Emergence of OXA-48–Like Genes in Carbapenem-Resistant Klebsiella Pneumoniae at a Tertiary Care Hospital in Pakistan

Sidra Naveed; Faisal  Hanif; Javiad  Usman; Rafia  Irfan; Warda  Furqan; Amna  Nasrullah

doi:10.51253/pafmj.v75i6.11768

Authors

Sidra Naveed Department of Microbiology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Faisal Hanif Department of Microbiology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Javiad Usman Department of Microbiology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Rafia Irfan Department of Microbiology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Warda Furqan Department of Microbiology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
Amna Nasrullah Department of Microbiology, Army Medical College Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i6.11768

Keywords:

Oxacillinase-48-like gene, Carbapenem-resistant Enterobacterales, Carbapenem-resistant Klebsiella pneumoniae, multi-drug resistance, Intensive Care Unit, Polymerase Chain Reaction, Infection prevention, and control.

Abstract

Objective: To determine the frequency of the Oxacillinase-48-like gene in Carbapenem-resistant Klebsiella pneumoniae isolates using conventional polymerase chain reaction (PCR).

Study Design: Cross-sectional descriptive study.

Place and Duration of the study: Clinical Pathology Laboratory of Army Medical College, Pak Emirates Military Hospital (PEMH), in collaboration with the Department of Molecular Biology, National University of Medical Sciences, Rawalpindi, Pakistan, from Nov 22 to Jun 23.

Methodology: A total of 266 clinical specimens, including blood, respiratory aspirates, pus, body fluids, and tissue, yielding carbapenem-resistant Klebsiella pneumoniae were analyzed. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar. Detection of the oxacillinase-48-like gene was conducted using conventional PCR. The primers used were forward (5ʹ-GCTTGATCGCCCTCGATT-3ʹ) and reverse (5ʹ-GATTTGCTCCGTGGCCGAAA-3ʹ). PCR products were analyzed using agarose gel electrophoresis. A 281 base pair band was considered positive for the OXA-48-like gene.

Results: Out of 266 carbapenem-resistant isolates, 200 tested positive for the oxacillinase-48-like gene, indicating a frequency of 75.18%. The study findings highlight a high prevalence of the OXA-48-like gene among carbapenem-resistant K. pneumoniae, emphasizing the urgent need for robust infection control strategies and strict implementation of antimicrobial stewardship programs.

Conclusion: The frequency of OXA-48-like gene in carbapenem-resistant Klebsiella pneumoniae was 75.1%. Immediate action is required to prevent its spread among high-risk patients, alongside reinforced antimicrobial stewardship efforts.

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