The Relationship Between OqxAB Efflux Pump and Drug Resistance in Klebsiella pneumoniae Isolated from Clinical Sources

Abstract

Background: Because Klebsiella pneumoniae resistance to the majority of antibiotics is developing quickly, it is important to study the efflux pump system that bacteria carry and the genes that encode them in order to find effective ways to stop or limit this resistance. Objective: To find out how common OqxAB-efflux pump genes are and if there is a link between these genes and antibiotic resistance in Klebsiella pneumoniae that has been isolated from different clinical sources. Method: In this investigation, 174 various clinical specimens were collected from Baghdad hospitals. Based on morphological characteristics, culture media, biochemical testing, the Vitek-2 system, and molecular diagnosis by the 16S rRNA gene, only 97 isolates were recognized as Klebsiella pneumoniae. The antibiotic susceptibility of the isolates to 21 antibiotics was also determined. The presence of the active efflux pump was determined phenotypically (ethidium-bromide cartwheel method) and genotypically by multiplex PCR. Results: All isolates were resistant to ampicillin and amoxicillin-clavulanate (100%). On the other hand, the percentage of resistance to cefotaxime, ceftazidime, and cefixime was 95.87%, 94.84%, and 95.87%, respectively. While tigecycline had the lowest resistance rate (11.43%), In the genotype detection assay for efflux pump genes, the results show that the percentages of oqx A and oqx B are 65% and 83.6%, respectively. Conclusion: The oqxA and oqxB genes have a direct relationship with antibiotic resistance in Klebsiella pneumoniae.