Abstract
Introduction: Health concerns about Klebsiella pneumoniae, which causes urinary tract infections (UTIs) and sepsis, are increasing worldwide. In addition, New Delhi metallo-ß-lactamase (NDM) carrier K. pneumoniae and other Gram-negative bacteria appear to cause serious clinical problems. This study aimed to reveal NDM-1 positive K. pneumoniae carrier status, molecular properties, and antibiotic resistance differences of patients who have bacteremia due to urinary system infections.
Methods: Blood culture, biochemical tests, Vitek2, polymerase chain reaction, sequencing, phylogenetic analysis, and multilocus sequence typing (MLST) methods were used for the microbiological analysis of K. pneumoniae strains.
Results: Overall, 146 K. pneumoniae strains were obtained from the cultures, 16 of which were found to be NDM-1 positive. Although these strains were discovered to have resistance to the authorized antibiotics, they were sensitive to gentamicin (CN), colistin (CT), and trimethoprim/sulfamethoxazole (SXT). Furthermore, it was found that the resistance rates of carbapenem (ertapenem (Etp), imipenem (Ipm), and meropenem (Mem)) were high. All K. pneumoniae strains represented extended-spectrum beta-lactam resistance. It was found that the phylogenetic affinities of K. pneumoniae strains were higher with Asian strains. Five and eleven K. pneumoniae isolates were determined to be ST17 and ST147 type variations, respectively, as a conclusion of the MLST study.
Conclusions: It was observed that the presence of NDM-1-positive K. pneumoniae may pose a serious problem in patients with bacteremia caused by UTI. It has been demonstrated that it is important to develop preventive and control measures in the hospital by considering NDM-1-positive K. pneumoniae strains with multi-drug resistance.