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IEM 2018, 4(1): 13-17 |
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Gheitani L, Fazeli H, Moghim S, Nasr Isfahani B. Prevalence of Carbapenemase and blaKPC gene in Klebsiella pneumoniae Strains Isolated from Isfahan Hospitals, Iran. IEM 2018; 4 (1) :13-17
URL: http://iem.modares.ac.ir/article-4-14172-en.html
URL: http://iem.modares.ac.ir/article-4-14172-en.html
1- Microbiology Department, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran
2- Microbiology Department, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran ,h_fazeli@med.mui.ac.ir
2- Microbiology Department, Medicine School, Isfahan University of Medical Sciences, Isfahan, Iran ,
Abstract: (5867 Views)
Aims: Klebsiella pneumoniae is a Gram-negative opportunistic pathogen. The carbapenems are effective therapeutic choice for the treatment of Klebsiella pneumonia infections. Carbapenemases are a group of enzymes capable of hydrolyzing carbapenems. This study was to introduce phenotypic and genotypic methods to identify the carbapenemase-producing isolates of Klebsiella pneumoniae.
Materials & Methods: this study was to introduce phenotypic and genotypic methods to identify the carbapenemase-producing isolates of Klebsiella pneumoniae. The Modified Hodge Test (MHT) was performed to determine the susceptibility of isolates to antibiotics. The final products of PCR were electrophoresed on agarose gel.
Findings: The highest rate of resistance were observed for piperacillin (84%) and the lowest for ertapenem (50%). The majority of MHT positive isolates was from urine (64.7%), while abdominal and cerebrospinal fluids (0%) were the lowest. In addition, the ICU wards with 47 (69.1%) and the emergency units with 4 (5.9%) samples, had the most and the least frequent cases, respectively. MHT was positive in 68 K. pneumoniae isolates, but none of them were positive for blaKPC gene.
Conclusion: The blaKPC gene has low prevalence in the Isfahan City, Iran.
Materials & Methods: this study was to introduce phenotypic and genotypic methods to identify the carbapenemase-producing isolates of Klebsiella pneumoniae. The Modified Hodge Test (MHT) was performed to determine the susceptibility of isolates to antibiotics. The final products of PCR were electrophoresed on agarose gel.
Findings: The highest rate of resistance were observed for piperacillin (84%) and the lowest for ertapenem (50%). The majority of MHT positive isolates was from urine (64.7%), while abdominal and cerebrospinal fluids (0%) were the lowest. In addition, the ICU wards with 47 (69.1%) and the emergency units with 4 (5.9%) samples, had the most and the least frequent cases, respectively. MHT was positive in 68 K. pneumoniae isolates, but none of them were positive for blaKPC gene.
Conclusion: The blaKPC gene has low prevalence in the Isfahan City, Iran.
Subject:
Bacteriology
Received: 2017/12/19 | Accepted: 2018/05/27 | Published: 2018/05/27
Received: 2017/12/19 | Accepted: 2018/05/27 | Published: 2018/05/27
References
1. Podschun R, Ullmann U. Klebsiella spp. As nosocomial pathogens: Epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev. 1998;11(4):589-603. [Link]
2. Perilli M, Bottoni C, Grimaldi A, Segatore B, Celenza G, Mariani M, et al. Carbapenem-resistant Klebsiella pneumoniae harbouring blaKPC-3 and blaVIM-2 from central Italy. Diagn Microbiol Infect Dis. 2013;75(2):218-21. [Link]
3. Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, et al. Novel carbapenem-hydrolyzing β-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother. 2001;45(4):1151-61. [Link]
4. Schwaber MJ, Klarfeld-Lidji Sh, Navon-Venezia Sh, Schwartz D, Leavitt A, Carmeli Y. Predictors of carbapenem-resistant Klebsiella pneumoniae acquisition among hospitalized adults and effect of acquisition on mortality. Antimicrob Agents Chemother. 2008;52(3):1028-33. [Link] [DOI:10.1128/AAC.01020-07]
5. Dehghan Banadkouki A, Eslami G, Zandi H, Dehghan Banadkouki A. Prevalence of qnr genes in extended-spectrum β-Lactamase producing Klebsiella pneumoniae isolated from clinical urine specimens in university teaching hospitals, Iran. Int J Med Lab. 2017;4(1):25-33. [Link]
6. Marchaim D, Navon-Venezia S, Schwaber MJ, Carmeli Y. Isolation of imipenem-resistant enterobacter species: Emergence of KPC-2 carbapenemase, molecular characterization, epidemiology, and outcomes. Antimicrob Agents Chemother. 2008;52(4):1413-8. [Link] [DOI:10.1128/AAC.01103-07]
7. Tsakris A, Poulou A, Themeli-Digalaki K, Voulgari E, Pittaras T, Sofianou D, et al. Use of boronic acid disk tests to detect extended-spectrum β-lactamases in clinical isolates of KPC carbapenemase-possessing Enterobacteriaceae. J Clin Microbiol. 2009;47(11):3420-6. [Link]
8. Poirel L, Héritier C, Spicq C, Nordmann P. In vivo acquisition of high-level resistance to imipenem in Escherichia coli. J Clin Microbiol. 2004;42(8):3831-3. [Link] [DOI:10.1128/JCM.42.8.3831-3833.2004]
9. Bialvaei AZ, Kafil HS, Asgharzadeh M, Yousef Memar M, Yousefi M. Current methods for the identification of carbapenemases. J Chemother. 2016;28(1):1-19. [Link]
10. Queenan AM, Bush K. Carbapenemases: The versatile β-lactamases. Clin Microbiol Rev. 2007;20(3):440-58. [Link]
11. Walsh TR. Emerging carbapenemases: A global perspective. Int J Antimicrob Agents. 2010;36 (Suppl 3):S8-14. [Link]
12. Meletis G, Tzampaz E, Protonotariou E, Sofianou D. Emergence of Klebsiella pneumoniae carrying blaVIM and blaKPC genes. Hippokratia. 2010;14(2):139-40. [Link]
13. Bradford PA, Bratu S, Urban C, Visalli M, Mariano N, Landman D, et al. Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 beta-lactamases in New York City. Clin Infect Dis. 2004;39(1):55-60. [Link]
14. Tzouvelekis LS, Markogiannakis A, Psichogiou M, Tassios PT, Daikos GL. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: An evolving crisis of global dimensions. Clin Microbiol Rev. 2012;25(4):682-707. [Link] [DOI:10.1128/CMR.05035-11]
15. Haji Hashemi B, Farzanehkhah M, Dolatyar A, Imani M, Farzami M, Rahbar M, et al. A study on prevalence of KPC producing from Klebsiella pneumoniae using Modified Hodge Test and CHROMagar in Iran. Ann Biol Res. 2012;3(12):5659-64. [Link]
16. Reller LB, Weinstein M, Jorgensen JH, Ferraro MJ. Antimicrobial susceptibility testing: A review of general principles and contemporary practices. Clin Infect Dis. 2009;49(11):1749-55. [Link] [DOI:10.1086/647952]
17. Ørstavik I, Ødegaard K. A simple test for penicillinase production in Staphylococcus aureus. Acta Pathol Microbiol Scand B Microbiol Immunol. 1971;79(6):855-6. [Link]
18. Mirnejhad R, Hashemizadeh F, Zamanzad B, Jahandideh S, Ansari N, Gholipour A. Identification of KPC-producing Klebsiella pneumoniae in clinical samples in Iran. Yafte J Med Sci. 2013;15(1):105-14. [Persian] [Link]
19. Chen S, Hu F, Xu X, Liu Y, Wu W, Zhu D, et al. High prevalence of KPC-2-type carbapenemase coupled with CTX-M-type extended-spectrum β-lactamases in carbapenem-resistant Klebsiella pneumoniae in a teaching hospital in China. Antimicrob Agents Chemother. 2011;55(5):2493-4. [Link]
20. Cury AP, Andreazzi D, Maffucci M, Caiaffa-Junior HH, Rossi F. The modified Hodge test is a useful tool for ruling out Klebsiella pneumoniae carbapenemase. Clinics (Sao Paulo). 2012;67(12):1427-31. [Link] [DOI:10.6061/clinics/2012(12)13]
21. Agha-Seyed Hosseini M, Firoozeh F, Piroozmand A, Gilasi HR. Carbapenemase-producing Klebsiella pneumoniae strains among clinical specimens in Kashan (2014-2015). J Kashan Univ Med Sci (FEYZ). 2016;20(3):267-73. [Persian] [Link]
22. Bina M, Pournajaf A, Mirkalantari Sh, Talebi M, Irajian Gh. Detection of the Klebsiella pneumoniae carbapenemase (KPC) in K. pneumoniae isolated from the clinical samples by the phenotypic and genotypic methods. Iran J Pathol. 2015;10(3):199-205. [Link]
23. Roudbari F, Ghazvini K, Heydari fork S, Kouhi Noghondar M, Amel Jamedar S, Youssefi M. Frequency of Klebsiella Pneumoniae producing Carbapenemase KPC in clinical specimens of Mashhad during 2014. Med J Mashhad Univ Med Sci. 2015;58(6):322-9. [Link]
24. Anderson K, Lonsway DR, Rasheed JK, Biddle J, Jensen B, McDougal LK, et al. Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobacteriaceae. J Clin Microbiol. 2007;45(8):2723-5. [Link]
25. Flonta M, Lupse M, Craciunas C, Almas A, Carstina D. Ertapenem resistance among extended-spectrum-β-lactamase producing Klebsiella pneumoniae isolates. Ther Pharmacol Clin Toxicol. 2011;15(2):121-5. [Link]
26. Nagaraj S, Chandran S, Shamanna P, Macaden R. Carbapenem resistance among Escherichia coli and Klebsiella pneumoniae in a tertiary care hospital in south India. Indian J Med Microbiol. 2012;30(1):93-5. [Link] [DOI:10.4103/0255-0857.93054]
27. Shibl A, Al-Agamy M, Memish Z, Senok A, Khader SA, Assiri A. The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis. 2013;17(12):e1130-3. [Link] [DOI:10.1016/j.ijid.2013.06.016]
28. uz Zaman T, Aldrees M, Al Johani SM, Alrodayyan M, Aldughashem FA, Balkhy HH. Multi-drug carbapenem-resistant Klebsiella pneumoniae infection carrying the OXA-48 gene and showing variations in outer membrane protein 36 causing an outbreak in a tertiary care hospital in Riyadh, Saudi Arabia. Int J Infect Dis. 2014;28:186-92. [Link]
29. Azimi L, Rastegar-Lari A, Talebi M, Ebrahimzadeh-Namvar A, Soleymanzadeh-Moghadam S. Evaluation of phenotypic methods for detection of Klebsiella Pneumoniae Carbapenemase-producing K. Pneumoniae in Tehran. J Med Bacteriol. 2015;2(3-4):26-31. [Link]
30. Eftekhar F, Naseh Z. Extended-spectrum β-lactamase and Carbapenemase production among burn and non-burn clinical isolates of Klebsiella Pneumoniae. Iran J Microbiol. 2015;7(3):144-9. [Link]
31. Zare A, Akya A, Nejat P. The frequency of blaVIM, blaIMP, blaKPC and blaNDM Carbapenemase genes in clinical isolates of Klebsiella Pneumoniae in Kermanshah medical centers. Shahid Sadoughi Univ Med Sci. 2015;23(8):760-9. [Persian] [Link]
32. Krishnappa LG, Marie MAM, Al Sheikh YA. Characterization of Carbapenem resistance mechanisms in Klebsiella Pneumoniae and in vitro synergy of the Colistin-Meropenem combination. J Chemother. 2015;27(5):277-82. [Link] [DOI:10.1179/1973947814Y.0000000197]
33. Shanmugam P, Meenakshisundaram J, JayaraMan P. blaKPC gene detection in clinical isolates of Carbapenem resistant Enterobacteriaceae in a tertiary care hospital. J Clin Diagn Res. 2013;7(12):2736-8. [Link]
34. Deshpande LM, Rhomberg PR, Sader HS, Jones RN. Emergence of serine Carbapenemases (KPC and SME) among clinical strains of Enterobacteriaceae isolated in the United States medical centers: Report from the MYSTIC Program (1999–2005). Diagn Microbiol Infect Dis. 2006;56(4):367-72. [Link] [DOI:10.1016/j.diagmicrobio.2006.07.004]
35. Shokri D, Mobasherizadeh S, Norouzi Baruq M, Yaran M. Isolation and identification of Carbapenemase KPC producing strains of Enterobacteriaceae and determination of their antibiotic susceptibility patterns. J Isfahan Med Sch. 2013;31(248):1247-56. [Persian] [Link]
36. Bratu S, Tolaney P, Karumudi U, Quale J, Mooty M, Nichani S, et al. Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: Molecular epidemiology and in vitro activity of polymyxin B and other agents. J Antimicrob Chemother. 2005;56(1):128-32. [Link]
37. Castanheira M, Sader HS, Deshpande LM, Fritsche TR, Jones RN. Antimicrobial activities of tigecycline and other broad-spectrum antimicrobials tested against serine carbapenemase- and metallo-beta-lactamase-producing enterobacteriaceae: Report from the SENTRY antimicrobial surveillance program. Antimicrob Agents Chemother. 2008;52(2):570-3. [Link]
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