Klebsiella pneumoniae and Escherichia coli Producing Carbapenemasses in Health Institutions of the Colombian Caribbean

Abstract

Introduction: bacterial resistance has become a problematic situation that increasingly threatens public health worldwide. The emergence of strains that produce carbapenemases, enzymes, with a broad spectrum to hydrolyze beta-lactams and resist the action of inhibitors. This puts at risk the use of carbapenem antibiotics as the last treatment of choice in infections caused by these isolates.

Objective: determine the frequency of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli isolated in four health institutions in Barranquilla and Valledupar.

Methodology: cross-sectional, retrospective descriptive study of molecular detection of six carbapenemase genes in Klebsiella pneumoniae and Escherichia coli between March 2019 and March 2020 using multiplex PCR.

Results: of 86 clinical isolates, E. coli was recovered in 32% of emergencies, 31% of outpatient clinics, 28% of hospitalized patients and 9% of ICUs. K. pneumoniae was recovered in 46.87% of hospitalized patients, 32.81% of ICU patients, 12.50% of emergency patients, and 7.81% of outpatient patients. At least one carbepenemase gene was detected in 77.9% of K. pneumoniae and 22% of E. coli. Of these, 88.37% (76/86) were blaKPC type carbapenemases and 1.16% (1/86) were blaVIM type carbapenemases.

Conclusions: K. pneumoniae was the most frequent microorganism in hospitalization (46.87%) and ICU (32.81%), which reflects its affinity for the hospital setting. Global resistance to carbapenems was confirmed in 89.53%, while the remaining percentage of isolates are attributed to another resistance mechanism not confirmed in the study.