Carbapenem-resistant Klebsiella pneumoniae in COVID-19 patients admitted to intensive care units of Zagazig University Hospitals

Abstract

Background: Continuous monitoring is crucial to detect infection by Carbapenemase-producing Klebsiella pneumoniae (CPKP) in intensive care COVID-19 patients. Aim: to evaluate the CR-KP colonization and co- infection and evaluate the antibiotic resistance pattern. Methods: A cross -sectional study was done on COVID-19 patients with CPKP infection in Zagazig University Hospitals where rectal swab samples were detected using XpertCarba-R Assay(Cepheid, Sunnyvale), while isolates from sputum, urine, and blood culture were identified phenotypically by VITEK® 2 (bioMérieux SA) and modified Hodge test while genotypically by XpertCarba-R Assay(Cepheid, Sunnyvale). Results: CPKP was found in 60 patients out of 140 patients (42.8%), with 34 CPKP identified from rectal swabs, 12 patients infected from diverse locations (blood, respiratory secretions, and urine), and 14 COVID-19 patients developing CPKP co-infection with colonization. A widespread resistance to all antibiotic classes was found on the antibiograms of CPKP isolates and the blaNDM was the most common genotype detected by preliminary PCR testing. Conclusion: Regarding CPKP infection, a continues focus should be taken when dealing with it, particularly among COVID-19 patients. The incidence of multi-drug resistance due to nosocomial infection can be decreased by the rigorous monitoring of colonized patients and expedite the infection control practices.