Prevalence and Molecular Detection of Carbapenemase Genes in Clinical Klebsiella pneumoniae Isolates From Khartoum State, Sudan.

BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is a critical global public health threat due to its multidrug resistance and limited treatment options. OBJECTIVE: This study is aimed at detecting carbapenemase genes in CRKP isolates obtained from various clinical specimens collected in Khartoum State, Sudan. METHODS: Fifty CRKP isolates were collected between November 2022 and February 2023 from urine, wound swabs, high vaginal swabs, sputum, stool, and blood samples. Demographic data and antibiotic history were recorded. DNA extraction and multiplex PCR were performed to detect blaKPC , blaNDM , blaOXA-48 , blaIMP , and blaSPM genes. RESULTS: Of the 50 isolates, 44 (88%) carried at least one carbapenemase gene, whereas 6 (12%) were negative for all tested genes. The most common gene was blaKPC (72%), followed by blaNDM (42%), blaSPM (38%), blaIMP (28%), and blaOXA-48 (10%). Multiple carbapenemase genes were detected in 28 isolates (56% of total isolates; 63.6% of positive isolates). No statistically significant associations were found between carbapenemase gene presence and patient age group or gender (p > 0.05). A significant association was observed between prior antibiotic exposure and the presence of blaSPM (p ≈ 0.020), and between blaNDM and infection site (p = 0.039), whereas no significant associations were found with the other genes. CONCLUSION: This study demonstrates a high prevalence of carbapenemase genes among CRKP isolates in Khartoum State, with frequent coexistence of multiple resistance genes. The significant association between prior antibiotic use and blaSPM highlights the role of antimicrobial pressure in resistance development. These findings emphasize the need for improved infection control measures and effective antimicrobial stewardship to limit the spread of carbapenem-resistant K. pneumoniae.