Multidrug Resistance in Integron Bearing Klebsiella pneumoniae isolated from Alexandria University Hospitals, Egypt
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Multidrug Resistance in Integron Bearing Klebsiella pneumoniae isolated from Alexandria University Hospitals, Egypt Marwa Atef Yakout1 · Ghada Hani Ali1 Received: 6 April 2020 / Accepted: 17 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Klebsiella pneumoniae is by far one of the most common Enterobacteriaceae associated with hospital-acquired infections. The dissemination of multi drug resistant Klebsiella pneumoniae is causing difficulty to treat infections worldwide. Of additional concern, multi drug resistant Klebsiella pneumoniae acquires and transfers antibiotic resistance genes among other bacterial isolates. Integrons have the main role in the acquisition as well as dissemination of resistance genes. Accordingly we aimed to investigate the frequency of resistance genes sul1, sul2, tetA, tetB and aac (3) IIa, class one (int1 gene) and class two integrons(int2 gene) in Klebsiella pneumoniae clinical isolates from four major hospitals in Alexandria, Egypt using Polymerase Chain Reaction. In addition we aimed to evaluate the association between multidrug resistance and presence of integrons in hospital-acquired Klebsiella pneumoniae in our hospitals. To the best of our knowledge, there is little information about integrons and acquisition of multiple antibiotic resistance in Klebsiella pneumoniae in hospitals in Alexandria, Egypt. In this study 76 isolates were resistant to sulphamethoxazole /trimethoprim. Of these 38 isolates (50%) harbored both genes sul1 and sul2 genes. 42 isolates out of the 60 (70%) isolates that showed resistance to tetracycline were tetA or tetB positive. The prevalence of int1 gene among all isolates tested was 90%, while only one isolate harbored the int2 gene (1%). Our results were indicative of the high prevalence of multidrug resistant Klebsiella pneumoniae as well as integrons that were found to play an essential role in the dissemination of antibiotic resistance genes in our hospitals.
Introduction According to the World Health Organization, the Centers for Disease Control and Prevention in the United States Klebsiella pneumoniae is considered one of the multi drug resistant emerging pathogens that represents a universal threat to human health. K. pneumoniae infections are particularly problematic among neonates, immunocompromised and elderly people. It is also responsible for a remarkable number of hospital-related infections such as, pulmonary system, circulating system, soft tissue and urinary tract infections worldwide [1–3]. A significant increase in the rates of resistance of K. pneumoniae strains isolated from clinical settings to the different drugs have been noticed lately [3, 4].
* Marwa Atef Yakout [email protected]; [email protected] 1
Department of Microbiology and Immunology, Faculty of Pharmacy and Drug Manufacturing, Pharos University in Alexandria, Smouha, Mahmoudeya Canal, Alexandria 21311, Egypt
Acquisition of resistance genes is considered one of the main factors that contributes for the wide spread
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