Molecular Detection of NDM-1 and ugpE Genes in Multidrug-Resistant Klebsiella pneumoniae Isolates and Their Correlation with Antibiotic Resistance

Background: Klebsiella pneumoniae is ubiquitous gram-negative encapsulated pathogen that has long been associated with variety of infections worldwide. Antimicrobial resistance, particularly multidrug resistance (MDR), shows a serious threat to public health, with K. pneumoniae being one of the leading culprits. Mechanisms such as production of carbapenemases like NDM-1 and virulence factors like ugpE contribute to resistance and pathogenesis. The study aimed to assess the expression of NDM-1 and ugpE genes in K. pneumoniae isolates and their association with antibiotic resistance. Method: Clinical samples were collected, and K. pneumoniae isolates were identified using biochemical tests and molecular techniques. Antibiotic susceptibility testing was conducted using the disk diffusion method, and MIC values were determined for colistin and meropenem. DNA and RNA were extracted, and PCR was performed to detect NDM-1, ugpE, and 16S rRNA genes. Gene expression was evaluated using quantitative real-time PCR. Results: Among 210 clinical samples, 90 K. pneumoniae isolates were identified. Antibiotic susceptibility testing revealed high resistance to multiple antibiotics, with vancomycin showing 100% resistance. PCR confirmed the presence of NDM-1 (23%) and ugpE (93%) genes. MIC results showed variable resistance patterns. Gene expression analysis demonstrated a significant decrease in NDM-1 expression and an increase in ugpE expression after colistin treatment, while meropenem treatment led to up-regulation of NDM-1. Conclusion: K. pneumoniae isolates exhibited high resistance to various antibiotics, with significant expression of NDM-1 and ugpE genes. Colistin treatment influenced gene expression more than meropenem, highlighting the importance of understanding resistance mechanisms for effective management of infections.