Molecular and phenotypic characterization of carbapenemase-producing Klebsiella pneumoniae in a tertiary university hospital in Bandar Abbas, Iran

Background and Aim : Infections with carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) are emerging as an important challenge in healthcare settings, which are most commonly encountered in hospitals. The aims of this study were to identify the antibiotic susceptibility and genes coding for carbapenemases in K. pneumoniae isolates in the Bandar Abbas, Iran.Methods : Two hundred K. pneumoniae isolates were obtained from clinical samples from Shahid Mohammadi Hospital, in Bandar Abbas. Identification and antimicrobial sensitivity test were performed with the disk diffusion method. The isolates were examined to determine the presence of selected antibiotic-resistant genes including NDM, IMP, VIM, SPM, and OXA۴۸ by PCR method. All of the isolates were DNA extracted by boiling method. Results : K. pneumoniae isolates were obtained from clinical samples including urine (۶۶.۵%; n = ۱۳۳), trachea (۹%; n = ۱۸), wound (۷.۵%; n = ۱۵), blood (۶%; n = ۱۲), sputum (۵%; n = ۱۰), discharge (۲%; n = ۴), BAL (۱%; n = ۲), eye infection (۲%; n = ۴), pleural fluid (۰.۵%; n = ۱), and ascites (۰.۵%; n = ۱). The disk diffusion results showed that ۱۰۷ (۵۳.۵%) of the isolates were resistant to piperacillin, ۱۰۰ (۵۰%) to sulfamethoxazole-trimethoprim, ۹۲ (۴۶%) to ceftazidime, ۹۳ (۴۶.۵%) to cefepime, ۸۹ (۴۴.۵%) to ampicillin-sulbactam, ۸۷ (۴۳.۵%) to aztreonam, ۶۴ (۳۲%) to ciprofloxacin, ۵۳ (۲۶.۵%) to piperacillin-tazobactam, ۵۷ (۲۸.۵%) to gentamicin, ۵۴ (۲۷%) to tetracycline and ۳۲ (۱۶%) to meropenem. PCR assays revealed that six isolates possessed the NDM gene. None of the isolates were possessed IMP, VIM, SPM, and OXA۴۸ genes.Conclusion : Based on the results, the prevalence of NDM-producing K. pneumoniae is higher compared to others carbapenemases genes (IMP, VIM, SPM, and OXA۴۸) in the Bandar Abbas, Iran.

Keywords:

Klebsiella pneumoniae , Antibiotic resistance , Carbapenemase