Extended and Pan-drug resistance in Klebsiella pneumoniae due to Carbapenemase and Extended Spectrum -lactamase enzymes

Purpose: Emergence of resistance to multiple antimicrobial agents in pathogenic bacteria has become a significant public health threat as there are fewer, or even sometimes no effective antimicrobial agents available for infections caused by these bacterial pathogens. Infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and Extended Spectrum -lactamase (ESBL) enzyme is a worldwide problem associated with high rates of treatment failure and mortality. Objective of the present investigation is to study molecular characterization of K. pneumoniae resistant due to ESBL and carbapenemase enzymes and other mechanism of antibiotic resistant. Methods: Three hundred and eleven K. pneumoniae cultures were isolated and identified from clinical samples from hospitals in Barshi-Solapur, Maharashtra, India. Antibiotic susceptibility was determined by manually as well as by Vitek-2 machine. The enzymatic -lactam resistance mechanism was confirmed through specific -lactamase gene PCR genotype determination. Results: ESBL resistance was observed in 310 (88.57%) isolates and carbapenemase in 181 (51.71%) isolates were the main mechanism of antibiotic resistance. We found 29 (8.28%) isolates K. pneumoniae pandrug resistant meaning resistant to all antibiotics and 52 (14.85%) isolates susceptible to colistin only. We found extreme drug resistance in 135 (38.57%) of the K. pneumoniae isolates. Majority of K. pneumoniae isolated were resistant to all antimicrobial agents denoting prevalence of high antibiotic resistance.