Abstract

The global emergence and spread of antimicrobial resistance genes, such as extended spectrum beta-lactamase (ESBL) and carbapenemase genes in Klebsiella pneumoniae strains, pose a significant public health threat. This is because carbapenems are considered the latest therapeutic agent used to treat diseases caused by multidrug-resistant gram-negative bacteria. The detection of carbapenemases is epidemiologically important because they are plasmid-mediated and can be transmitted horizontally between different bacterial species. The purpose of the work is to assess the spectrum of antibiotic resistance of carbapenemase-producing strains of K. pneumoniae circulating in hospitals in St. Petersburg using phenotypic and genotypic methods. An assessment of the sensitivity of 182 K. pneumoniae strains isolated from samples of patients admitted to hospitals in St. Petersburg in to 18 antimicrobial drugs was carried out. Resistance to antibiotics was assessed by the disk diffusion method. Carbapenemase genes were detected by molecular genetic (PCR) and phenotypic (CIM) methods. Most of the strains were resistant to ticarcillin / clavulanate, as well as quinolones, third and fourth generation cephalosporins, netilmicin, and gentamicin. The investigated microorganisms showed a moderate percentage of resistance to amikacin, meropenem and imipenem. The main type of carbapenemases produced by K. pneumoniae strains were metallo-beta-lactamases of the NDM group (60.4%) and serine carbapenemases of the OXA-48 group (49.5%). In the course of the study, a serine carbapenemase of the GES type was found in one strain. Carbapenemases of the KPC group were found in only 1.1% of the tested strains. The results of the study demonstrate a high level of resistance of K. pneumoniae nosocomial isolates to various antimicrobial drugs. In this regard, the range of antibiotics for the treatment of Klebsiella spp. infections is significantly reduced, which can lead to a decrease in the effectiveness of clinical therapy