Detection of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae Implicated in Urinary Tract Infection

Background and Objectives: Carbapenemase-producing bacteria are super bugs that make Urinary Tract Infections (UTIs) difficult to treat with drug of last resort such as carbapenem and other antibiotic thus limiting the treatment options. Carbapenemase production is increasing in clinical isolates of E. coli and K. pneumoniae, their potential to spread widely among patients necessitates molecular detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae implicated in Urinary Tract Infection.

Methodology: A total of twelve (12) non-repeated clinical isolate of Escherichia coli (E1, E2, E3, E4, E5, E6, E7) and Klebsiella pneumoniae (K8, K9, K10, K11, K12) were selected based on their in vitro phenotypic resistant to carbapenem antibiotics from patients diagnosed with urinary tract infection at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FEUTHA) Ebonyi Sate Nigeria. Escherichia coli and Klebsiella pneumoniae were further confirmed using standard routine microbiological technique for isolation and identification of bacteria. Escherichia coli and Klebsiella pneumoniae strains were further screen for carbapenemase-producing gene by PCR specific primer.

Result: PCR analysis with specific primer for carbapenemase gene revealed the presence and predominant of blaKPC in Escherichia coli and Klebsiella pneumoniae 12(100 %) followed by blaNDM 11(91.7 %), blaIMP 7(58.3 %) and blaVIM 2(16.7) as the least carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae. blaKPC was predominant in Escherichia coli 7(58.3 %) followed by blaNDM 6(50.0 %) and blaIMP 5(41.7 %) while both blaOXA and blaVIM (16.7 %) were the least detected carbapenemase gene. Klebsiella pneumoniae harbor high proportion of blaNDM and blaKPC both recording 5(41.7 %) followed by blaOXA and blaIMP both recording 2(16.7 %) but blaVIM gene was not identified in Klebsiella pneumoniae.

Conclusion: The current findings highlight the occurrence of carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae implicated in UTI. Since these genes are carried on the bacteria plasmid there is a tendency of cross-species dissemination over time. The detection of carbapenemase-producing gene call for prompt epidemiological surveillance and preventive strategies to limit the spread of these carbapenemase resistant genetic determinant and the need for antibiotic susceptibility testing of available antibiotic agent.