The relationship between class I and II integrons and antibiotic resistance in Klebsiella pneumoniae clinical strains isolated from patients in Isfahan hospitals

Integrons are recognized for their capacity to transfer antibiotic resistance genes between pathogenic bacteria including K. pneumoniae. The objective of this study was to assess the correlation between class I and II integrons and the antimicrobial resistance among clinical strains of K. pneumoniae, in patients in Isfahan. A total of ۹۶ strains of K. pneumoniae were procured from ۲۰۰ clinical specimens. The identification of the isolates was carried out through biochemical analyses and tracing the ۱۶S-۲۳S ITS sequence. The antibiotic sensitivity pattern was assessed by disk diffusion. Detection of the genes encoding class I and II integrons in resistant clinical isolates was done by PCR. From ۹۶ K. pneumoniae isolates, ۸۱ isolates (۸۴.۴%), exhibited resistance to multiple antibiotics. The isolates exhibited the maximum level of resistance towards meropenem, which was evident in ۷۳ of the isolates, followed closely by amikacin in ۶۷ isolates. Conversely, gentamicin displayed the least level of resistance (in ۱۲ isolates). Men from the emergency and intensive care units exhibited a higher frequency of isolates and associated drug-resistant strains. Elderly individuals exhibited a notably elevated frequency of the isolates and resistant variants. A significant proportion of resistant strains were found to possess both class I and II integrons (۸۲.۷۲% and ۸۶.۴۲%, respectively). Moreover, a relatively high percentage of resistant strains (۷۰.۳۷%) were found to harbor both classes of integrons. The results indicated a notable incidence of integron-dependent resistance, thereby emphasizing the need for an informed approach towards diagnosis and management of such infections.

Keywords:

Klebsiella pneumoniae , Multi-drug resistance , class I and II integrons , Meropenem , ۱۶S-۲۳S ITS sequence