Antibiotic resistance, multidrug resistance and enterobacterial repetitive intergenic consensus polymerase chain reaction profiles of clinically important Klebsiella species

Background: Klebsiella species are important opportunistic pathogens causing a variety of infections, especially in hospitalized and immunocompromised patients. Objectives: To investigate the clinical prevalence of five different Klebsiella species (K. pneumoniae, K. ornithinolytica, K. oxytoca, K. terrigena, and K. rhinoscleromatis) including antibiotic resistance profiles using six different antibiotics and combinations (trimethoprim-sulfamethoxazole, ampicillin-sulbactam, imipenem, piperacillin-tazobactam, ciprofloxacin, ceftizoxime). Methods: Resistance of Klebsiella spp. including multidrug resistant (MDR) strains was determined by using a Kirby-Bauer disk diffusion method and genotypical analysis was performed by enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction (PCR). Results: Urine samples and the urology service unit were the most common sources of K. ornithinolytica, K. pneumoniae, and K. terrigena strains. The greatest drug resistance was observed against trimethoprimsulfamethoxazole (88%), the least resistance was observed against imipenem (12%). Apart from these, 11 different antibiotypes were generated and antibiotype AI (resistant only to trimethoprim-sulfamethoxazole) was the most frequently observed (40%). MDR profiles of Klebsiella spp. were also investigated and 25% of all Klebsiella spp. strains were found to be MDR; and 65% of these were isolated from urine samples. MDR strains were mostly found to be K. ornithinolytica (35%) followed by K. pneumoniae (29%). Genotyping was performed by using ERIC PCR and Klebsiella spp. strains were grouped in 23 genotypes with a similarity coefficient of 70%. Conclusions: Antibiotyping and antibiotype profiles may provide valuable information for hospitalized patients that could identify problem spots and allow evidence-based provision of preventive measures against nosocomial emergence of infections with new MDR strains.