Phenotypic Study on Some Virulence Factors and Molecular Screening of Aminoglycoside Resistance among Klebsiella pneumoniae Strains Isolated from Urinary Tract Infections in Pediatric Cases in Egypt

Abstract

Aim of the Work: The aim of this study was to identify aminoglycoside resistance among Klebsiella pneumoniae strains isolated from cases of urinary tract infections in pediatrics and to evaluate the presence of 16S rRNA methylase genes including armA and rmtB genes in the isolated strains. Materials and Methods: Ninety-eight Klebsiella pneumonia strains were isolated and identified by conventional microbiological methods, 65.3% isolated from cases with cystitis and 34.7% from cases with pyelonephritis. Antimicrobial susceptibility testing was done using disc diffusion test. Presence of 16S rRNA methylase genes including armA and rmtB genes were detected by polymerase chain reaction [PCR]. Results: The overall aminoglycoside resistance was 48%. Individually, the rate of resistance against Amikacin and Gentamycin were 22%, 26% respectively. Also, 73.5% were multidrug-resistant [MDR], 20.4% were extensive drug resistant [XDR] and 61.2% strains were extended-spectrum β-lactamases [ESBL] producers. PCR amplification of 16S rRNA methylase genes revealed that armA was the most prevalent gene detected in 30 isolates; while rmtB was detected in only 17 cases. Conclusion: This finding highlights the alarmingly increase in multidrug-resistant Klebsiella pneumoniae isolates with high frequency of 16S rRNA methylase genes. Consequently, following a wise antibiotic policy is critically necessary to limit the potential spread of resistant genes.