Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine
Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a difficult to treat organism owing to limited therapeutic options. So far, little is known about the molecular characteristics of CRKP in Palestine. Objectives: The aim of this study was to investigate the antimicrobial resistance pat...
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Elsevier
2025-03-01
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| Series: | International Journal of Medical Microbiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1438422125000013 |
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| author | Nahed Al Laham Ahmed Al Afifi Alexander Mellmann Frieder Schaumburg |
| author_facet | Nahed Al Laham Ahmed Al Afifi Alexander Mellmann Frieder Schaumburg |
| author_sort | Nahed Al Laham |
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| description | Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a difficult to treat organism owing to limited therapeutic options. So far, little is known about the molecular characteristics of CRKP in Palestine. Objectives: The aim of this study was to investigate the antimicrobial resistance patterns, multilocus sequence types (ST) and resistance genes among clinical K. pneumoniae isolates from hospitalized patients in Gaza Strip, Palestine. Methods: K. pneumoniae from blood cultures (n = 55) were collected at two hospitals in Gaza Strip (2023) and identified by MALDI-TOF-MS. Antimicrobial susceptibility testing was done using VITEK-2 automated systems. Carbapenemases were phenotypically detected. Whole genome sequencing (WGS) of all CRKP isolates was performed to assess determinants for carbapenem resistance and genotypes. Results: Of all K. pneumoniae isolates, 40 % (n = 22/55) were CRKP. Among CRKP, cefiderocol showed the least resistance (46 %, n = 10/22) while ceftazidime/avibactam showed a synergistic effect with aztreonam (36 %, n = 8/22). The majority (86 %, n = 19/22) of CRKP carried metallo-β-lactamases, and only 9 % (n = 2/22) encoded OXA-48 carbapenemase. WGS of CRKP revealed that the predominant genotype is multilocus sequence type ST147 harboring blaNDM-5 and blaCTX-M-15. Conclusion: The proportion of CRKP among all K. pneumoniae from bloodstream infection in Gaza Strip is high (40 %) and mainly associated with the blaNDM-5-positive high-risk clone ST147. |
| format | Article |
| id | doaj-art-e7313067c835495184d1275dba9ab396 |
| institution | Kabale University |
| issn | 1438-4221 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
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| series | International Journal of Medical Microbiology |
| spelling | doaj-art-e7313067c835495184d1275dba9ab3962025-01-09T06:13:31ZengElsevierInternational Journal of Medical Microbiology1438-42212025-03-01318151645Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, PalestineNahed Al Laham0Ahmed Al Afifi1Alexander Mellmann2Frieder Schaumburg3Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Azhar University-Gaza, Gaza Strip, PalestineDepartment of Microbiology, The Central Laboratories, Ministry of Health, Gaza Strip, PalestineInstitute of Hygiene, University Hospital Münster, Münster, GermanyInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany; Correspondence to: Institute of Medical Microbiology, University Hospital Münster, Domagkstrasse 10, Münster 48149, Germany.Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a difficult to treat organism owing to limited therapeutic options. So far, little is known about the molecular characteristics of CRKP in Palestine. Objectives: The aim of this study was to investigate the antimicrobial resistance patterns, multilocus sequence types (ST) and resistance genes among clinical K. pneumoniae isolates from hospitalized patients in Gaza Strip, Palestine. Methods: K. pneumoniae from blood cultures (n = 55) were collected at two hospitals in Gaza Strip (2023) and identified by MALDI-TOF-MS. Antimicrobial susceptibility testing was done using VITEK-2 automated systems. Carbapenemases were phenotypically detected. Whole genome sequencing (WGS) of all CRKP isolates was performed to assess determinants for carbapenem resistance and genotypes. Results: Of all K. pneumoniae isolates, 40 % (n = 22/55) were CRKP. Among CRKP, cefiderocol showed the least resistance (46 %, n = 10/22) while ceftazidime/avibactam showed a synergistic effect with aztreonam (36 %, n = 8/22). The majority (86 %, n = 19/22) of CRKP carried metallo-β-lactamases, and only 9 % (n = 2/22) encoded OXA-48 carbapenemase. WGS of CRKP revealed that the predominant genotype is multilocus sequence type ST147 harboring blaNDM-5 and blaCTX-M-15. Conclusion: The proportion of CRKP among all K. pneumoniae from bloodstream infection in Gaza Strip is high (40 %) and mainly associated with the blaNDM-5-positive high-risk clone ST147.http://www.sciencedirect.com/science/article/pii/S1438422125000013Klebsiella pneumoniaeAntimicrobial susceptibility testingCarbapenemaseBlood cultureGaza StripHypervirulent |
| spellingShingle | Nahed Al Laham Ahmed Al Afifi Alexander Mellmann Frieder Schaumburg Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine International Journal of Medical Microbiology Klebsiella pneumoniae Antimicrobial susceptibility testing Carbapenemase Blood culture Gaza Strip Hypervirulent |
| title | Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine |
| title_full | Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine |
| title_fullStr | Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine |
| title_full_unstemmed | Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine |
| title_short | Characterization of carbapenem-resistant Klebsiella pneumoniae from blood cultures in Gaza Strip hospitals, Palestine |
| title_sort | characterization of carbapenem resistant klebsiella pneumoniae from blood cultures in gaza strip hospitals palestine |
| topic | Klebsiella pneumoniae Antimicrobial susceptibility testing Carbapenemase Blood culture Gaza Strip Hypervirulent |
| url | http://www.sciencedirect.com/science/article/pii/S1438422125000013 |
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