Prevalence of extended-spectrum β-lactamases in Klebsiella pneumoniae clinical isolates in Bandar Abbas, Iran

Background and Aim : Klebsiella pneumoniae (K. pneumoniae) is an important pathogen that causes several infections in hospitalized immunocompromised patients with severe underlying diseases. Extended-spectrum β-lctamases (ESBLs) are enzymes that hydrolyze the beta-lactam ring of β-lactam antibiotics such as penicillins, first, second and third-generation cephalosporins, and monobactams. This study was conducted to identify the ESBL-producing K. pneumoniae genes and the antibiotic susceptibility of clinical isolates in Shahid Mohammadi Hospital, Bandar Abbas, Iran.Methods : A total of ۳۰۰ K. pneumoniae were isolated from various clinical samples from ۲۰۱۸-۲۰۱۹. The antimicrobial susceptibility patterns were analyzed using the disk diffusion test. Multiplex PCR was carried out to determine the presence of the resistance-conferring genes blaCTX-M, blaSHV, and blaTEM.Results : K. pneumoniae isolates were obtained from urine (۵۱.۳%; n = ۱۵۴), trachea (۱۶.۳%; n = ۴۹), wound (۱۱%; n = ۳۳), blood (۷.۳%; n = ۲۲), sputum (۷%; n = ۲۱), discharge (۳%; n = ۹), BAL (۲%; n = ۶), eye infection (۱.۳%; n = ۴), pleural fluid (۰.۳%; n = ۱), and ascites (۰.۳%; n = ۱). The disk diffusion results showed that ۱۹۷ (۶۵.۷%) of the isolates were resistant to piperacillin, ۱۸۱ (۶۰.۳%) to sulfamethoxazole-trimethoprim, ۱۶۴ (۵۴.۷%) to ceftazidime, ۱۵۸ (۵۲.۷%) to cefepime, ۱۵۰ (۵۰%) to ampicillin-sulbactam, ۱۴۸ (۴۹.۳%) to aztreonam, ۱۳۳ (۴۴.۳%) to ciprofloxacin, ۱۰۶ (۳۵.۳%) to piperacillin-tazobactam, ۱۰۴ (۳۴.۷%) to gentamicin, ۸۹ (۲۹.۷%) to tetracycline and ۸۱ (۲۷%) to meropenem. The blaSHV gene was the most prevalent gene ۲۵۸ (۸۶%). The other genes including blaCTX-M and blaTEM genes were detected in ۱۲۹ (۴۳%) and ۸۱ (۲۷%) isolates, respectively.Conclusion : These results showed a high prevalence of genes encoding ESBL and antibiotic resistance in the K. pneumoniae isolates.

Keywords:

Klebsiella pneumoniae , Antibiotic resistance , beta-Lactamases