The Prevalence of ESBLs Producing Klebsiella pneumoniae Isolates in Some Major Hospitals, Iran

Ghafourian, Sobhan; Sadeghifard, Nourkhoda; Mohebi, Reza; Neela, Vasanthakumari; Maleki, Afshin; Hematian, Ali; Rhabar, Mohammad; Raftari, Mohammad; Ranjbar, Reza

doi:10.2174/1874285801105010091

Cited by 62 publications

(48 citation statements)

References 14 publications

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“…A study conducted by Ghafourian et al (24) in 2011 in Iran determined that 94% of K. pneumoniae strains carried the bla SHV gene, which is in parallel with our results (24) . In recent years, the high relative prevalence of the bla SHV gene in ESBL-producing K. pneumoniae strains has been reported worldwide.…”

Section: Discussionsupporting

confidence: 91%

First report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-producing Klebsiella pneumoniae from Iran

Zahedani

Rigi

Bokaeian

et al. 2016

Rev. Soc. Bras. Med. Trop.

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Introduction: Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes capable of hydrolyzing beta-lactams. The aim of this study was to describe the prevalence of TEM-and SHV-type ESBL-producing Klebsiella pneumoniae strains in Zahedan, Southeast Iran. Methods: A total of 170 non-repetitive K. pneumoniae strains were collected from patients referred to three teaching hospitals of Zahedan. Antibiotic susceptibility testing was determined for 17 antibiotics using the Kirby-Bauer disc diffusion method. The frequency of ESBL-producing strains was calculated, and minimum inhibitory concentrations of ESBLproducing strains were determined for cefotaxime, ceftazidime, ceftriaxone, and cefpodoxime. The presence of bla TEM and bla SHV genes was tested in all ESBL-producing strains using polymerase chain reaction and DNA sequencing. Results: Among the 170 K. pneumoniae clinical isolates, 55 (32.4%) were ESBL producers; 92.7% (n=51) and 72.7% (n=40) of the isolates carried the bla SHV and bla TEM genes, respectively, and 67.3% (n=37) carried both genes. The sequencing results showed that all bla TEM types were bla TEM-1 , except for two isolates that were bla . The bla SHV types were bla SHV-1 , bla SHV-11 , bla , bla SHV-99 , bla , and bla . Conclusions: The percentage of bla TEM and bla SHV among ESBL-producing K. pneumoniae isolates from Zahedan is relatively high, indicating the need for further surveillance and consideration in antibiotic use. To the best of our knowledge, this is the fi rst report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-type ESBLs among clinical isolates of K. pneumoniae from Iran, and TEM-1, SHV-1, SHV-11, and SHV-12 appear to be the dominant ESBLs in this region.

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Section: Discussionsupporting

confidence: 91%

First report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-producing Klebsiella pneumoniae from Iran

Zahedani

Rigi

Bokaeian

et al. 2016

Rev. Soc. Bras. Med. Trop.

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“…The results obtained from this study showed a high resistance of K. pneumonia isolates to cefixime, cefotaxime, ceftriaxone, ceftazidime, and trimethoprim/sulfamethoxazole. This is similar to recent articles in which resistances ranged between 50% and 99% for cefotaxime (3,28) and was up to 20% for trimethoprim-sulfamethoxazole (29). In our hospital, the high resistance of K. pneumonia to cefixime, cefotaxime, ceftriaxone, and ceftazidime was a disturbing finding since these are among the most widely used empirical therapies for febrile infections such as UTI.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of Extended Spectrum β-Lactamase inKlebsiella pneumoniaIsolates in a Teaching Hospital of Zahedan City, Iran

Mahbobeh¹,

Bahman²,

Rashki

et al. 2014

Avicenna J Clin Microbiol Infect

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Background: Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumonia has become widespread in hospitals and is increasing in community settings. Most of K. pneumonia that harbor these enzymes, display resistance to other unrelated antimicrobial agents and thus, often pose a therapeutic dilemma. Objectives: This study was conducted to determine the prevalence of ESBL-producing K. pneumonia in a major university hospital in Zahedan, Iran. Materials and Methods:The susceptibility of 83 K. pneumonia isolates to 12 antibiotics was assessed using Kirby-Bauer disc diffusion method. For the ESBL phenotypic test, double-disk diffusion (DD) method was used. Results: The highest resistance rates of the isolates were seen against cefixime (82%), cefotaxime (81%), ceftriaxone (73%), ceftazidime (72%), and azithromycin (60%), consecutively. The lowest resistance rates were observed against gentamicin (58%), tetracycline (59%), nalidixic acid (59%), and amikacin (63%), consecutively. ESBLs were found in 65% of K. pneumonia isolates. Conclusions: We found that 65% of K. pneumonia isolates produced ESBL. Therapeutic strategies to control infections should be carefully formulated in teaching hospitals. The high percentage of drug resistance in ESBL-producing K. pneumonia suggests that routine detection of ESBL by reliable laboratory methods is required.

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“…The rate of detection of ESBLs in K. pneumoniae was calculated to be 42.68%; this was lower than the rate observed in Iran (59.20%), and higher than that seen in Beijing (32.21%). However, the rate of detection of CTX-M ESBLs in ESBL-positive K. pneumoniae (87.62%) was similar to that seen in Beijing (84.80%), and higher than that in Iran (23.90%) (Feizabadi et al, 2010;Ghafourian et al, 2011;Zou et al, 2011;An et al, 2012). Therefore, we concluded that the production of ESBLs and CTX-M ESBLs differed regionally; this may be attributed to the increasing habit of antibiotic use, or the choice of detection method.…”

Section: Discussionmentioning

confidence: 50%

Analysis of the drug-resistant characteristics of Klebsiella pneumoniae isolated from the respiratory tract and CTX-M ESBL genes

et al. 2015

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ABSTRACT. The main aim of this study was to understand the relationship between the drug-resistant characteristics of Klebsiella pneumoniae and CTX-M-type extended spectrum β-lactamases (ESBLs), and to detect the distributions of CTX-M-type ESBLs in clinically isolated strains. CTX-M ESBL genes isolated from the clinical samples were amplified by polymerase chain reaction and identified by sequence analysis; the antibiotic susceptibility of the samples was determined using the Kirby-Bauer disc-diffusion method. One hundred and five strains among the 246 isolated strains of K. pneumoniae tested positive for ESBL production (42.68%); 92 of these produced CTX-M ESBLs. Of the 92 CTX-M ESBL strains, 81 produced CTX-M-1 ESBLs and 11 produced CTX-M-25 ESBLs. Fifty-seven of the CTX-M-1 ESBL-and six of the CTX-M-25 ESBL-producing bacteria had CTX-M ESBL genes that coexisted in the plasmid and chromosome. The KirbyBauer antibiotic susceptibility method revealed that CTX-M ESBLpositive strains showed a higher rate of resistance to cefazolin, cefoxitin, cefuroxime, ceftazidime, cefotaxime, aztreonam, levofloxacin, and 12044 S.Y. Huang et al. ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (4): 12043-12048 (2015) cotrimoxazole, compared to the CTX-M ESBL-negative strains (P < 0.05). The CTX-M ESBL genes were commonly observed in the K. pneumoniae isolated from respiratory tract samples; these were significantly associated with the drug-resistant characteristics of K. pneumoniae to β-lactam antibiotics.

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The Prevalence of ESBLs Producing Klebsiella pneumoniae Isolates in Some Major Hospitals, Iran

Cited by 62 publications

References 14 publications

First report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-producing Klebsiella pneumoniae from Iran

First report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-producing Klebsiella pneumoniae from Iran

Prevalence of Extended Spectrum β-Lactamase inKlebsiella pneumoniaIsolates in a Teaching Hospital of Zahedan City, Iran

Analysis of the drug-resistant characteristics of Klebsiella pneumoniae isolated from the respiratory tract and CTX-M ESBL genes

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