Article Sidebar

Published
June 22, 2026
Download
PDF
Statistic
Read Counter : 0 Download : 0

Main Article Content

Abstract

Background: Klebsiella pneumoniae is a globally recognized opportunistic pathogen  associated with multidrug resistance (MDR).


Objective: This study evaluated the      phenotypic distribution of MDR and carbapenem resistance among K. pneumoniae isolates.


Materials and Methods: A total 200 specimens collected from four teaching hospitals in Nasiriya, Iraq(Nasiriya General Hospital, Al-Musawy, Al-Haboubi, Bint Al-Huda), between October and December 2025, from which 88 isolates were identified as K. pneumoniae using biochemical methods and the VITEK®2 system. Antimicrobial susceptibility testing was performed by the Kirby–Bauer disk diffusion method, and carbapenemase production was detected using the Modified Hodge Test (MHT).


Results: Blood samples constituted the majority of isolates (35.2%). MDR was observed in 88   isolates, with the highest resistance rates to ampicillin (68.18%) and ceftazidime (62.5%). Carbapenemase production was confirmed in 32.95% of isolates.


Conclusion: These findings indicate a high burden of MDR K. pneumoniae, underscoring the urgent need for strengthened infection control measures and rational antibiotic management in local hospitals.

Keywords

Klebsiella pneumoniae Antimicrobial resistance (AMR) Carbapenem.

Article Details

License

Copyright (c) 2026 Zahraa Hasan Flaih, Faten Naeem Abbas

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

References

  1. Abbas FN. Molecular detection of bla(SHV), bla(IMP), and bla(VIM) β-lactamases genes among Klebsiella pneumoniae strains. Indian J Forensic Med Toxicol. 2021;15(2):2333-2338. https://doi.org/10.37506/ijfmt.v15i2.14721
  2. Idrees EK, Aldriwesh MG, Alkhulaifi MM, Alghoribi MF. Systematic review of multidrug-resistant Klebsiella pneumoniae in the Arabian Peninsula: molecular epidemiology and resistance patterns. Front Microbiol. 2025;16:1489317. https://doi.org/10.3389/fmicb.2025.1489317
  3. Goodman KE, Simner PJ, Tamma PD, Milstone AM. Infection control implications of heterogeneous resistance mechanisms in carbapenem-resistant Enterobacteriaceae (CRE). Expert Rev Anti Infect Ther. 2016;14(1):95-108. https://doi.org/10.1586/14787210.2016.1106940
  4. Li Y, Kumar S, Zhang L, Wu H, Wu H. Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae. Open Med (Wars). 2023;18(1):1-12. https://doi.org/10.1515/med-2023-0707
  5. Abodakpi H, Wanger A, Tam VH. What the Clinical Microbiologist Should Know About Pharmacokinetics/Pharmacodynamics in the Era of Emerging Multidrug Resistance: Focusing on β-Lactam/β-Lactamase Inhibitor Combinations. Clin Lab Med. 2019;39(3):473-485. https://doi.org/10.1016/j.cll.2019.05.006
  6. Gheitani L, Fazeli H, Moghim S, Isfahani BN. Frequency Determination of Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) Isolated from hospitals in Isfahan of Iran and Evaluation of Synergistic Effect of Colistin and Meropenem on them. Cell Mol Biol (Noisy-le-grand). 2018;64(1):70-74. https://doi.org/10.14715/cmb/2018.64.1.13
  7. Santella B, Boccella M, Folliero V, Iervolino D, Pagliano P, Fortino L, et al. Antimicrobial susceptibility profiles of Klebsiella pneumoniae strains collected from clinical samples in a hospital in Southern Italy. Can J Infect Dis Med Microbiol. 2024;2024:5548434. https://doi.org/10.1155/2024/5548434
  8. Worku M, Belay S, Molla T, Aynalem M, Assefa M. Prevalence and antimicrobial susceptibility pattern of Klebsiella pneumoniae isolated from various clinical specimens at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. BMC Infect Dis. 2024;24(1):917. https://doi.org/10.1186/s12879-024-09811-1
  9. Naqid IA, Hussein NR, Balatay AA, Saeed KA, Ahmed HA. The antimicrobial resistance pattern of Klebsiella pneumoniae isolated from the clinical specimens in Duhok City in Kurdistan Region of Iraq. J Kermanshah Univ Med Sci. 2020;24(2):e106135. https://doi.org/10.5812/jkums.106135
  10. Yazdansetad S, Alkhudhairy MK, Najafpour R, Farajtabrizi E, Al-Mosawi RM, Saki M, et al. Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran. Heliyon. 2019;5(9):e02349. https://doi.org/10.1016/j.heliyon.2019.e02349
  11. Hashim HT, Hashim AT, Ali HT, Mohamed H, Elrefaey A, Almamoury A, Aji N. Prevalence and pattern of antibiotic use and resistance among Iraqi patients: a cross-sectional study. African Health Sciences. 2024;24:47–57. https://doi.org/10.4314/ahs.v24i3.7
  12. Mihajlović-Ukropina M, Trudić A, Jelesić Z, Medić D, Milosavljević B, Zivlak B. Detection of carbapenemase genes in Klebsiella pneumoniae isolates. Srp Arh Celok Lek. 2016;144(5-6):307-311. http://doi.org/10.2298/SARH1606307M
  13. Sharma S, Sharma A. Detection of NDM, VIM, IMP metallo-β-lactamase genes in Klebsiella pneumoniae isolated from clinical samples at a tertiary care centre: a study from southern Rajasthan. Global Journal for Research Analysis. 2024;13(10). https://doi.org/10.36106/gjra/0907732
  14. Nirwati H, Sinanjung K, Fahrunissa F, Wijaya F, Napitupulu S, Hati VP, et al. Biofilm formation and antibiotic resistance of Klebsiella pneumoniae isolated from clinical samples in a tertiary care hospital, Klaten, Indonesia. BMC Proc. 2019;13(Suppl 11):20. https://doi.org/10.1186/s12919-019-0176-7
  15. Getie M, Tafere W, Tsega A, Gebreyesus T, Belay G, Abate A, et al. Antimicrobial resistance profiles of bacteria from clinical specimens at Amhara Public Health Institute, Bahir Dar, Ethiopia: a retrospective study. PLoS One. 2025;20(12):e0337332. https://doi.org/10.1371/journal.pone.0337332
  16. Al-Qaysi AK, Ahmed MM, Habeeb WH, Al-meani AL, Salih M, Janaby AL, et al. Genetic variants of multidrug-resistant Klebsiella pneumoniae isolated from Al-Ramadi Teaching Hospital, Iraq. Open Microbiol J. 2024;18(1):1-12. http://dx.doi.org/10.2174/0118742858298979240628070603
  17. Bleriot I, Blasco L, Delgado-Valverde M, Gual-de-Torrella A, Ambroa A, Fernandez-Garcia L, et al. Mechanisms of tolerance and resistance to chlorhexidine in clinical strains of Klebsiella pneumoniae producing carbapenemase: role of new type II toxin-antitoxin system, PemIK. Toxins. 2020;12(9):566. https://doi.org/10.3390/toxins12090566
  18. Hosseinzadeh Z, Sedigh Ebrahim-Saraie H, Sarvari J, Mardaneh J, Dehghani B, Rokni-Hosseini SMH, et al. Emerge of blaNDM-1 and blaOXA-48-like harboring carbapenem-resistant Klebsiella pneumoniae isolates from hospitalized patients in southwestern Iran. J Chin Med Assoc. 2018;81(6):536-540. https://doi.org/10.1016/j.jcma.2017.08.015
  19. Pourgholi L, Farhadinia H, Hosseindokht M, Ziaee S, Nosrati R, Nosrati M, et al. Analysis of carbapenemases genes of carbapenem-resistant Klebsiella pneumoniae isolated from Tehran Heart Center. Iran J Microbiol. 2022;14(1):38-46. https://doi.org/10.18502/ijm.v14i1.8799
  20. Almofty NY. Study of Some Resistance Genes of Salmonella from Asymptomatic Patients in Baghdad Government. Journal of Biomedicine and Biochemistry. 2024;3(3):9–15. https://doi.org/10.57238/jbb.2024.7471.1131

Similar Articles

You may also start an advanced similarity search for this article.