Molecular typing of extended -spectrum beta-lactamase-producing klebsiella pneumonia isolates using rep-PCR genomic fingerprinting technique

Enterobacterial"repetitive intergenic consensus (ERIC) sequence analysis is a powerful tool for epidemiological analysis of bacterial species. Multidrug resistance are important determinants of intrinsic and/or acquired resistance to these antimicrobials in important human pathogens. The present study was designed to study determine the antimicrobial susceptibility" and genetic relatedness of K. pneumoniae strains obtained from Ramadi Hospitals, Western Iraq, using the ERIC–PCR approach. For the first time, this study reports genetic relatedness of K. pneumoniae strains among β-lactam resistant Klebsiella pneumoniae isolates in Anbar Governance/ Iraq. Fifty one of β-lactam – cephalosporins K. pneumoniae was collected from different clinical sources such as (burns, wounds, sputum, blood and urine isolates) from Anbar Teaching Hospitals. All isolates were identified by conventional method and Vitek-2 System. The susceptibility test to different antibiotics was done by AST- card using Vitek-2 System and Kirby – Bauer disk diffusion method. The highest isolation rate of Klebsiella pneumoniae was from urine source 62.745%, sputum 29.411%, while rate wound, blood, burn were 5.88%, 1.96 %, and 5/75, respectively. The current study showed that resistance percentage was Augmentin (96%), Cefotaxime (92%), Ceftriaxone = Ceftazidime (88%), Amikacin (48%), Levofloxaccin (42%), and Meropenem (26%). Percentage of Multi - Drug Resistant (MDR), In this study Extensively Drug Resistant (XDR), and Pan Drug Resistant (PDR) in were with ratio 44 (88%), 4 (8%), 2 (4%), respectively. The phenotypic detection of Extended-Spectrum β-lactamases enzymes were performed by Modified Hodge test, mCIM, eCIM. All isolates are cephalosporins gene-producing, (100%) gave positive result with mCIM and SBL, and 4% gave positive result for modified Hodg test(MHT). It was found that ten isolates produced ESBLS in percentage 100%.The enzymatic activity for ESBls values of isolates ranged between values(0.11-0.7). ERIC-PCR results and data analysis indicate that there are 23 distinct ERIC types. The findings of this study show an increase in the prevalence of multiresistant K. Pneumoniae in the hospitals studied. The ERIC PCR results revealed a high level of genetic diversity across K. Pneumoniae strains, showing that K. Pneumoniae isolates are polyclonal in Anbar hospitals. Some isolates had similar ERIC profile, two from urine (13, 14), two from sputum (11 and 12) and two from urine (1,3) showed genetically homogeneous profile.