Molecular Detection of ESBL and Carbapenemase Resistance in Klebsiella pneumonia

Abstract

This study investigates the antibiotic resistance of Klebsiella pneumoniae isolates from patients in Intensive Care Units (ICUs) at the Zliten Medical Center, focusing on detection of extended-spectrum beta-lactamases (ESBLs) and carbapenemase resistance enzymes. The research reveals alarming resistance rates, with K. pneumoniae exhibiting up to 96% resistance to key β-lactam antibiotics, including Cephalothin, Cefuroxime, Ceftriaxone, and Cefepime. Colistin stands out as the only antibiotic with 100% sensitivity among all tested isolates. Moderate sensitivity was noted for Amikacin (38%), Gentamicin (34%), and Meropenem (36%). Statistical analysis indicated weak associations between antibiotic response categories and distribution, except for Tigecycline, which demonstrated a significant association (p = 0.025). Resistance patterns varied by sample source, with high levels of resistance observed across swabs, blood, sputum, and urine, although no significant statistical relationship was established, aside from a near-significant trend with Nitrofurantoin (p = 0.051). The Surgical ICU presented the highest resistance levels, particularly to Ertapenem, Imipenem, and Ceftazidime, with Tigecycline resistance varying significantly by ward (p = 0.028). Phenotypic testing revealed that 94% of isolates exhibited at least one resistance phenotype, underscoring the clinical challenge posed by multidrug-resistant K. pneumoniae. These findings highlight the urgent need for enhanced surveillance and intervention strategies to mitigate the spread of antibiotic resistance in critical care settings.