Molecular Epidemiology of Carbapenemase and Extended-Spectrum Beta-Lactamase Genes in Multidrug-Resistant Pseudomonas aeruginosa and Klebsiella pneumoniae Isolated from Nosocomial Wound Infections
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The global spread of carbapenemase and extended-spectrum beta-lactamase (ESBL) genes in Pseudomonas aeruginosa and Klebsiella pneumoniae poses a significant threat to healthcare systems. This study aimed to characterize the molecular epidemiology of these resistance determinants in wound infection isolates. Over six months (March-August 2023), 112 non-duplicate Gram-negative isolates (65 P. aeruginosa and 47 K. pneumoniae) were collected from wound infections at a tertiary care hospital. Antimicrobial susceptibility was determined by disk diffusion and broth microdilution. Carbapenemase production was confirmed by the modified carbapenem inactivation method (mCIM). Genotypic characterization of resistance genes (blaNDM-1, blaKPC-2, blaOXA-48, blaVIM, blaIMP, blaTEM, blaSHV, blaOXA-1) was performed via multiplex PCR. Carbapenem resistance was found in 69.6% of isolates, with K. pneumoniae exhibiting higher resistance (76.6%) than P. aeruginosa (64.6%). The blaNDM-1 gene was predominant (47.4%), particularly in K. pneumoniae (58.3%). ESBL genes, especially blaTEM (71.8%) and blaSHV (44.9%), were also prevalent. Notably, 52.6% of carbapenem-resistant isolates co-harbored multiple resistance genes, with blaNDM-1 + blaTEM being the most common combination (25.6%). The study highlights the alarming prevalence of carbapenemase and ESBL genes in nosocomial wound isolates, with blaNDM-1 emerging as the dominant resistance mechanism. The high rate of genetic co-carriage underlines the emergence of pan-drug-resistant phenotypes, emphasizing the urgent need for molecular surveillance and enhanced infection control in hospital settings.
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