Characterization of antibiotic resistance of isolates of Klebsiella pneumoniae causing health care-associated infections (HAIs) in the Department of Nariño.

Caracterización de la resistencia antibiótica de aislados de Klebsiella pneumoniae causante de Infecciones Asociadas a la Atención en Salud (IAAS) en el Departamento de Nariño.

Introduction: Klebsiellapneumoniae is a critical priority pathogen that causes health care-associated infections (HAIs). K. pneumoniae bacteria exhibit various mechanisms of antibiotic resistance through mutation or horizontal gene transfer. Objective: In this study, the antibiotic resistance and genomic profiles of K. pneumoniae isolates isolated from HAIs in the Department of Nariño between 2021 and 2023 were evaluated. Methodology: Forty-four bacterial isolates were analyzed at the 16S rRNA gene level. Resistance to 13 antibiotics was evaluated via MicroScan autoSCAN-4 equipment. Genetic variability was determined by in silico cutting with restriction enzymes and genotyping using the BOX-A1R-based repetitive extragenic palindromic-PCR (BOX-PCR) and Enterobacterial repetitive intergenic consensus (ERIC-PCR) markers; subsequently, the genetic results, resistance results, microbiological data and origin of infection were related to the construction of a dendrogram. Results: Forty-four isolates were identified as K. pneumoniae (% identity>97%, e≈0, coverage>96%), 95% of which presented multiresistance, and >80% were resistant to fluoroquinolones, beta-lactams, and combined antibiotics. The genetic profiles demonstrated high variability among the isolates. A high frequency of isolates from ICUs and blood samples was evident, and coinfection with COVID-19 was observed in 20% of the samples analyzed. Conclusion: There is marked antibiotic resistance and genomic variability in K. pneumoniae isolates isolated from HAIs. This study corroborates the alarming problem that public health may face due to antimicrobial resistance (AMR).