MONITORING THE SPREAD OF ANTIBIOTIC-RESISTANT STRAINS K. PNEUMONIAE ISOLATED FROM PATIENTS WITH UPPER AND LOWER RESPIRATORY TRACT INFECTIONS
DOI:
https://doi.org/10.11603/1681-2727.2025.1.14861Keywords:
Klebsiella pneumoniae, antibiotic resistance, infectious diseases of the respiratory tractAbstract
The aim of the study was to analyze the antibiotic resistance profile of K. pneumoniae strains isolated from patients with pharyngitis, bronchitis and community-acquired pneumonia.
Materials and methods. A total of 230 patients were examined. Clinical material was nasopharyngeal washout, sputum and wash water obtained during bronchoalveolar lavage. Identification of isolated pure cultures and determination of bacterial susceptibility to antibiotics was performed using an automatic bacteriological analyzer BD Phoenix M50 (USA). EUCAST 2023 standards were used to interpret the results.
Results. The study analyzed the antibiotic resistance profile of K. pneumoniae strains isolated from 230 patients with pharyngitis, bronchitis and community-acquired pneumonia. K. pneumoniae was isolated from patients with pneumonia in 24.0 % of cases, bronchitis – 15.1 %, pharyngitis – 10.2 % both in monoculture and in associations with C. albicans, P. aeruginosa, A. baumanii and sometimes with Proteus spp. Bacteria were most resistant to amoxiclav and ampicillin (88.9 to 100.0 %) in diseases of both upper and lower respiratory tract. K. pneumoniae strains isolated from patients with pharyngitis were more susceptible to cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and glycylcyclines than bacteria isolated from patients with bronchitis and pneumonia. The level of resistance to cephalosporins, carbapenems and fluoroquinolones in K. pneumoniae strains isolated from patients with bronchitis and pneumonia ranged from 50.0–85.7 %. K. pneumoniae showed resistance to two to fourteen antibiotics. The majority of multidrug-resistant strains were isolated from patients with bronchitis and pneumonia, among which bacteria resistant to beta-lactams, aminoglycosides, fluoroquinolones and glycylcyclines predominated.
Conclusion. K. pneumoniae is isolated in patients with pneumonia both in monoculture and in associations with C. albicans, P. aeruginosa, A. baumanii and sometimes with Proteus spp. Bacteria were most resistant to amoxiclav and ampicillin (88.9 to 100,0 %) in diseases of both the upper and lower respiratory tract. The majority of multidrug-resistant strains were isolated from patients with bronchitis and pneumonia, among which bacteria resistant to beta-lactams, aminoglycosides, fluoroquinolones and glycylcyclines predominated.
References
Mil-Homens, D., Martins, M., Barbosa, J., Serafim, G., Sarmento, M. J., Pires, R. F., Rodrigues, V., Bonifácio, V. D. B., & Pinto, S. N. (2021). Carbapenem-Resistant Klebsiella pneumoniae Clinical Isolates: In Vivo Virulence Assessment in Galleria mellonella and Potential Therapeutics by Polycationic Oligoethyleneimine. Antibiotics (Basel, Switzerland), 10(1), 56. DOI: https://doi.org/10.3390/antibiotics10010056
Chang, D., Sharma, L., Dela Cruz, C. S., & Zhang, D. (2021). Clinical Epidemiology, Risk Factors, and Control Strategies of Klebsiella pneumoniae Infection. Frontiers in microbiology, 12, 750662. DOI: https://doi.org/10.3389/fmicb.2021.750662
Navon-Venezia, S., Kondratyeva, K., & Carattoli, A. (2017). Klebsiella pneumoniae: a major worldwide source and shuttle for antibiotic resistance. FEMS microbiology reviews, 41(3), 252–275. DOI: https://doi.org/10.1093/femsre/fux013
Paczosa, M. K., & Mecsas, J. (2016). Klebsiella pneumoniae: Going on the Offense with a Strong Defense. Microbiology and molecular biology reviews: MMBR, 80(3), 629–661. DOI: https://doi.org/10.1128/MMBR.00078-15
Bautista-Cerón, A., Monroy-Pérez, E., García-Cortés, L. R., Rojas-Jiménez, E. A., Vaca-Paniagua, F., & Paniagua-Contreras, G. L. (2022). Hypervirulence and Multiresistance to Antibiotics in Klebsiella pneumoniae Strains Isolated from Patients with Hospital- and Community-Acquired Infections in a Mexican Medical Center. Microorganisms, 10(10), 2043. DOI: https://doi.org/10.3390/microorganisms10102043
Lee, C. R., Lee, J. H., Park, K. S., Jeon, J. H., Kim, Y. B., Cha, C. J., Jeong, B. C., & Lee, S. H. (2017). Antimicrobial Resistance of Hypervirulent Klebsiella pneumoniae: Epidemiology, Hypervirulence-Associated Determinants, and Resistance Mechanisms. Frontiers in cellular and infection microbiology, 7, 483. DOI: https://doi.org/10.3389/fcimb.2017.00483
Shon, A. S., Bajwa, R. P., & Russo, T. A. (2013). Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: a new and dangerous breed. Virulence, 4(2), 107–118. DOI: https://doi.org/10.4161/viru.22718
Russo, T. A., & Marr, C. M. (2019). Hypervirulent Klebsiella pneumoniae. Clinical microbiology reviews, 32(3), e00001-19. DOI: https://doi.org/10.1128/CMR.00001-19
Kocsis B. (2023). Hypervirulent Klebsiella pneumoniae: An update on epidemiology, detection and antibiotic resistance. Acta microbiologica et immunologica Hungarica, 70(4), 278–287. DOI: https://doi.org/10.1556/030.2023.02186
Ramadan, R. A., Bedawy, A. M., Negm, E. M., Hassan, T. H., Ibrahim, D. A., ElSheikh, S. M., & Amer, R. M. (2022). Carbapenem-Resistant Klebsiella pneumoniae Among Patients with Ventilator-Associated Pneumonia: Evaluation of Antibiotic Combinations and Susceptibility to New Antibiotics. Infection and drug resistance, 15, 3537–3548. DOI: https://doi.org/10.2147/IDR.S371248
Gasser, M., Zingg, W., Cassini, A., Kronenberg, A., & Swiss Centre for Antibiotic Resistance (2019). Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in Switzerland. The Lancet. Infectious diseases, 19(1), 17–18. DOI: https://doi.org/10.1016/S1473-3099(18)30708-4
Shahid, M., Saeed, N. K., Ahmad, N., Shadab, M., Joji, R. M., Al-Mahmeed, A., Bindayna, K. M., Tabbara, K. S., Ismaeel, A. Y., & Dar, F. K. (2023). Molecular Screening of Carbapenem-Resistant K. pneumoniae (CRKP) Clinical Isolates for Concomitant Occurrence of Beta-Lactam Genes (CTX-M, TEM, and SHV) in the Kingdom of Bahrain. Journal of clinical medicine, 12(24), 7522. DOI: https://doi.org/10.3390/jcm12247522
Kao, C. Y., Zhang, Y. Z., Bregente, C. J. B., Kuo, P. Y., Chen, P. K., Chao, J. Y., Duong, T. T. T., Wang, M. C., Thuy, T. T. D., Hidrosollo, J. H., Tsai, P. F., Li, Y. C., & Lin, W. H. (2023). A 24-year longitudinal study of Klebsiella pneumoniae isolated from patients with bacteraemia and urinary tract infections reveals the association between capsular serotypes, antibiotic resistance, and virulence gene distribution. Epidemiology and infection, 151, e155. DOI: https://doi.org/10.1017/S0950268823001486
Zhang, R., Chan, E. W., Zhou, H., & Chen, S. (2017). Prevalence and genetic characteristics of carbapenem-resistant Enterobacteriaceae strains in China. The Lancet. Infectious diseases, 17(3), 256–257. https://doi.org/10.1016/S1473-3099(17)30072-5. DOI: https://doi.org/10.1016/S1473-3099(17)30072-5
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Н. І. Коваленко, О. О. Вовк, І. В. Новікова, О. В. Кризьська
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal Infectious Disease (Infektsiini Khvoroby) allows the author(s) to hold the copyright without registration
Users can use, reuse and build upon the material published in the journal but only for non-commercial purposes
This journal is available through Creative Commons (CC) License BY-NC "Attribution-NonCommercial" 4.0
