Efflux-mediated tigecycline resistance in Klebsiella pneumoniae isolates: Genetic determinants and epidemiological insights | ||
| Microbes and Infectious Diseases | ||
| Articles in Press, Accepted Manuscript, Available Online from 02 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mid.2025.410998.3083 | ||
| Authors | ||
| Fatma M. Ayman* ; Ahmed A. Abdelaziz; Amal M. Abo-Kamer; Lamia A. Youssif | ||
| Department of Microbiology and Immunology, Faculty of Pharmacy, Tanta University, Tanta, Egypt | ||
| Abstract | ||
| Objectives: Tigecycline, a last-resort antibiotic for treating multidrug-resistant (MDR) Gram-negative bacterial infections, has increasingly encountered resistance, particularly in Klebsiella species. Understanding the molecular epidemiology and mechanisms underlying tigecycline resistance is crucial for developing effective therapeutic strategies. Methods: This study investigates the prevalence and genetic basis of tigecycline resistance in Klebsiella clinical isolates using the N-phenyl-1-naphthylamine (NPN) efflux assay and reverse transcription polymerase chain reaction (RT-PCR). Results: The NPN efflux assay was employed to assess the activity of efflux pumps, a key resistance mechanism, while RT-PCR was used to quantify the expression levels of resistance-associated genes, including acrA, acrB, and ramA. Molecular epidemiological analysis revealed a high prevalence of resistant Klebsiella strains, with increased efflux activity correlating with upregulated efflux pump genes. Mutations in regulatory genes such as ramR were also identified, further contributing to resistance. Conclusion: These findings highlight the critical role of efflux-mediated resistance in Klebsiella and emphasize the need for molecular surveillance, antimicrobial stewardship, and targeted interventions to combat tigecycline resistance. | ||
| Keywords | ||
| Tigecycline resistance Klebsiella; NPN efflux assay; RT-PCR; efflux pumps; molecular epidemiology | ||
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