Background and Objectives: The global rise of multidrug-resistant bacteria poses a major healthcare challenge. Carbapenemase-producing Klebsiella pneumoniae, especially ST23, has emerged as a significant hospital-acquired pathogen. This study aimed to determine the prevalence, antimicrobial resistance profiles, and genetic features of carbapenemase-producing K. pneumoniae ST23 isolated from patients and hospital environments in a tertiary care hospital. Materials and Methods: Over nine months, 150 samples were collected—75 clinical (blood, urine, wound swabs, respiratory secretions) and 75 environmental (beds, ventilators, door handles, and surfaces). Standard microbiological techniques and the VITEK 2 Compact system were used for identification. Antimicrobial susceptibility testing assessed carbapenem resistance. Multiplex PCR was performed on phenotypically resistant isolates to detect blaKPC, blaNDM, blaOXA-48, blaVIM, and blaIMP genes. MLST confirmed ST23 strains. Results: Of 150 samples, 68 isolates were K. pneumoniae, with 43 (28. 6%) carbapenemase producers. Most (60. 5%) originated from clinical samples, mainly urine and wound swabs. VITEK analysis showed imipenem and meropenem resistance rates above 75%. PCR revealed gene prevalence: blaNDM (58. 1%), blaOXA-48 (46. 5%), blaKPC (30. 2%), blaVIM (27. 9%), and blaIMP (23. 2%). Co-expression of multiple genes occurred in 38% of isolates. All genotypically positive isolates were confirmed as ST23 by MLST. Discussion: The frequent detection of blaNDM and blaOXA-48, especially in clinical and environmental ST23 strains, underscores hospitals as key reservoirs for resistance. These findings highlight the urgent need for surveillance, strict hygiene, and molecular diagnostics to control hospital-acquired infections and limit community spread.
Mohammed et al. (Tue,) studied this question.