Molecular Identification and Antimicrobial Resistance Determinant of Klebsiella pneumoniae Isolate from Diabetic Foot Wounds in Benue State, Nigeria

Abstract

Diabetic foot wounds (DFWs) represent one of the most serious complications of diabetes mellitus and are frequently associated with bacterial infections that complicate treatment and increase the risk of amputation. Among the bacterial pathogens implicated in these infections, Klebsiella pneumoniae has emerged as a major opportunistic pathogen due to its increasing multidrug resistance and ability to acquire virulence determinants. This study investigated the molecular characteristics and antimicrobial resistance determinants of Klebsiella pneumoniae isolated from diabetic foot wounds in selected tertiary health facilities in Benue State, Nigeria. A total of 57 K. pneumoniae isolates were subjected to phenotypic screening for extended-spectrum β-lactamase (ESBL) production using the double-disc synergy test and confirmatory combination disk method. Molecular detection of resistance genes including blaCTX-M, blaNDM, and blaKPC was performed using polymerase chain reaction (PCR). The results showed that 12 (21.1%) isolates were ESBL producers while 45 (78.9%) were non-producers. The distribution of ESBL isolates across the three senatorial zones showed that Zone B had the highest prevalence (58.3%), followed by Zone A (25.0%) and Zone C (16.7%). Molecular analysis revealed the presence of the blaCTX-M gene, confirming ESBL production in several isolates, while the NDM gene was detected in two isolates. No isolates were found to carry the KPC gene. The findings highlight the growing burden of ESBL-producing K. pneumoniae in diabetic foot infections and underscore the need for continuous molecular surveillance, antimicrobial stewardship, and improved infection control strategies in healthcare facilities in Nigeria.