Klebsiella pneumoniae isolated from an Egyptian pediatric hospital: Prevalence, antibiotic resistance, biofilm formation, and genotyping

Document Type : Original Article


1 Department of Microbiology, Medical Research Institute, Alexandria University, Alexandria, Egypt.

2 Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt.

3 Department of Microbiology and Biotechnology, College of Pharmacy, Arab Academy for Science, Technology and Maritime Transport (AASTMT), Alexandria, Egypt


Background: Klebsiella pneumoniae (K. pneumoniae) is a significant contributor to nosocomial infections in neonates and children. This is due to a variety of virulence mechanisms, such as the ability to form biofilms and antibiotic resistance. Hence, this study aimed to evaluate the prevalence of K. pneumoniae infections among children, to determine the association of their antimicrobial resistance patterns, biofilm formation ability, and their molecular genotypes. Methods: Forty-six K. pneumoniae isolates were collected from a pediatric hospital in Alexandria, Egypt. After being identified by conventional methods, they were tested for their susceptibility to different classes of antibiotics, biofilm formation ability, and were genotyped by enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR). Results: Klebsiella pneumoniae was the most prevalent bacteria isolated from children (36%). Antimicrobial susceptibility testing revealed that the majority of our isolates (47.8%) were extensively drug-resistant (XDR) and 41.3 % were multi-drug resistant (MDR). Among the isolates, 80.4% were biofilm producers. No statistically significant association was noticed between the biofilm-producing ability and the drug-resistance type. Based on ERIC-PCR profile results, isolates were classified into 3 main clusters and 30 different ERIC genotypes. Moreover, no statistically significant association was found between ERIC-PCR clusters and neither the ability to produce biofilm nor the drug-resistance type. Conclusions: The results of this study indicate an alarming increase in the antimicrobial resistance patterns among K. pneumoniae isolated from neonates and children. ERIC-PCR typing showed high genetic diversity among K. pneumoniae isolates, indicating a polyclonal distribution of K. pneumoniae isolates within the hospital averments.


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