Molecular Characterization of Efflux Pump Genes among Carbapenems Resistant Klebsiella pneumoniae Isolated from Burns Infections
Abstract
The emergence of multi-drug resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP) poses an increasing risk, particularly for individuals suffering from burn injuries. The efflux pump system in drug-resistant K. pneumoniae is dangerous. Consequently, the purpose of this study was to determine whether antibiotic resistance in K. pneumoniae isolated from wound patients is related to the smvA, smvR, and cepA efflux pump genes. Ninety clinical isolates of K. pneumonia bacteria were obtained from 250 burn patients (36%) who were consulted in the hospitals in Baghdad, Iraq, between August 2023 and March 2024. After identifying the isolates, the disc diffusion method was used for antibiotic susceptibility. The polymerase chain reaction (PCR) method was employed to investigate the frequency of efflux genes (smvA, smvR, and cepA). Additionally, online software (NCBI) was used to analyze the cepA gene's sequence. The results showed that Tigecyclin (87.77%) and Colistin (72.22%) had the highest percentage of antibiotic sensitivity against K. pneumoniae, while Meropenem (56.66%) and Imipenem (53.33%) had moderate sensitivity. On the other hand, Amoxicillin-clavulanic acid (94.44%) had the highest percentage of antibiotic resistance by K. pneumoniae, and 47 (52.2%) of the isolates were Multi-Drug Resistant (MDR) K. pneumoniae. The results of PCR revealed that the efflux pumps genes smvA, and smvR were present in all isolates, while cepA gene was identified in 72 isolates (80%). The carbapenem-resistant local isolate K85's cepA sequence was aligned with a gene from reference strains found in GenBank, yielding results that showed 99% identity and some variations in the query's nucleotides in the positions 97, 101, 307, 394, 580, 583,656,798 (delesion), and 922 of the subject. In conclusion, there was a high prevalence of smv efflux pump genes and present a variations among cepA gene among the carbapenem resistant local isolates from burn patients.
