Genetic diversity, drug resistance, and biofilm formation in Klebsiella pneumoniae associated with nosocomial infection in Pelotas, RS, Brazil.

Abstract

Antibiotic resistance and the potential persistence of Klebsiella pneumoniae strains in hospital environments is an important challenge for human medicine. This research aims to detect resistance to antibiotics, biofilm formation, and the genetic pattern among clinical isolates associated with nosocomial infection obtained from a university hospital in the city of Pelotas, RS, Brazil. Twenty-eight isolates were identified at the species level by polymerase chain reaction (PCR) and were characterized regarding the profile of biofilm formation and antibiotic resistance. The genetic relationship was determined through pulsed-field gel electrophoresis (PFGE). The antibiotic resistance profile was made following the standards established by CLSI. All clinical isolates included in this study were confirmed as belonging to the species K. pneumoniae, 96.42% were considered strong biofilm formers and all were positive in the Congo Red agar (CRA) test. Thus, 64.29% of isolates were classified as multidrug-resistant (MDR), 25% as extensively drug-resistant (XDR), and 7.14% as pandrug-resistant (PDR). PFGE fingerprint analysis revealed 18 clones and of these, 15 have a unique pattern and another three were groups with patterns > 80% similarity. The clinical isolates used were collected over two years and revealed a genetic relationship. The same clone was identified in different types of samples and different years, demonstrating the permanence of the strain in the hospital environment. Our results reaffirm the need for greater measures of control and disinfection within the hospital environment, and the priority of therapeutic measures to contain the propagation of K. pneumoniae.