Evaluation of Carbapenems Resistance and Frequency of Klebsiella pneumoniae Carbapenemase (KPC) Enzyme in Klebsiella pneumoniae Strains Isolated from Clinical Samples and Determination of their Acquired Resistant profiles

The resistance of Klebsiella pneumoniae strains to antibiotics is an important challenge for human health. The aims of this study were evaluation of the carbapenemase resistance and Klebsiella pneumoniae carbapenemase (KPC) enzyme in Klebsiella pneumoniae isolates and determination of their acquired resistance profiles.
In a cross-sectional study, Klebsiella pneumoniae strains were isolated from different clinical specimens during one year. Their acquired resistance profiles were determined by 31 antibiotics from 17 classes and the numbers of Multi-drug resistance (MDR), extended drug resistance (XDR) and pan drug resistant (PDR) strains were determined. In carbapenem resistant strains, the Minimum Inhibitory Concentration (MIC) of imipenem and meropenem were calculated by Epsilometer test (Etest) method. Prevalence of the KPC enzyme in these strains was determined by phenotype method using Modified Hodge Test.
Findings: Among the 98 isolated Klebsiella pneumoniae strains, the most effective antibiotics were colistin, tigecycline and chloramphenicol respectively. The 99% of strains were MDR and 6% were XDR and no PDR strain was detected. Resistance to carbapenems in these strains were 64.3% for Doripenem, 69.4% for Ertapenem, 58.2% for imipenem (55.1% in E-test method) and 64.3 for meropenem (65.3% in E-test method). Expression of KPC enzymes in 71% of strains was identified.
Discussion & This study demonstrates the high prevalence of MDR strains and carbapenem drugs resistance and also high frequency of Klebsiella pneumoniae carbapenemase (KPC) enzyme in the Klebsiella pneumoniae isolates that it shows the urgent revision of the patterns of antibiotics consumption is necessary.