The Molecular Epidemiology of Resistance to Antibiotics among Klebsiella pneumoniae Isolates in Azerbaijan, Iran

Abstract

Introduction. Klebsiella pneumoniae (K. pneumoniae) is one of the leading causes of hospital-acquired and community-acquired infections in the world. This study was conducted to investigate the molecular epidemiology of drug resistance in clinical isolates of K. pneumoniae in Azerbaijan, Iran. Materials and Methods. A total of 100 nonduplicated isolates were obtained from the different wards of Azerbaijan state hospitals, Iran, from 2019 to 2020. Antibiotic susceptibility testing was done. The DNA was extracted, and the PCR for evaluation of the resistance genes was carried out. Results. The highest antibiotic resistance was shown to ampicillin (96%), and the highest susceptibility was shown to tigecycline (9%), and 85% of isolates were multidrug resistant. The most frequent ESBL gene in the tested isolates was blaSHV-1 in 58%, followed by blaCTXM-15 (55%) and blaSHV-11(42%). The qepA, oqxB, and oqxA genes were found to be 95%, 87.5%, and 70%, respectively. We detected tetB in 42%, tetA in 32%, tetD in 21%, and tetC in 16%. Seventy isolates were resistant to co-trimoxazole, and the rate of resistance genes was sul1 in 71%, followed by sul2 (43%), dfr (29%), and sul3 (7%). The most common aminoglycoside resistance genes were ant3Ia, aac6Ib, aph3Ib, and APHs in 44%, 32%, 32%, and 31.4%, respectively. The most frequent resistance gene to fosfomycin was fosA (40%) and fosX (40%) followed by fosC (20%). Conclusion. The results of this study indicate the high frequency of drug resistance among K. pneumoniae isolated from hospitals of Azerbaijan state. The present study shows the presence of high levels of drug-resistant genes in various antibiotics, which are usually used in the treatment of infections due to K. pneumoniae.

Prevalence of Multidrug-Resistant Klebsiella pneumoniae Clinical Isolates in Nepal

“…The number of studies included in the meta-analysis was limited due to the study's search limitations. In Nepal, the occurrence of the pathogen to cause the infection ranges from about 7% to 37% displaying rise in the infection [ 21 – 36 ]. The results in this study determined the combined estimation of K .…”

“…pneumoniae (pooled prevalence, 64%). In various locations, the multidrug resistance was seen to vary from 6% to 91% [ 4 , 23 , 26 , 27 , 29 – 36 ].…”

Diminished Susceptibility to Cefoperazone/Sulbactam and Piperacillin/Tazobactam in Enterobacteriaceae Due to Narrow-Spectrum β-Lactamases as Well as Omp Mutation

“…TEM-1, SHV-1, and OXY-1 β-lactamases are narrow-spectrum β-lactamases, which belong to group 2be in the Bush-Jacoby classification scheme (Paterson and Bonomo 2005;Kashefieh et al 2021;Rehman et al 2021). Enterobacteriaceae with TEM-1, SHV-1, or OXY-1 β-lactamase are usually susceptible to CSL and TZP.…”

Study of aerobic and anaerobic bacterial profile of nosocomial infections and their antibiotic resistance in a referral center, Southwest Iran: A three year cross-sectional study

“…As the effectiveness of antibiotics is declining owing to the persistence of AMR, physicians have to use last-resort classes of medicine that are always unavailable in developing countries. Such medicines are highly expensive and have varied side effects [ 5 ]. I did not understand the meaning.…”

“…Researchers have long time ago been warned of the excess use of antimicrobials and the resultant AMR as a forthcoming challenge for the health system of Iran. Considering the available meta-analysis information, it is evident that the Iranian population as a serious concern are confronted with a high rate of AMR to the bacteria, including Staphylococcus aureus with resistance to methicillin (20.48% to 90%), and Klebsiella pneumonia with 96% and 77% resistance rate to ampicillin and co-trimoxazole respectively [ 2 , 5 ]. The rate of multi-drug resistant (MDR) Pseudomonas aeroginosa was also estimated as 58% [ 7 ].…”