The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors
Abstract Background Carbapenem resistant Enterobacteriaceae is a growing concern worldwide including Malaysia. The emergence of this pathogen is worrying because carbapenem is one of the 'last-line' antibiotics. The main objective of this study was to determine the prevalence of genetic me...
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doaj-be059e20c9404ef0942c52b3ed41d4b42020-11-25T00:47:45ZengBMCAntimicrobial Resistance and Infection Control2047-29942017-01-016111310.1186/s13756-016-0164-xThe emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factorsYe-Mun Low0Polly Soo-Xi Yap1Kartini Abdul Jabar2Sasheela Ponnampalavanar3Rina Karunakaran4Rukumani Velayuthan5Chun-Wie Chong6Sazaly Abu Bakar7Mohd Yasim Md Yusof8Cindy Shuan-Ju Teh9Department of Medical Microbiology, University of MalayaDepartment of Medical Microbiology, University of MalayaDepartment of Medical Microbiology, University of MalayaDepartment of Medicine, University of MalayaDepartment of Medical Microbiology, University of MalayaDepartment of Medical Microbiology, University of MalayaDepartment of Life Sciences, International Medical UniversityDepartment of Medical Microbiology, University of MalayaDepartment of Medical Microbiology, University of MalayaDepartment of Medical Microbiology, University of MalayaAbstract Background Carbapenem resistant Enterobacteriaceae is a growing concern worldwide including Malaysia. The emergence of this pathogen is worrying because carbapenem is one of the 'last-line' antibiotics. The main objective of this study was to determine the prevalence of genetic mechanisms and clinical risk factors of carbapenem resistant Klebsiella pneumoniae (K. pneumoniae) in Malaysia. Methods In this study, seventeen carbapenem resistant K. pneumoniae strains isolated from a tertiary teaching hospital in 2013 were studied. Minimal inhibitory concentration (MIC) of the bacterial strains was determined and genes associated with carbapenemases and extended-spectrum-beta-lactamases (ESBLs) were sequenced and compared with the closest representatives published in public domains. All strains were also sub-typed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Statistical analyses were performed to determine the correlation between risk factors for acquiring carbapenem resistant K. pneumoniae and in-hospital mortality. Results The predominant carbapenemase was bla OXA-48, detected in 12 strains (70.59%). Other carbapenemases detected in this study were bla KPC-2, bla IMP-8, bla NMC-A and bla NDM-1. Nine different pulsotypes were identified and nine strains which were affiliated with ST101, the predominant sequence type had similar PFGE patterns (similarity index of 85%). Based on univariate statistical analysis, resistance to imipenem and usage of mechanical ventilation showed a statistically significant effect separately to in-hospital mortality. Conclusion The diverse genetic mechanisms harbored by these carbapenem resistant K. pneumoniae facilitates its spread and complicates its detection. Thus, correlation between microbiological trends with host characteristics and clinical factors will provide a better insight of rational treatment strategies and pathogen control.http://link.springer.com/article/10.1186/s13756-016-0164-xCarbapenem resistant K. pneumoniaeOXA-48KPC-2ST101Enterobacteriaceae |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ye-Mun Low Polly Soo-Xi Yap Kartini Abdul Jabar Sasheela Ponnampalavanar Rina Karunakaran Rukumani Velayuthan Chun-Wie Chong Sazaly Abu Bakar Mohd Yasim Md Yusof Cindy Shuan-Ju Teh |
spellingShingle |
Ye-Mun Low Polly Soo-Xi Yap Kartini Abdul Jabar Sasheela Ponnampalavanar Rina Karunakaran Rukumani Velayuthan Chun-Wie Chong Sazaly Abu Bakar Mohd Yasim Md Yusof Cindy Shuan-Ju Teh The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors Antimicrobial Resistance and Infection Control Carbapenem resistant K. pneumoniae OXA-48 KPC-2 ST101 Enterobacteriaceae |
author_facet |
Ye-Mun Low Polly Soo-Xi Yap Kartini Abdul Jabar Sasheela Ponnampalavanar Rina Karunakaran Rukumani Velayuthan Chun-Wie Chong Sazaly Abu Bakar Mohd Yasim Md Yusof Cindy Shuan-Ju Teh |
author_sort |
Ye-Mun Low |
title |
The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors |
title_short |
The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors |
title_full |
The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors |
title_fullStr |
The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors |
title_full_unstemmed |
The emergence of carbapenem resistant Klebsiella pneumoniae in Malaysia: correlation between microbiological trends with host characteristics and clinical factors |
title_sort |
emergence of carbapenem resistant klebsiella pneumoniae in malaysia: correlation between microbiological trends with host characteristics and clinical factors |
publisher |
BMC |
series |
Antimicrobial Resistance and Infection Control |
issn |
2047-2994 |
publishDate |
2017-01-01 |
description |
Abstract Background Carbapenem resistant Enterobacteriaceae is a growing concern worldwide including Malaysia. The emergence of this pathogen is worrying because carbapenem is one of the 'last-line' antibiotics. The main objective of this study was to determine the prevalence of genetic mechanisms and clinical risk factors of carbapenem resistant Klebsiella pneumoniae (K. pneumoniae) in Malaysia. Methods In this study, seventeen carbapenem resistant K. pneumoniae strains isolated from a tertiary teaching hospital in 2013 were studied. Minimal inhibitory concentration (MIC) of the bacterial strains was determined and genes associated with carbapenemases and extended-spectrum-beta-lactamases (ESBLs) were sequenced and compared with the closest representatives published in public domains. All strains were also sub-typed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Statistical analyses were performed to determine the correlation between risk factors for acquiring carbapenem resistant K. pneumoniae and in-hospital mortality. Results The predominant carbapenemase was bla OXA-48, detected in 12 strains (70.59%). Other carbapenemases detected in this study were bla KPC-2, bla IMP-8, bla NMC-A and bla NDM-1. Nine different pulsotypes were identified and nine strains which were affiliated with ST101, the predominant sequence type had similar PFGE patterns (similarity index of 85%). Based on univariate statistical analysis, resistance to imipenem and usage of mechanical ventilation showed a statistically significant effect separately to in-hospital mortality. Conclusion The diverse genetic mechanisms harbored by these carbapenem resistant K. pneumoniae facilitates its spread and complicates its detection. Thus, correlation between microbiological trends with host characteristics and clinical factors will provide a better insight of rational treatment strategies and pathogen control. |
topic |
Carbapenem resistant K. pneumoniae OXA-48 KPC-2 ST101 Enterobacteriaceae |
url |
http://link.springer.com/article/10.1186/s13756-016-0164-x |
work_keys_str_mv |
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