Resistance to antibacterial drugs and bacteriophages of Klebsiella pneumoniae isolates isolated from children of different ages with intestinal infections

The aim is to study the antibiotic and phage resistance of K. pneumoniae strains isolated from children with acute intestinal infections. Materials and methods. 490 K. pneumoniae strains isolated by the bacteriological method from feces from patients with intestinal infections of various etiologies aged from 1 month to 18 years in the period 2019—2021 were studied. The diagnosis of intestinal infection caused by K. pneumoniae was established taking into account the detection of the pathogen at a concentration of at least 5 lg CFU/g (n = 283; 57.8%). Children with Klebsiella seeding, made up three age groups: from 1 to 12 months of life (n = 245; 50%); from 1 to 3 years (n = 131; 26.7%); from 3 to 18 years (n = 114; 23.3%). Results. A higher frequency of K. pneumoniae seeding in high concentrations from fecal samples of children with intestinal infections aged from 1 to 12 months was established (?2 = 14.24; p < 0.001). Analysis of the frequency of K. pneumoniae resistance to antimicrobials revealed its increase to ampicillin/sulbactam from 4.2 ± 1.6% to 9.7 ± 1.9% and to gentamicin from 3.0 ± 1.3% to 7.6 ± 1.7% (p < 0.05) with an increase in the concentration of the pathogen from 3—4 to 5—6 lg CFU/ml. In K. pneumoniae strains isolated in low concentrations, resistance to polyvalent anti-klebsiella bacteriophage was significantly higher than to monovalent bacteriophage. Conclusion. Children of the first year of life belong to the risk group for the development of klebsiella intestinal infection. An increase in the frequency of K. pneumoniae resistance to ampicillin/sulbactam and gentamicin correlates with an increase in the concentration of the pathogen in fecal samples.

1. Sergevnin V.I. Current trends in the long-term dynamics of the incidence of acute intestinal infections of bacterial and viral etiology Epidemiologiya i Vakcinoprofilaktika=Epidemiology and Vaccination prevention. 2020; 19(4):4—19. (in Russ.)

2. Kovalev O.B., Molochkova O.V., Konyaev K.S., Pylaeva E.Yu., Anufrieva P.A., Kurmanova V.V., Korsunsky A.A., Kashchenko O.A., Galeeva E.V., Krylatova N.I. The etiology and clinical manifestations of acute intestinal infections in children, according to the according to the Moscow hospital for 2016—2018. Detskie Infektsii = Children's Infections. 2019; 18(2):54—57. doi.org/10.22627/2072-8107-2019-18-2-54-57. (in Russ.)

3. Murzabaeva R.T., Mavzyutov A.R., Valishin D.A. Clinical and immunological parallels in acute intestinal infections caused by opportunistic enterobacteria. Infekcionnye Bolezni=Infectious Diseases. 2018; 16(4):79—85. DOI:10.20953/1729-9225-2018-4-79-85(in Russ.)

4. Aftaeva L.N., Mel'nikov V.L., Ondrikova E.A., Ondrikov N.A. Etiology of acute intestinal infections in children. Sovremennaya Medicina: Aktual'nye Voprosy=Modern Medicine: Topical Issues. 2017; 4(56):28—33. (in Russ.)

5. Mustaeva G.B. Features of the course of klebsiella infection according to the Samarkand Regional Clinical Hospital. Vestnik nauki i obrazovaniya=Bulletin of Science and Education. 2020; 18—2(96):81—85. (in Russ.)

6. Li B., Zhang J., Chen Y. et al. Alterations in microbiota and their metabolites are associated with beneficial effects of bile acid sequestrant on icteric primary biliary Cholangitis. Gut Microbes. 2021; 13(1): e1946366.

7. Tang R., Wei Y., Li Y. et al. Gut microbial profile is altered in primary biliary cholangitis and partially restored after UDCA therapy. Gut. 2018; 67: 534—571.

8. Ageevec V.A., Ageevec I.V., Sidorenko S.V. Convergence of multiple resistance and hypervirulence in Klebsiella pneumoniae. Infekciya i Immunitet=Infection and Immunity. 2022; 12(3):450—460. doi.org/10.15789/2220-7619-COM-1825 (in Russ.)

9. Kryazhev D.V., Boriskina E.V., Gordinskaya N.A. Sensitivity to bacteriophages in Klebsiella pneumoniae ecovars isolated in a children's hospital. Zhurnal Infektologii=Journal of Infectology. 2022; 14(4S2):42—43. (in Russ.)

10. Nikolaeva I.V., Anohin V.A., Haertynov H.S., Semenova D.R., Shajhieva G.S., Skvorcova N.N. Nosocomial klebsiella infection in newborns. Prakticheskaya Medicina=Practical Medicine. 2016; 8 (100):23—28. (in Russ.)

11. Lev A.I., Astashkin E.I., Kislichkina A.A., Solovieva E.V., Kombarova T.I., Korobova O.V., Ershova O.N., Alexandrova I.A., Malikov V.E., Bogun A.G., A.I. Borzilov A.I., Volozhantsev N.V., Svetoch E.A., Fursova N.K. Comparative analysis of Klebsiella pneumoniae strains isolated in 2012—2016 that differ by antibiotic resistance genes and virulence genes profiles. Pathogens and Global Health. 2018; 30:1—10.

12. Shamina O.V., Samojlova E.A., Novikova I.E., Lazareva A.V. Klebsiella pneumoniae: microbiological characteristics, antibiotic resistance and virulence. Rossijskij Pediatricheskij Zhurnal=Russian Pediatric Journal. 2020; 23(3):191—197. doi.org/10.18821/1560-9561-2020-23-3-191-197. (in Russ.)

13. Burganova R.F., Potaturkina-Nesterova N.I., Nemova I.S. Detection of Klebsiella pneumonia genes encoding pathogenicity factors in dysbiotic disorders against the background of blastocyst invasion. Fundamental'nye Issledovaniya=Fundamental Research. 2011; 9:21—24. (in Russ.)

14. Pron'ko N.V., Kras'ko YU.P. Clinical and epidemiological features of klebsiella infection in children at the present stage. Aktual'naya Infektologiya=Actual Infectology. 2019; 7(3):155—159. doi:10.22141/2312-413x.7.3.2019.170996. (in Russ.)

15. Kuz'menko S.A., Brusina E.B. Medical technologies affecting the infection of children with Klebsiella bacteria, infection prevention. Chronos. 2020; 8(46):39—43. (in Russ.)

16. Chicherin I.YU., Pogorel'skij I.P., Kolodkin A.M., Lundovskih I.A., Shabalina M.R., Kolevatyh E.P. The role of colonization resistance of the gastric and intestinal mucosa in the development of bacterial infections of the gastrointestinal tract. Infekcionnye Bolezni=Infectious Diseases. 2019; 17(3):55—68. DOI:10.20953/1729-9225-2019-3-55-68. (in Russ.)

17. Bondarenko V.M., Fialkina S.V., Agapova O.V. Klebsiella and klebsiellosises. Tver: Publishing house «Triada», 2008:160. (in Russ.)