Characterization of phenotypic and genotypic traits of Klebsiella pneumoniae strains resistant to 3rd generation cephalosporins in hospital settings: A case study in Ho Chi Minh City, Vietnam

越南胡志明市医院环境中耐第三代头孢菌素肺炎克雷伯菌菌株的表型和基因型特征分析:案例研究

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Abstract

BACKGROUND: Klebsiella pneumoniae is a dangerous pathogen, responsible for a variety of infections and has been growing resistance to antibiotics, making it difficult to treat diseases caused by this bacterium. A better understanding of the phenotypic and genotypic characteristics of this bacterium is essential for developing more effective treatments. This study examines the prevalence of Klebsiella pneumoniae in patient samples from eight hospitals in Ho Chi Minh City, Vietnam, in 2023, focusing on its AmpC β-lactamase, ESBL, and carbapenemase genotypes. METHODS AND RESULTS: A total of 230 Klebsiella pneumoniae strains were isolated from clinical specimens, including sputum, pus, urine, bronchial lavage fluid, blood, and other fluids. The disk diffusion method detected the presence of these resistance enzymes, while multiplex real-time PCR identified the associated genes. Results showed that 78.7% of isolates produced AmpC β-lactamase, 21.3% produced ESBL, and 27.0% produced carbapenemase. ESBL-producing strains (90.9%) were more common than AmpC (67.4%) and carbapenemase (45.7%) strains. Additionally, 27.0% of isolates produced multiple resistance enzymes. The most prevalent AmpC gene was DHA (63.5%), while SHV (84.3%), TEM (55.2%), and CTX-M (70.0%) were the most common ESBL genes. OXA-48 (31.3%) was the dominant carbapenemase gene, followed by NDM1 (24.8%) and KPC (9.1%). On average, each strain carried 3.3 resistance genes. CONCLUSIONS: This study reveals a high prevalence of antimicrobial resistance in Klebsiella pneumoniae isolates from patient samples in Ho Chi Minh City hospitals, notably to third-generation cephalosporins and carbapenems. These findings highlight the need for ongoing surveillance and improved treatment strategies.

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