Bacteriological and molecular study of Klebsiella pneumoniae isolated from patients with urinary tract infections from Ramadi Hospital

Antibiotic resistance is a global problem that healthcare organizations are facing head-on. The multidrug-resistant isolates of pathogenic Klebsiella pneumoniae are evolving quickly, and they often represent a major hazard to patients owing to the elevated mortality rate brought on by the diminished efficacy of available treatments. This cross-sectional study was done from September to December 2022 at the AL-Ramadi Teaching Hospital in Iraq. During that time, 150 urine samples were taken from people of both sexes who had urinary tract infections. Subsequently underwent Gram-stain microscopy and were cultured on MacConkey agar to grow exclusively gram-negative bacteria. The VITEK-2 system was used to identify K. pneumoniae isolates and analyze their antibiotic sensitivity and resistance profiles. PCR was used to identify resistance genes. The number of females was higher than the number of males. E. coli was the most common bacterial isolate, followed by "K. pneumonia, P. mirabilis, S. epidermis, S. aureus, and P. aeruginosa", in that order. Out of a total of 54 bacterial isolates, only 36 were found to be positive, whereas 18 isolates were found to be negative for the string test. Erythromycin had the highest rate of resistance, followed by Oxacillin and Lincomycin. Meropenem and Amikacin, on the other hand, had the lowest rates of resistance. The bla-oxa-1gene had the highest frequency, followed by the rmtC gene and the bla-ctx-m gene, while the armA gene has the lowest frequency among bacterial isolates. K. pneumoniae isolates with a positive string test indicating resistance to the studied antimicrobials showed a greater resistance level than those with a negative string test, with the exception of Erythromycin, Tobramycin, and Imipenem. On the other hand, Cefotaxime resistance in both kinds of bacteria is equal. The bla-oxa-1, bla-ctx-m, rmtC, and armA genes in K. pneumoniae isolates play an important role in antibiotic resistance, making treatment difficult, especially with hypervirulent isolate infections, which are more common in females than males.