Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia
Non-carbapenemase-producing carbapenem-resistant <i>Klebsiella pneumoniae</i> (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 profil...
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| Format: | Article |
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MDPI AG
2022-11-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/11/1670 |
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| author | Yee Qing Lee Sasheela Sri La Sri Ponnampalavanar Chun Wie Chong Rina Karunakaran Kumutha Malar Vellasamy Kartini Abdul Jabar Zhi Xian Kong Min Yi Lau Cindy Shuan Ju Teh |
| author_facet | Yee Qing Lee Sasheela Sri La Sri Ponnampalavanar Chun Wie Chong Rina Karunakaran Kumutha Malar Vellasamy Kartini Abdul Jabar Zhi Xian Kong Min Yi Lau Cindy Shuan Ju Teh |
| author_sort | Yee Qing Lee |
| collection | DOAJ |
| description | Non-carbapenemase-producing carbapenem-resistant <i>Klebsiella pneumoniae</i> (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 <i>bla</i><sub>TEM</sub>, <i>bla</i><sub>SHV</sub>, <i>bla</i><sub>CTX-M</sub>, <i>bla</i><sub>OXA</sub>, and <i>bla</i><sub>DHA</sub>. 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. |
| first_indexed | 2024-03-09T18:31:33Z |
| format | Article |
| id | doaj.art-b64cb129422d4a7688539b16c5f0be58 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T18:31:33Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b64cb129422d4a7688539b16c5f0be582023-11-24T07:31:35ZengMDPI AGAntibiotics2079-63822022-11-011111167010.3390/antibiotics11111670Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in MalaysiaYee Qing Lee0Sasheela Sri La Sri Ponnampalavanar1Chun Wie Chong2Rina Karunakaran3Kumutha Malar Vellasamy4Kartini Abdul Jabar5Zhi Xian Kong6Min Yi Lau7Cindy Shuan Ju Teh8Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaSchool of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway 47500, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaDepartment of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, MalaysiaNon-carbapenemase-producing carbapenem-resistant <i>Klebsiella pneumoniae</i> (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 <i>bla</i><sub>TEM</sub>, <i>bla</i><sub>SHV</sub>, <i>bla</i><sub>CTX-M</sub>, <i>bla</i><sub>OXA</sub>, and <i>bla</i><sub>DHA</sub>. 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.https://www.mdpi.com/2079-6382/11/11/1670all-cause in-hospital mortalityCharlson Comorbidity Index (CCI)efflux pumpnon-carbapenemase-producing carbapenem-resistant <i>Klebsiella pneumoniae</i>porin lossresistance genes |
| spellingShingle | Yee Qing Lee Sasheela Sri La Sri Ponnampalavanar Chun Wie Chong Rina Karunakaran Kumutha Malar Vellasamy Kartini Abdul Jabar Zhi Xian Kong Min Yi Lau Cindy Shuan Ju Teh Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia Antibiotics all-cause in-hospital mortality Charlson Comorbidity Index (CCI) efflux pump non-carbapenemase-producing carbapenem-resistant <i>Klebsiella pneumoniae</i> porin loss resistance genes |
| title | Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia |
| title_full | Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia |
| title_fullStr | Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia |
| title_full_unstemmed | Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia |
| title_short | Characterisation of Non-Carbapenemase-Producing Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Based on Their Clinical and Molecular Profile in Malaysia |
| title_sort | characterisation of non carbapenemase producing carbapenem resistant i klebsiella pneumoniae i based on their clinical and molecular profile in malaysia |
| topic | all-cause in-hospital mortality Charlson Comorbidity Index (CCI) efflux pump non-carbapenemase-producing carbapenem-resistant <i>Klebsiella pneumoniae</i> porin loss resistance genes |
| url | https://www.mdpi.com/2079-6382/11/11/1670 |
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