Frequency of Carbapenemase Producing Klebsiella pneumoniae in Makkah, Saudi Arabia

Abstract

Objective: Carbapenemase producing Klebsiella pneumoniae is emerging as an important pathogen worldwide which has alarming clinical threat with serious effects on patients \' outcome. The aim of our study is to determine prevalence of carbapenemase producing K. pneumoniae and its antibiotic susceptibility pattern in tertiary care hospitals. Methods: A prospective study was performed on 260 clinical isolates of K. pneumoniae collected from five different hospitals of Makkah, Saudi Arabia from January to July 2015. All clinical isolates were confirmed as K. pneumoniae using Vitek 2 system. These isolates were then screened for potential carbapenemase producers by determining reduced susceptibility to carbapenems using representative antibiotic disks of third generation cephalosporins and carbapenems in the disk diffusion test following guidelines of Clinical and Laboratory Standards Institute. Minimum inhibitory concentration of isolates found positive in screening test were determined for cephalosporins, carbapenems, aminoglycosides and tigecycline and colistin using Vitek-2 system. Modified Hodge test was performed to detect carbapenemase production on the isolates suspected for carbapenemase production. Results: Out of 260 K. pneumoniae isolates, 31 (11.9%) have shown 100% resistance to all cephalosporins. Of 31 K. pneumoniae isolates, 15 (48.4%) were found positive for carbapenemase. All carbapenem resistant isolates were sensitive to colistin and tigecycline. However, these isolates have shown resistance to amikacin (41.9%) and gentamicin (51.6%), respectively. Conclusion: This is the first report from Makkah reporting carbapenamse producing K.pneumoniae. Of 12% potential carbapenemase producing K.pneumoniae, 48.4% were found positive for carbapenemase production. Molecular characterization of these strains will help to determine the type of carbapenemase prevalent in this area. J Microbiol Infect Dis 2016;6(3): 121-127.