Klebsiella pneumoniae: a Major Pathogen Causing Ventilator Associated Pneumonia at Suez Canal University Hospitals

Background: Klebsiella Pneumoniae (K. pneumoniae) is a serious emerging challenge among mechanically ventilated patients due to its disease severity, high virulence and antimicrobial resistance. Genotyping of such an aggressive pathogen is critical tool in restricting Klebsiella infections. Objective: This study aimed to characterize the diversity of Klebsiella pneumoniae complex (KPC) isolates causing ventilator associated pneumonia (VAP) for further reducing morbidity and mortality rates of intensive care unit (ICU) patients. Methodology: K. pneumoniae spp. were isolated from endotracheal tube aspirate specimens of patients admitted to ICU at Suez Canal University Hospitals (SCUHs). Species identification was done using conventional microbiological methods. Antimicrobial susceptibility testing was performed by disk diffusion method. Confirmation of K. pneumoniae was done by PCR amplification of gyrA gene. Genotyping was done by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method using TaqI and HaeIII restriction enzymes. Results: Out of 83 specimens, 32 Enterobacteriaceae strains were isolated, 65.6% were identified to be K. pneumoniae. PCR-RFLP identified 17 isolates(81%) as KPI, 3 (14.3%) as KPII and 1 (4.7%) as KPIII. High rates of MDR and XDR were reported. Among KPI, 8 isolates (47.1%) showed MDR and 8 isolates (47.1%) showed XDR. For KPII, 2 isolates (66.7%) showed MDR and 1(33.3%) showed XDR. The only KPIII isolate was XDR. Conclusion: GyrA PCR-RFLP provides a reliable tool for genotyping of KPC isolates. MDR and XDR KPC isolates are common causative pathogens for VAP at SCUHs and can initiate future outbreaks of nosocomial infections which obligates strengthening the infection control measures to combat such aggressive infections.