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月3日

查看全文
  • Shashi Gurung,
  • Milan Kumar Upreti,
  • Agrani Paudel,
  • Khadga Bikram Angbuhang,
  • Sanjit Shrestha,
  • Upendra Thapa Shrestha,
  • Megha Raj Banjara

摘要

Objective

Klebsiella pneumoniae, a major nosocomial pathogen, is increasingly associated with multidrug resistance and carbapenem production, posing a significant therapeutic challenge on a global scale. The study aimed to determine the distribution, antimicrobial susceptibility pattern, and molecular identification of blaKPC−2 and blaVIM genes among carbapenem-resistant K. pneumoniae isolated from clinical specimens.

Methods

Between January and June 2024, a hospital-based cross-sectional study was carried out at Kirtipur Hospital in Nepal. Standard microbiological protocols were adopted for the processing of 5002 clinical samples. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method following CLSI guidelines. The modified carbapenem inactivation method (mCIM) and the EDTA-modified carbapenem inactivation method (eCIM) were used to confirm carbapenemase production phenotypically, and the polymerase chain reaction (PCR) was used to detect the blaKPC−2 and blaVIM genes at the molecular level.

Results

Of the total samples, 18.3% (917) showed bacterial growth, with K. pneumoniae accounting for 7.6% (n = 70) of isolates, predominantly from wound/pus (35.7%), urine (32.8%), and blood (17.1%) specimens. High resistance was observed against imipenem (68.6%), ceftazidime (64.3%), and ceftriaxone (62.9%), whereas tigecycline and doxycycline remained the most effective ones. Twelve (30.8%) of the 39 carbapenem-resistant isolates were determined to be carbapenemases producers, all harboring blaKPC−2 (100%) and three (25%) additionally carrying blaVIM.

Conclusion

The dominance of KPC-mediated resistance among the hospitalized patients, underscores the need for rigorous infection control, ongoing molecular surveillance, and prudent antimicrobial stewardship to stop the spread of high-risk K. pneumoniae strains in healthcare environments.