Prevalence of CTX-M and TEM β-lactamases in Klebsiella pneumoniae Isolates from Patients with Urinary Tract Infection, Al-Zahra Hospital, Isfahan, Iran

Maleki, Nafiseh; Tahanasab, Zahra; Mobasherizadeh, Sina; Rezaei, Amir; Faghri, Jamshid

doi:10.4103/abr.abr_17_17

Cited by 18 publications

(11 citation statements)

References 21 publications

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“…The current study showed the occurrence of 100% for MDR K. pneumoniae strains, but in other studies conducted in Iran, the frequency of these strains was reported to be 74% and 46.6%, which is less than our results [28, 29]. The possible explanation for this higher rate of MDR characteristic, mainly in developing countries, could be irregular antibiotic prescription, sampling biases, genetic variations, geographic differences, social behaviors, and dissimilar patients' characteristics [28].…”

Section: Discussioncontrasting

confidence: 96%

Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran

Yazdansetad

Alkhudhairy

Najafpour

et al. 2019

Heliyon

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Infections caused by extended-spectrum β-lactamases (ESBLs) producing bacteria, including Klebsiella pneumoniae have increasingly subjected to therapeutic limitations and patients with these infections are at high risk for treatment failure, long hospital stays, high health care costs, and high mortality. The aim of this study was to screen the prevalence of the blaTEM,blaCTX-M and blaSHV ESBL genes in K. pneumoniae strains isolated from nosocomial urinary tract infections (UTIs). During the March 2016 to December 2017, one hundred isolates of K. pneumoniae were collected from urine specimens of patients suffering from nosocomial UTI referred to Khatam Al-Anbia hospital in Shahrud, north-central Iran. All isolates were identified by standard bacteriological tests. The pattern of antibiotic susceptibility was determined according to the CLSI guidelines. The presence of the ESBLs was investigated using the double-disc synergy test (DDST). Polymerase chain reaction technique was used to detect the blaTEM, blaCTX-M and blaSHV genes in DDST positive isolates. Most isolates showed remarkable resistance to tested antibiotics with highest rate against nitrofurantoin (75%) and trimethoprim/sulfamethoxazole (65%). The imipenem was the most effective antibiotic against K. pneumoniae isolates. ESBL phenotype was detected in 50 (50%) of isolates. The prevalence of blaTEM, blaCTX-M and blaSHV genes among 50 ESBLs-positive isolates was 25 (50%), 15 (30%) and 35 (70%) respectively. The blaTEM and blaSHV genes were seen in 25 isolates (50%) simultaneously. The findings of this study indicated the 50% frequency rate of ESBL-producing K. pneumoniae in our geographic region. Since the treatment of infections caused by this bacterium is associated with many limitations, this high prevalence is a warning sign to adopt new control policies to prevent further spread of this microorganism.

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Section: Discussioncontrasting

confidence: 96%

Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran

Yazdansetad

Alkhudhairy

Najafpour

et al. 2019

Heliyon

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“…Based on the previous studies, the frequency of MDR in the ESBL-producing K. pneumonia isolates ranges from 63.33 to 92%. That is consistent with the findings of the current study (5,(20)(21)(22). Accordingly, more than 86% of ESBLproducing strains were resistant against cephalosporins.…”

Section: Discussionsupporting

confidence: 93%

“…Along with other gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii, K. pneumonia pathogens are commonly isolated from patients with burn infections (4). Most of such infections are caused by multidrug-resistant (MDR) strains that interrupt the treatment processes (5). Besides, extended-spectrum beta-lactamase (ESBL)producing K. pneumonia isolates are highly resistant to antibiotics, which further complicate infections and the treatment processes of burn patients.…”

Section: Introductionmentioning

confidence: 99%

Frequency of qnr and aac(6’)Ib-cr Genes Among ESBL-Producing Klebsiella pneumoniae Strains Isolated from Burn Patients in Kermanshah, Iran

Vaziri

Afsharian

Mansouri

et al. 2020

Jundishapur J Microbiol

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Background: Assessment of bacteria such as Klebsiella pneumonia has shown that Plasmid-mediated quinolone resistance (PMQR) affects antibiotics resistance (e.g., quinolones). Objectives: We studied the prevalence of qnr and aac(6’)Ib-cr genes in extended-spectrum beta-lactamase (ESBL)-producing K. pneumonia strains isolated from burn wounds of patients in the city of Kermanshah, Iran. Methods: This descriptive-analytical study was conducted on 126 K. pneumonia strains isolated collected from burn wounds. Biochemical tests were used to detect the strains. The frequency of the ESBL-producing isolates was determined by phenotypic tests of the combination disk (CD) method after determining the antibiotic susceptibility pattern of the isolates through the Kirby-Bauer disc diffusion test. The prevalence of the qnr and aac(6’)-Ib-cr genes was determined using their special primers as well as polymerase chain reaction (PCR). Results: Of the 126 K. pneumonia isolates, 52 (41.3%) were identified as ESBL-producing strains. ESBL-producing isolates showed higher resistance against antibiotics than non-ESBL-producing ones. PMQR relevance and resistance to ciprofloxacin were, respectively, determined at 80.76% and 59.6%. The most frequent gene was aac(6’)-Ib-cr (n = 70, 55.6%), followed by the qnrB (n = 44, 34.9%. Conclusions: This study showed a high prevalence of qnr genes in ESBL-producing K. pneumonia isolates and antibiotic resistance. Given the horizontal transmission of antibiotic resistance genes among bacteria by mobile genetic elements, timely identification of infections caused by ESBL-producing and antimicrobial-resistant K. pneumonia strains is of paramount importance.

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“…pAmpC beta lactamase genes were reported by two studies in clinical isolates of Klebsiella pneumoniae (Mansouri et al, 2012; Kiaei et al, 2018). PFGE and ERIC-PCR analysis in these studies showed the presence of different clones in each clinical center (Akya et al, 2018; Hashemizadeh et al, 2018; Kiaei et al, 2018; Maleki et al, 2018). This is with the exception of one study where high clonal relatedness among ESBL K. pneumoniae strains was reported (Ghaffarian et al, 2018).…”

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 71%

“…In Iran, studies have shown that in Klebsiella spp., resistance to extended spectrum beta lactams is mainly mediated via the production of CTX-M variants (CTX-M-15, CTX-M-3, CTX-M-8, CTX-M-1, and CTX-M-2) (Feizabadi et al, 2010; Peerayeh et al, 2014; Bialvaei et al, 2016; Akya et al, 2018; Dehshiri et al, 2018) and to a lesser degree via SHV (SHV-12, SHV-11, SHV-5) (Feizabadi et al, 2010; Shakib et al, 2018), TEM genes (Gholipour et al, 2014; Maleki et al, 2018) and others (VEB, PER, and GES) (Sedighi et al, 2017). pAmpC beta lactamase genes were reported by two studies in clinical isolates of Klebsiella pneumoniae (Mansouri et al, 2012; Kiaei et al, 2018).…”

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

et al. 2019

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In the last decade, extended-spectrum cephalosporin and carbapenem resistant Gram-negative bacilli (GNB) have been extensively reported in the literature as being disseminated in humans but also in animals and the environment. These resistant organisms often cause treatment challenges due to their wide spectrum of antibiotic resistance. With the emergence of colistin resistance in animals and its subsequent detection in humans, the situation has worsened. Several studies reported the transmission of resistant organisms from animals to humans. Studies from the middle east highlight the spread of resistant organisms in hospitals and to a lesser extent in livestock and the environment. In view of the recent socio-economical conflicts that these countries are facing in addition to the constant population mobilization; we attempt in this review to highlight the gaps of the prevalence of resistance, antibiotic consumption reports, infection control measures and other risk factors contributing in particular to the spread of resistance in these countries. In hospitals, carbapenemases producers appear to be dominant. In contrast, extended spectrum beta lactamases (ESBL) and colistin resistance are becoming a serious problem in animals. This is mainly due to the continuous use of colistin in veterinary medicine even though it is now abandoned in the human sphere. In the environment, despite the small number of reports, ESBL and carbapenemases producers were both detected. This highlights the importance of the latter as a bridge between humans and animals in the transmission chain. In this review, we note that in the majority of the Middle Eastern area, little is known about the level of antibiotic consumption especially in the community and animal farms. Furthermore, some countries are currently facing issues with immigrants, poverty and poor living conditions which has been imposed by the civil war crisis. This all greatly facilitates the dissemination of resistance in all environments. In the one health concept, this work re-emphasizes the need to have global intervention measures to avoid dissemination of antibiotic resistance in humans, animals and the environment in Middle Eastern countries.

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Prevalence of CTX-M and TEM β-lactamases in Klebsiella pneumoniae Isolates from Patients with Urinary Tract Infection, Al-Zahra Hospital, Isfahan, Iran

Cited by 18 publications

References 21 publications

Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran

Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran

Frequency of qnr and aac(6’)Ib-cr Genes Among ESBL-Producing Klebsiella pneumoniae Strains Isolated from Burn Patients in Kermanshah, Iran

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

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