Intense Intestinal Carriage of Carbapenemase-Producing Klebsiella pneumoniae Co-harboring OXA-48, KPC, VIM, and NDM Among Preterm Neonates in a Moroccan Neonatal Intensive Care Unit

Benboubker Moussa; Fouzia Hmami; Btissam Arhoun; Samira El Fakir; Abdelhamid M Massik; Salim Belchkar; Lahbib Hibaoui; Bouchra Oumokhtar

doi:10.7759/cureus.50095

Intense Intestinal Carriage of Carbapenemase-Producing Klebsiella pneumoniae Co-harboring OXA-48, KPC, VIM, and NDM Among Preterm Neonates in a Moroccan Neonatal Intensive Care Unit

Cureus. 2023 Dec 7;15(12):e50095. doi: 10.7759/cureus.50095. eCollection 2023 Dec.

Authors

Benboubker Moussa¹, Fouzia Hmami², Btissam Arhoun³, Samira El Fakir⁴, Abdelhamid M Massik⁵, Salim Belchkar⁶, Lahbib Hibaoui⁵, Bouchra Oumokhtar⁷

Affiliations

¹ Human Pathology Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
² Neonatal Intensive Care Unit, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
³ Microbiology and Molecular Biology Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
⁴ Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
⁵ Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
⁶ Epidemiology and Health Science Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.
⁷ Microbiology and Molecular Biology Laboratory, Microorganisms Team, Genomics and Oncogene Factors, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR.

Abstract

Introduction: This study aimed to investigate the prevalence and the carbapenemase production ability of Klebsiella pneumoniae isolates from premature neonates' intestinal tracts in a Moroccan neonatal intensive care unit Methodology: Active rectal screening was performed among 339 preterm infants. The collected isolates were subjected to antibiotic susceptibility testing, phenotypic analysis of carbapenemase production, and molecular detection of carbapenemase genes.

Results: Out of 293 K. pneumoniae isolates collected, 31.05% (91) were resistant to carbapenem and produced carbapenemase, resulting in a 22.12% rate of intestinal carriage. Among the carbapenem-resistant K. pneumoniae isolates, 40.65% (37) had co-harbored carbapenemase genes. All isolates contained the blaOXA-48 gene, and the blaNDM, blaVIM, and blaKPC genes were detected in 30.76%, 9.89%, and 2.19% of the isolates, respectively. Out of 30.76% of these isolates had both the blaOXA-48 and blaNDM genes, 8.79% had both blaOXA-48 and blaVIM, and only 2.20% had both blaOXA-48 and blaKPC genes. Furthermore, 88.57% of carbapenem-resistantK. pneumoniae isolates co-harboring carbapenemase genes were genetically related strains.

Conclusions: This study revealed a high prevalence of intestinal carriage of carbapenem-resistant K. pneumoniae. Therefore, implementing effective screening and diagnostic measures, and focusing on antimicrobial stewardship are essential to preventing the spread of these resistant strains and minimizing the risk they pose to premature infants.

Keywords: carbapenemase; intestinal colonization; klebsiella pneumoniae; nicu; preterm infants.