The antibiotic resistance of Klebsiella pneumonia and Escherichia coli isolates and the spread of carbapenemases in a multidisciplinary hospital

The study of antibiotic resistance of Klebsiella pneumonia and Escherichia coli isolates and the distribution of carbapenemase genes was conducted in the multi-profile emergency hospital in the Republic of Sakha (Yakutia). The structure of isolated microorganisms is dominated by pathogens of Enterobacterales genus: K. pneumonia was isolated in 29.9% (n=3314) and E. coli 20.8% (n=2306) of samples. The proportion of meropenem-resistant K. pneumonia strains was 47.5% of isolates, E. coli 13%. As a result of the study, totally 8 carbapenemase genes were isolated. The most common genes for K. pneumonia and E. coli isolates by detection frequency were OXA48 (24.9%), ctxM-1 (24.0%), SHV (21.8%), TEM (12.9%) and NDM (10.8%). In this case, combinations of 3 to 5 gene types were most often observed: 3 types were isolated in 86 (33.9%) strains, 4 types in 56 (22.0%) and 5 types in 54 (21.3%). The presence of 1 gene type was found in 33 (13.0%) strains, 2 types in 16 (6.3%), 6 types in 3 (1.2%) and 7 types in 6 (2.4%). Microbiological monitoring, control of local resistance to antibiotics in the hospital and the study of resistance mechanisms can increase the effectiveness of antimicrobial therapy, and also serve as an effective method of combating the spread of resistant strains of microorganisms.