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Sains Malaysiana 54(7)(2025): 1751-1762
http://doi.org/10.17576/jsm-2025-5407-09
The Molecular Characteristics of
Extended-Spectrum β-Lactamases (ESBL), Carbapenem-Resistant
Enterobacterales (CRE) and Susceptible Isolates of Klebsiella pneumoniae and Escherichia coli in Hospital Pakar Universiti Sains Malaysia
(HPUSM), Kelantan, Malaysia
(Pencirian Molekul Spektrum Lanjutan
β-Lactamases (ESBL), Carbapenem-Rintang Enterobacterales (CRE) serta Pencilan
Kerentanan Klebsiella pneumoniae dan Escherichia coli di Hospital
Pakar Universiti Sains Malaysia (HPUSM), Kelantan, Malaysia)
NUR HUSNA SHAHIMI1,
ZETI NORFIDIYATI SALMUNA2, MAWADDAH MOHD AZLAN1, HASLIZAI
HASSAN1 & NIK YUSNORAINI YUSOF1,*
1Institute for Research in Molecular
Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, 16150 Kubang
Kerian, Kelantan, Malaysia
2Department of Medical Microbiology and
Parasitology, School of Medical Sciences, Health Campus, Universiti Sains
Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
Diserahkan:
29 Ogos 2024/Diterima: 14 Mei 2025
Abstract
Multidrug-resistance Klebsiella
pneumoniae (MDR-KP) has become a major challenge to clinicians as it caused significant morbidity and mortality among hospitalized patients. This
study aims to determine the antibiotic susceptibility profiles of 17 K.
pneumoniae strains isolated to different antimicrobial agents and to
characterize the genes encoding extended-spectrum β-lactamase (ESBL), AmpC
and (Carbapenem Resistance Enterobacteriacae (CRE) phenotypes by using VITEK
AST (Antimicrobial Susceptibility Test), phenotypic
disk confirmatory test (PDCT) and polymerase chain reaction (PCR). Out of 17 K.
pneumoniae isolates tested, seven (41.2%) were confirmed to be ESBL
producers, carrying blaTEM (1; 14.3%), blaSHV(1;
14.3%), blaCTXM-1 (4; 57.14%), blaCTXM-14 (2;
28.6%) and co-existence of both blaTEM and blaCTXM-1 (1;
14.3%) genes, while four K. pneumoniae (23.5%) isolates were CRE
strains, carrying co-existence of blaTEMand blaCTXM-1 genes, as well as blaNDM-1 (4; 100%). blaTEM and blaCTXMgenes were the most predominant genes
detected in both K. pneumoniae ESBL and CRE isolates and blaNDM-1 genes was detected in K. pneumoniae CRE isolates which were in line with
other findings worldwide. Understanding this link highlights the need for strategic
antibiotic usage in healthcare settings by providing a deeper understanding of
antibiotic resistance trends in multidrug resistant (MDR) organisms.
Keywords: Antibiotic resistant; CRE; ESBL; Klebsiella
pneumoniae
Abstrak
Klebsiella pneumoniae rintang pelbagai ubat (MDR-KP) telah
menjadi cabaran utama bagi pakar klinikal kerana ia menyebabkan morbiditi dan
kematian yang signifikan dalam kalangan pesakit yang telah dirawat di hospital.
Penyelidikan ini bertujuan untuk menentukan profil kerentanan antibiotik bagi
17 strain K. pneumoniae yang dipencilkan kepada agen antimikrob yang
berbeza dan untuk mencirikan gen beta-laktamase spektrum lanjutan (ESBL), AmpC
dan Enterobcacteriacae perintang karbapenem (CRE) menggunakan VITEK AST
(Ujian Kecenderungan Antimikrob), ujian pengesahan cakera fenotipik (PDCT) dan
reaksi rantaian polimerase (PCR). Daripada 17 pencilan K. pneumoniae yang diuji, tujuh pencilan (41.2%) telah disahkan sebagai pengeluar ESBL,
membawa gen blaTEM (1; 14.3%), blaSHV(1;
14.3%), blaCTXM-1 (4; 57.14%), blaCTXM-14 (2;
28.6%) serta kewujudan bersama blaTEM dan blaCTXM-1 (1;
14,5%), manakala empat pencilan CRE (23.5%) membawa kewujudan bersama gen blaTEM, blaCTXM-1 serta blaNDM-1 (4, 100%). Gen blaTEM dan blaCTXM adalah gen yang paling dominan yang dikesan
dalam kedua-dua pencilan K. pneumoniae ESBL dan CRE serta blaNDM-1 telah ditemui dalam K. pneumoniae CRE dan keputusan ini adalah sejajar
dengan penemuan lain di seluruh dunia. Memahami hubungan antara kedua-dua ini
menyerlahkan kepentingan penggunaan antibiotik secara strategik dalam penjagaan
kesihatan dengan menyediakan pemahaman yang lebih mendalam mengenai kerintangan
antibiotik dalam organisma yang rintang pelbagai ubat (MDR).
Kata
kunci: CRE; ESBL; Klebsiella pneumoniae; rintang antibiotik
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*Pengarang untuk surat-menyurat; email: nikyus@usm.my
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