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چکیده
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Background: Klebsiella pneumoniae is a significant opportunistic pathogen that causes serious diseases linked to healthcare settings, including pneumonia, bloodstream, and urinary tract infections. The development of multidrug-resistant bacteria, especially due to the synthesis of carbapenemases and extended-spectrum β-lactamases (ESBLs), is a significant management challenge. The genes blaCTX-M (conferring resistance to cephalosporins) and blaKPC (conferring resistance to carbapenems) are key to this resistance, posing a serious risk to public health and effective treatment, especially in hospital setting. Research Aim: The study aims to isolate and identify Klebsiella pneumoniae from various clinical samples in a Baghdad Hospital, molecularly detect the presence of blaCTX-M and blaKPC genes in the isolates, profile the phenotypic and antibiotic resistance patterns, and correlate the molecular findings with the phenotypic resistance data to understand the prevailing resistance mechanisms. Methodology: A total of 120 clinical samples (sputum, urine, blood, and wound swabs) were collected from patients. Bacterial isolation and identification were performed using standard microbiological culture and biochemical tests. Antibiotic susceptibility was determined using automated systems (VITEK 2). Genomic DNA was extracted from confirmed K. pneumoniae isolates, and polymerase chain reaction (PCR) with specific primers was employed for the detection of blaCTX-M and blaKPC genes. Result: Klebsiella pneumoniae accounted for 30.83% (37/120) of all bacterial isolates, making it the most frequently isolated pathogen. Molecular identification of the 37 samples of K. pneumoniae isolated showed a high frequency of resistance genes: 32.43% (12/37) and 48.64% (18/37) of the isolates had blaCTX-M and blaKPC, respectively. Phenotypic testing showed concerning resistance rates to key antibiotics, including high-level resistance to carbapenems and cephalosporins in many isolates, which correlated with the presence of the detected genes. The findings indicate a serious burden of carbapenem and extended-spectrum cephalosporin resistance mediated by blaKPC and blaCTX-M among clinical K. pneumoniae strains in Baghdad Teaching Hospital, highlighting an urgent need for enhanced surveillance and infection control measures.
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