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Emergence and predominance of carbapenem-resistant Klebsiella pneumoniae ST-1671 in a tertiary hospital in central Iran
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DOI：10.1186/s13213-026-01846-w.png)
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Abstract
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Infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are a serious threat to public health, and the spread of these strains is a critical concern. The aim of this study was to evaluate the prevalence of clinical CRKP isolates and their carbapenem-resistance genes, and to examine the clonal and genetic diversity of the isolates. Different clinical specimens from hospitalized patients were investigated for K. pneumoniae. Susceptibility to carbapenems was evaluated by the disk diffusion method. The carbapenem inactivation method (CIM) and combined disk test (CDT) were used to investigate the activity of carbapenemase and metallo-beta-lactamase (MBL), respectively. Molecular detection of carbapenem resistance genes was done by polymerase chain reaction (PCR). Genotyping of isolates was performed using multilocus sequence typing (MLST). Of 200 clinical K. pneumoniae isolates, 84 (42%) were identified as CRKP, of which 54 (64.29%) and 30 (35.71%) were MBL-producer and MBL-non-producer, respectively. The blaSIM, blaVIM, blaNDM-1, and blaIMP genes were found in 28 (51.85%), 54 (100%), 25 (46.29%), and 3 (5.55%) MBL-producing isolates. The blaKPC gene was detected in all (100%) MBL-non-producers, while no blaGES gene was found. MLST typing of 30 selected isolates showed five sequence types (STs), of which ST1671 was the most prevalent (n = 14, 46.66%), with the majority of isolates (n = 11, 78.57%) recovered from the neurology ICU. The increase in carbapenemase and MBL resistance among clinical isolates of K. pneumoniae should be of concern to hospital infection control authorities. The spread of the same ST (ST1671) among several isolates with different resistances suggests the need for further investigation in this area.
Keywords:
Klebsiella pneumoniae
Carbapenem resistance genes
Metallo-beta-lactamase (MBLs)
Sequence type
Ceftazidime-avibactam (CZA)
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