The Rising Menace: Carbapenem-Resistant Klebsiella pneumoniae in a Tertiary Care Center and Co-dominance of blaNDM, blaOXA-48 Along With the Emergence of blaVIM.

Background and objective Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a significant cause of hospital-acquired infections, with significant implications for patient outcomes due to limited treatment options and high mortality rates. This study aimed to determine the prevalence, phenotypic resistance patterns, and molecular characteristics of CR-Kp isolates. Methods This was a cross-sectional study conducted for a period of one year. A total of 186 non-duplicate Klebsiella pneumoniae (K. pneumoniae) isolates from various samples were subjected to antibiotic susceptibility testing. Phenotypic detection of carbapenemase production was performed using the modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), and combined disc testing (CDT). Genotypic analysis using PCR was performed on 20 representative CR-Kp isolates to detect blaNDM, blaKPC, blaOXA-48, blaIMP, and blaVIM genes. Results Out of 186 K. pneumoniae isolates, 120 (64.52%) were carbapenem-resistant based on Kirby-Bauer disc diffusion method. Respiratory and bloodstream infections showed the highest CR-Kp prevalence. Phenotypic methods detected carbapenemase activity in 61.29% (combined disk test), 48.92% (mCIM), and 40.86% (MHT) in K. pneumoniae isolates. Genotypic testing revealed bla NDM in 100% and bla OXA-48 in 65% of the tested isolates, with bla VIM detected in one isolate. No bla KPC or bla IMP genes were identified. CR-Kp isolates exhibited high resistance to fluoroquinolones, cephalosporins, and aminoglycosides. Conclusions The high prevalence of bla NDM- and bla OXA-48-mediated carbapenem resistance in K. pneumoniae highlights a growing threat to antimicrobial efficacy. Routine molecular surveillance and stringent antibiotic stewardship initiatives are urgently needed to limit the spread of CR-Kp in hospital settings.