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Characterization of Beta-Lactam Resistance Genes and Virulence Factors Associated with Multidrug-Resistant Klebsiella pneumoniae Isolated from Patients at Major Hospitals in Trinidad, West Indies

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Abstract

Accurate species identification and antibiotic resistance profiling are essential for the effective management of infections caused by bacterial pathogens. In this study, 373 clinical isolates of K. pneumoniae from major hospitals in Trinidad, West Indies, were characterized for resistance against beta-lactam antibiotics and the presence of genes encoding important virulence factors. Most of the isolates showed extended spectrum β-lactamase (ESBL) activity but few also displayed carbapenemase or ‘ESBL + carbapenemase’ activities. Polymerase chain reaction analysis revealed the presence of genes for ESBL subtypes blaTEM, blaSHV, and blaCTX-M that were dominant in isolates with the ESBL phenotype as well as those that did not show ESBL or carbapenemase activities. The carbapenem resistance gene, blaKPC, and the metallo-β-lactamase (MBL) gene, blaNDM-1, were also detected in some of the isolates. Multiple virulence genes were also detected, but the fimH-uge was the most common combination found among the local isolates. The findings of this study represent the first comprehensive study on the prevalence of ESBL, KPC and MBL genes and virulence profiling in antibiotic-resistant K. pneumoniae in Trinidad. Furthermore, the occurrence of multiple resistant phenotypes and gene combinations were revealed, though at low prevalence rates. This work emphasizes the need to implement molecular-based techniques in diagnostic workflows for rapid and accurate species identification and profiling of resistance and virulence genes in K. pneumoniae in Trinidad and Tobago.

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Data Availability

The dataset used and analyzed in this study is available via supplementary material and or linked within the manuscript.

Code Availability

Not applicable.

Abbreviations

K. pneumoniae :

Klebsiella pnuemoniae

MDR:

Multiple drug resistant

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Acknowledgements

We thank Professor Patrick Akpaka (North Central Regional Health Authority, Trinidad and Tobago), Dr. Rajeev Nagessar (Eastern Regional Health Authority, Trinidad and Tobago), Dr. Madhura Manjunath (North West Regional Health Authority, Trinidad and Tobago), Dr. Alisa Nobee (South West Regional Health Authority), and the laboratory technical staff for conveniently compiling isolates that were used in this study. We also thank Mr. Stephen D. B. Jr Ramnarine (University of the West Indies, St. Augustine, Trinidad and Tobago) for his extensive review of the manuscript.

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Authors and Affiliations

  1. Department of Life Sciences, Faculty of Science and Technology, The University of the West Indies, Rm 120, St. Augustine, Trinidad and Tobago

    Aarti Pustam, Jayaraj Jayaraman & Adesh Ramsubhag

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  1. Aarti Pustam
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Contributions

All authors contributed to the study’s conception and design. In-house primer design, material preparation, and collection of the isolates from the Microbiology laboratory at the Regional Health Authorities were done by AP. Analysis was performed by AP and AR. The first draft of the manuscript was written by AP, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Adesh Ramsubhag.

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Approval was obtained from the ethics committee of the University of the West Indies, St. Augustine, Trinidad, and Tobago and the major Regional Health Authorities in Trinidad and Tobago.

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Pustam, A., Jayaraman, J. & Ramsubhag, A. Characterization of Beta-Lactam Resistance Genes and Virulence Factors Associated with Multidrug-Resistant Klebsiella pneumoniae Isolated from Patients at Major Hospitals in Trinidad, West Indies. Curr Microbiol 79, 278 (2022). https://doi.org/10.1007/s00284-022-02972-9

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