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CARBAPENEMASE GENE CO-OPERATE WITH ESBL, AMPC IN ANTIBIOTIC RESISTANCE OF KLEBSIELLA PNEUMONIAE
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Abstract
Background: Klebsiella pneumoniae is a multi-drug resistant bacteria with a high rate of antibiotic resistance, including new generation antibiotics due to the co - operation of carbapenenase genes with ESBL, AmpC genes. Aims: The aims is determine the co - operation of carbapenenase genes with ESBL, AmpC genes of K. pneumoniae in antibiotics resistance. Methods: This study was a cross-sectional descriptive design in prospect conducted on K. pneumoniae strains isolated from sputum of hospitalized community-acquired pneumonia patients. The research method is traditional culturing to determine antibiotic MICs and multiplex real-time PCR technique to identify genes encoding carbapenemase, ESBL and AmpC. Results: The proportion of K. pneumoniae carrying carbapnenemase genes was 48.9%, of which the OXA-48-like reached at 81.8% and strains carrying ³ 2 genes were 100% resistant to meropenem. The proportion of K. pneumoniae strains carrying carbapenemase genes co - operation with ESBL genes was 77.3%, and they were completely resistant to cefoxitin and 52.9% resistant to ceftazidime/avibactam. K. pneumoniae strains carrying carbapenemase genes couple with AmpC genes had a rate of 27.3% and these strains were 100% resistant to cefoxitin and 83.3% to ceftazidime but all of them were sensitive to ceftazidime/avibactam because avibactam inhibited AmpC (β -lactamase class C). Conclusions: K. pneumoniae strains carrying carbapenemase genes co - operation with ESBL genes have a ceftazidime/avibactam resistance at the rate of 52.9% and cefoxitin resistance completely. The carbapenemase co – operating with AmpC gene has 100% resistance to cefoxitin, 83.3% resistance to ceftazidime but 100% sensitivity to ceftazidime/avibactam.
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Keywords
carbapenemase – producing, Klebsiella pneumoniae, ESBL, AmpC, co - operate, antibiotic resistance
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