Molecular Characterization of Extended spectrum beta-lactamases (ESBLs) Carbapenem-Resistant Genesin Klebsiella pneumoniae Isolated from Iranian Hospital
Sajad Yaghoubi, Shahriar Yavari, Khali Azizian, Meghdad Abdollahpour-Alitappeh, Asiyeh Dezhkam, Yousef Erfani, Zahra Mousavi
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ABSTRACTBackground: Carbapenem-resistant Klebsiella isolates are describedas one of the most significant problemsworldwide. The aim of this study was to determinethe prevalence of extended spectrum beta-lactamase (ESBL) subtypes and carbapenem-resistant genes in Klebsiella pneumoniae (K. pneumonia) speciesisolatedfrom patients at Shariatee Hospital in Tehran, Iran.Methods: Fifty isolates of K. pneumoniae were isolated and identified from Shariatee Hospital in Tehran from January 2014 to February 2016. Disk diffusion and E-test minimum inhibitory concentration (MIC) testing methods were carried out to characterize the isolates.Modified Hodge Testing (MHT) and carbapenem inactivation method test (CIM), was used to confirm carbapenemase activity.Finally, Sequencing and polymerase chain reaction (PCR) was applied for further analysis.Results: Our findings showed that the prevalence of blaCTX-M 33 (63.46%) genes was the most prevalent ones. blaCTX-M15 19 (36.53%)was found to be the most commonly detected subtype in CTX-M groups. blaKPC, blaOXA-48, and blaNDM1 were detected in 3 (5.76%), 6 (11.53%), and 12 (23.7%) of the carbapenem-resistant isolates, respectively.Conclusions: Our study displayed that the CIM test has a great potential to detect carbapenem-resistant Klebsiella (CRK). Based on our results, there are a need for further considerations regarding the emergence anddiagnosis of isolates harboring ESBL subtypes and carbapenem genes. Further attention should be paidfor the treatment of patients with highlyresistant-isolates.Keywords: Klebsiella pneumoniae, New Delhi metallo-beta-lactamase-1, Extended-spectrum ß-lactamase
Background: Carbapenem-resistant Klebsiella isolates are describedas one of the most significant problemsworldwide. The aim of this study was to determinethe prevalence of extended spectrum beta-lactamase (ESBL) subtypes and carbapenem-resistant genes in Klebsiella pneumoniae (K. pneumonia) speciesisolatedfrom patients at Shariatee Hospital in Tehran, Iran.
Methods: Fifty isolates of K. pneumoniae were isolated and identified from Shariatee Hospital in Tehran from January 2014 to February 2016. Disk diffusion and E-test minimum inhibitory concentration (MIC) testing methods were carried out to characterize the isolates.Modified Hodge Testing (MHT) and carbapenem inactivation method test (CIM), was used to confirm carbapenemase activity.Finally, Sequencing and polymerase chain reaction (PCR) was applied for further analysis.
Results: Our findings showed that the prevalence of blaCTX-M 33 (63.46%) genes was the most prevalent ones. blaCTX-M15 19 (36.53%)was found to be the most commonly detected subtype in CTX-M groups. blaKPC, blaOXA-48, and blaNDM1 were detected in 3 (5.76%), 6 (11.53%), and 12 (23.7%) of the carbapenem-resistant isolates, respectively.
Conclusions: Our study displayed that the CIM test has a great potential to detect carbapenem-resistant Klebsiella (CRK). Based on our results, there are a need for further considerations regarding the emergence anddiagnosis of isolates harboring ESBL subtypes and carbapenem genes. Further attention should be paidfor the treatment of patients with highlyresistant-isolates.
Keywords: Klebsiella pneumoniae, New Delhi metallo-beta-lactamase-1, Extended-spectrum ß-lactamase