Phenotypic Investigation of Beta-Lactamase Enzymes in multidrug resistant Klebsiella pneumoniae clinically isolated in Diyala Governorate /Iraq

Background: Klebsiella pneumoniae is one of the main causes of many opportunistic infections, and it is highly resistant to antibiotics, due to the many virulence factors including beta-lactamase enzymes that enable it to cause pneumonia, urinary tract infection, wound infections and burns, bacteremia and meningitis. Methods:132 samples were obtained from different clinical sources from Baquba Teaching Hospital and Al-Batool Maternity and Children Hospital in Diyala Governorate /Iraq during the period from (September to December 2023). K. pneumoniae isolates were identified based on phenotypic diagnosis and biochemical tests, Confirmation of the results by VITEK2 system. The disc diffusion method was used to determine the ability of the bacterial isolates to resist antibiotics using 12 antibiotics and production of beta-lactamase enzymes. Results: out of a total of 132 samples, 50 samples (37.87%) were K. pneumoniae. The results of antibiotic sensitivity showed that resistant isolates were 100% resistant to of Ampicillin,70% Aztreonam ,74% ceftazidime ,92% ceftriaxone, 48% Imipenem and Meropenem, 48% Amikacin, 38% Gentamicin, 42% Tobramycin, 46% Levofloxacin and Ciprofloxacin, 68% Trimethoprim/sulfamethoxazole. The isolates showed multiple and different antibiotic resistance, 30 isolates by 60% with multiple resistance (MDR). 14 (28%) with Extensive drug resistance (XDR).  The phenotypic detection of beta-lactamase enzymes was performed for 20 of the MDR isolates. The results showed that the percentage of the presence Extended spectrum β-Lactamase enzymes ESBLs was 80%, Metallo β-Lactamase enzymes MBLs was 100% and AmpC enzymes 25%. Conclusion: We need to develop valuable strategies for the prevention and control of infections.