Evaluation of the Ability to Form Biofilms in KPC-Producing and ESBL-Producing Klebsiella pneumoniae Isolated from Clinical Samples

Carolina Sabença; Eliana Costa; Sara Sousa; Lillian Barros; Ana Oliveira; Sónia Ramos; Gilberto Igrejas; Carmen Torres; Patrícia Poeta

doi:10.3390/antibiotics12071143

Evaluation of the Ability to Form Biofilms in KPC-Producing and ESBL-Producing Klebsiella pneumoniae Isolated from Clinical Samples

Antibiotics (Basel). 2023 Jul 2;12(7):1143. doi: 10.3390/antibiotics12071143.

Authors

Carolina Sabença^{1

2

3

4}, Eliana Costa⁵, Sara Sousa⁵, Lillian Barros^{6

7}, Ana Oliveira⁸, Sónia Ramos⁹, Gilberto Igrejas^{2

3

4}, Carmen Torres¹⁰, Patrícia Poeta^{1

4

11

12}

Affiliations

¹ MicroART-Antibiotic Resistance Team, Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal.
² Department of Genetics and Biotechnology, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal.
³ Functional Genomics and Proteomics Unit, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal.
⁴ Associated Laboratory for Green Chemistry, University NOVA of Lisbon, 1099-085 Caparica, Portugal.
⁵ Hospital Centre of Trás-os-Montes and Alto Douro, Clinical Pathology Department, 5000-508 Vila Real, Portugal.
⁶ Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal.
⁷ Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal.
⁸ Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Caparica, Portugal.
⁹ Faculty of Veterinary Medicine, Centro Universitário de Lisboa, Campo Grande, 376, 1749-024 Lisbon, Portugal.
¹⁰ Area Biochemistry and Molecular Biology, University of La Rioja, 26006 Logroño, Spain.
¹¹ CECAV-Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal.
¹² Veterinary and Animal Research Centre, Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), 5000-801 Vila Real, Portugal.

Abstract

The appearance of Klebsiella pneumoniae strains producing extended-spectrum β-lactamase (ESBL), and carbapenemase (KPC) has turned into a significant public health issue. ESBL- and KPC-producing K. pneumoniae's ability to form biofilms is a significant concern as it can promote the spread of antibiotic resistance and prolong infections in healthcare facilities. A total of 45 K. pneumoniae strains were isolated from human infections. Antibiograms were performed for 17 antibiotics, ESBL production was tested by Etest ESBL PM/PML, a rapid test was used to detect KPC carbapenemases, and resistance genes were detected by PCR. Biofilm production was detected by the microtiter plate method. A total of 73% of multidrug resistance was found, with the highest resistance rates to ampicillin, trimethoprim-sulfamethoxazole, cefotaxime, amoxicillin-clavulanic acid, and aztreonam. Simultaneously, the most effective antibiotics were tetracycline and amikacin. bla_CTX-M, bla_TEM, bla_SHV, aac(3)-II, aadA1, tetA, cmlA, catA, gyrA, gyrB, parC, sul1, sul2, sul3, bla_KPC, bla_OXA, and bla_PER genes were detected. Biofilm production showed that 80% of K. pneumoniae strains were biofilm producers. Most ESBL- and KPC-producing isolates were weak biofilm producers (40.0% and 60.0%, respectively). There was no correlation between the ability to form stronger biofilms and the presence of ESBL and KPC enzymes in K. pneumoniae isolates.

Keywords: Klebsiella pneumoniae; Klebsiella pneumoniae carbapenemase (KPC); antimicrobial resistance; biofilm; extended-spectrum β-lactamase (ESBL).

Abstract

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