A multicenter study of β-lactamase-producing Klebsiella pneumoniae isolated from university teaching hospitals of Urmia, Iran
Introduction: Klebsiella pneumoniae is an opportunistic pathogen accounting for 5-7% of hospital acquired infections. The emergence of carbapenem-resistant Klebsiella pneumoniae has been increasing rapidly over recent years causing many therapeutic problems worldwide. This study aimed to research the antimicrobial resistance profile, detect β-lactamase genes among clinical isolates of K. pneumoniae, and determine their clonal relatedness.
Methodology: All Klebsiella pneumoniae isolates were obtained from teaching hospitals in Urmia, Iran. Antimicrobial susceptibility testing was done by the disk diffusion method. Furthermore, minimum inhibitory concentrations of imipenem were determined by applying Etest strips. Screening of β-lactamase-producing isolates was performed by the combined disk method and modified Hodge test. The detection of β-lactamase genes was conducted by polymerase chain reaction (PCR), and isolates’ clonal relatedness was evaluated by random amplified polymorphic DNA (RAPD)-PCR.
Results: Overall, 45 out of 182 (24.7%) K. pneumoniae isolates were non-susceptible to imipenem. The combined disk method and modified Hodge test revealed that 93.3% and 71.1% of the imipenem non-susceptible isolates were β-lactamase producers, respectively. The presence of blaVIM, blaNDM, blaKPC, and blaIMP genes was confirmed in 48.9%, 15.6%, 11.1%, and 6.7% of the β-lactamase-producing isolates, respectively. RAPD-PCR revealed that 73% of these isolates were classified into six different clusters.
Conclusions: A relatively high prevalence of β-lactamase genes was seen among multidrug-resistant isolates of K. pneumoniae. Most patients infected with β-lactamase-producing isolates had a history of long-term hospitalization and nosocomial infections. The predominance of β-lactamase genes in intensive care unit and internal units alarm clinicians to the growth of hospitalization and mortality rates.
Copyright (c) 2019 Narges Darabi, Morteza Motazakker, Hamid Reza Khalkhali, Saber Yousefi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).