Endemic dissemination of different sequence types of carbapenem-resistant <em>Klebsiella pneumoniae</em> strains harboring <em>bla</em>_NDM and <em>16S</em> <em>rRNA methylase</em> genes in Kerman hospitals, Iran, from 2015 to 2017

Abstract

IntroductionThe emergence and spread of Klebsiella pneumoniae strains resistant to multiple antimicrobial agents are considered as a serious challenge for nosocomial infections.Materials and methodsIn this study, 175 nonrepetitive clinical isolates of K. pneumoniae were collected from hospitalized patients in Kerman, Iran. Extended-spectrum β-lactamases (ESBLs), AmpC, and carbapenemase-producing isolates were recognized by phenotypic methods. The resistance genes including efflux pumps oqxA/oqxB, 16S rRNA methylase, ESBL, AmpC, and carbapenemase were detected by PCR-sequencing method. Molecular typing was performed by enterobacterial repetitive intergenic consensus-PCR and multilocus sequence typing methods among blaNDM-positive isolates.ResultsThirty-seven (21.14%) isolates along with sequence types (STs): ST43, ST268, ST340, ST392, ST147, and ST16 were harbored blaNDM. ST43 in 2015 and ST268 during 2016–2017 were the most frequent STs among New Delhi metallo-beta-lactamase (NDM)-positive isolates. We found the distribution of some isolates with blaNDM, blaCTX-M, blaSHV, blaOXA, blaTEM, blaCMY, rmtC, and oqxA/oqxB. Enterobacterial repetitive intergenic consensus-PCR represented seven clusters (A–G) plus four singletons among NDM-positive isolates. This study provides the first report of blaNDM-1-positve K. pneumoniae along with ST268 as well as the spread of nosocomial infections with six different STs harboring blaNDM-1 and other resistance genes in hospital settings especially neonatal intensive care unit.ConclusionThe dissemination of various clones of NDM-producing K. pneumoniae can contribute to increase the rate of their spread in health care settings. Therefore, molecular typing and detection of resistance genes have an important role in preventing and controlling infection by limiting the dissemination of multidrug-resistant isolates.

The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring blaNDM/OXA-48 carbapenemases in a tertiary care center of Iran

“…In the current study, ST392 has detected among NDM positive isolates with different ERIC patterns. Another detected ST, ST147 which is an international clone, has been reported from center, south and south east of Iran [6][7][8]. In our study, ST147 has been associated with CTX-M-G1, bla SHV-, aac6Ib-cr and armA.…”

“…Iran, as one of the Middle East countries, neighbor countries where the NDM and OXA-48 producing bacteria are endemic [6]. While bla NDM producing K. pneumoniae isolates have been reported from different cities of Iran in recent years, sequence types of these isolates are determined and published from three cities located in the center, south, and south-east of this country [6][7][8]. In our previous study, we reported a relatively high prevalence of bla OXA-48 /bla NDM-1 producing Enterobacteriaceae isolates collected from the large tertiary hospital of Semnan [9], an important city along the historical Silk Road.…”

Virulence Factors, Capsular Serotypes and Antimicrobial Resistance of Hypervirulent Klebsiella pneumoniae and Classical Klebsiella pneumoniae in Southeast Iran

“…Similarly, a high rate of imipenem resistance in K. pneumoniae was reported from Iran [29,30]. Our previous studies demonstrated that New Delhi Metallo-beta lactamase (NDM) is responsible for carbapenem resistance in K. pneumoniae in Kerman, Iran [31,32]. Although the prevalence of imipenem-resistant hvKP strains in our study was low, the enhanced virulence of these strains and the possibility of acquiring antimicrobial resistance are a cause for concern.…”

Clinical and microbiological characteristics of nosocomial, healthcare-associated, and community-acquired Klebsiella pneumoniae infections in Guangzhou, China

“…Polymerase chain reaction (PCR) was performed to detect carbapenemase genes (bla KPC , bla NDM , bla GIM , bla SPM , bla IMP , bla SIM , bla VIM , bla IMI and bla OXA-48-like ) in the CRKP strains and ESBLs genes (bla TEM , bla SHV , bla CTX-M-group , bla OXA-1-like , bla CTX-M-1-group, bla CTX-M-2group , bla CTX-M-9-group ) in the ESBL-producing strains [17,[19][20][21][22]. The commercial kits Green Taq Mix (Vazyme, Nanjing, China) and specific primers were used to detect resistance genes.…”