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CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(04): 312-316
DOI: 10.4103/JLP.JLP_111_19
Original Article

Prevalence and clonal relatedness of NDM and OXA-48-producing Klebsiella pneumoniae in a tertiary care hospital in South India

Poothakuzhiyil Remya
Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Mariappan Shanthi
Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
,
Uma Sekar
Department of Microbiology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
› Author Affiliations Financial support and sponsorship This study was supported by the Founder Chancellor Sri Ramasamy Udayar Fellowship, provided by Sri Ramachandra Institute of Higher Education and Research.
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Abstract

BACKGROUND: Carbapenems are used for the treatment of serious infections caused by multidrug-resistant Klebsiella pneumoniae. Resistance to carbapenems in K. pneumoniae is mainly due to metallo-beta-lactamases (NDM, IMP, and VIM) and class D oxacillinase (OXA-48-like).

AIM AND OBJECTIVE: This study was undertaken to detect the genes encoding for carbapenemase in K. pneumoniae and to determine the clonal relatedness of selected isolates of K. pneumoniae producing NDM and OXA-48 by pulsed-field gel electrophoresis method (PFGE).

MATERIALS AND METHODS: The isolates were collected over a period of 1 year. A total of 370 clinically significant, nonduplicate isolates of K. pneumoniae were included in this study. Phenotypic tests for the detection of carbapenemases were performed for all the isolates. Polymerase chain reaction (PCR) was carried out for the detection of carbapenemase genes such as blaKPC, blaIMP, blaVIM,blaNDM, and blaOXA-48. PFGE was performed, and the PFGE profiles were analyzed and compared using BioNumerics version 7.6.

RESULTS: Of the 370 isolates of K. pneumoniae, carbapenemase genes were detected in 13.78% (51/370). blaOXA-48was the prevalent gene detected followed by blaNDMand blaKPC. Thirty strains of K. pneumoniae selected by PFGE analysis were divided into five clusters (A, B, C, D, and E). Cluster C was the major type detected carrying blaNDMand blaOXA-48genes.

CONCLUSION:blaOXA-48was the most prevalent gene detected in this study. PCR is useful in detecting carbapenemase genes, especially blaNDM, which may show false susceptibility to carbapenems. There was no direct correlation detected between PFGE profiles and antibiotic susceptibility pattern. PFGE has revealed the genomic diversity among isolates, thereby suggesting heterogeneity in strain circulation within intensive care unit and wards of the hospital. Monitoring and molecular typing is essential to curtail the spread of multidrug-resistant strains and control the outbreaks of infection.

Key words

Carbapenemase - clonal relatedness - genotypic tests - Klebsiella pneumoniae - phenotypic tests - prevalence


Publication History

Received: 09 July 2019

Accepted: 24 November 2019

Article published online:
07 April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
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