Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant Klebsiella pneumoniae based on their clinical and molecular profile in Malaysia

Document Type

Article

Publication Date

11-1-2022

Abstract

Non-carbapenemase-producing carbapenem-resistant Klebsiella pneumoniae (NC-CRKP) confers carbapenem resistance through a combination of chromosomal mutations and acquired non-carbapenemase resistance mechanisms. In this study, we aimed to evaluate the clinical and molecular profiles of NC-CRKP isolated from patients in a tertiary teaching hospital in Malaysia from January 2013 to October 2019. During the study period, 54 NC-CRKP-infected/colonised patients' isolates were obtained. Clinical parameters were assessed in 52 patients. The all-cause in-hospital mortality rate among NC-CRKP patients was 46.2% (24/52). Twenty-three (44.2%) patients were infected, while others were colonised. Based on the Charlson Comorbidity Index (CCI) score, 92.3% (48/52) of the infected/colonised patients had a score of >= 1. Resistance genes found among the 54 NC-CRKP isolates were bla(TEM), bla(SHV), bla(CTX-M), bla(OXA), and bla(DHA). Porin loss was detected in 25/54 (46.3%) strains. None of the isolated strains conferred carbapenem resistance through the efflux pumps system. In conclusion, only 25/54 (46.3%) NC-CRKP conferred carbapenem resistance through a combination of porin loss and the acquisition of non-carbapenemase resistance mechanisms. The carbapenem resistance mechanisms for the remaining strains (53.7%) should be further investigated as rapid identification and distinction of the NC-CRKP mechanisms enable optimal treatment and infection control efforts.

Keywords

All-cause in-hospital mortality, Charlson Comorbidity Index (CCI), Efflux pump, Non-carbapenemase-producing carbapenem-resistant Klebsiella pneumoniae, Porin loss, Resistance genes

Publication Title

Antibiotics-Basel

Divisions

medicinedept

Funders

Ministry of Higher Education (Malaysia), Fundamental Research Grant Scheme (FRGS),FRGS/1/2018/SKK11/UM/02/4,FP013-2018A,IF066-2020

Volume

11

Issue

11

Publisher

MDPI

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