Identification of extended-spectrum-beta-lactamases(ESBLs), metallo-beta-lactamases (MBLs), Amp-C and KPC -lactamases among Klebsiella pneumoniae isolated from adults and pediatric patients in Iran

Abstract

Klebsiella pneumoniae is one of the major bacteria that cause acute infections. β-lactamases are main defensive mechanisms in bacteria against drugs. The aim of this study was to determine antibiotic resistance patterns and detection of extended-spectrum-beta-lactamase (ESBL), MBL, Amp-C and KPC β-lactamases among K. pneumoniae strains isolated from adults and infants. This descriptive study was done on 83 K. pneumoniae isolated from two hospitals. Antibiotic susceptibility tests were performed by Kirby-Bauer disc diffusion and broth microdilution methods according to Clinical Laboratory Standards Institute (CLSI) guidelines. ESBLs, MBL, Amp-C and KPC producing strains were detected by phenotypic confirmatory test, combination disk diffusion test (CDDT), Amp-C detection kit and Modified Hodge test, respectively. From 83 K. pneumoniae strains, 48 (57.5%), 3 (3.5%), 23 (28%) and 5 (6%) were ESBL, MBL, Amp-C and KPC positive, respectively. In this study, Fosfomycin and Tigecycline were more active than other antibiotics. The results demonstrated that incidence of ESBLs, Amp-C, MBLs and KPC was critical especially in infants. Therefore, detection of drug resistance patterns in K. pneumoniae and β-lactamases producing isolates is important for the prevention and control of these infections.

Phenotypic and genotypic detection of metallo-β-lactamases in A. baumanii isolates obtained from clinical samples in Shahrekord, southwest Iran

“…Decreased permeability of the outer membrane and increased efflux pump are the other mechanisms of carbapenem resistance [8, 9]. There are a number of MBLs genes such as imipenemase (IMP), Verona integron-encoded metallo-beta-lactamases (VIM), Sno Paolo metallo (SPM), New-Delhi metallo-β-lactamase (NDM), German imipenemase (GIM), Kyorin University Hospital imipenemase (KHM), and Australian imipenemase (AIM) [10, 11]. IMP, VIM and SPM are the most important genes of MBLs that have been detected in A .…”

Low Prevalence of Carbapenem-Resistant Klebsiella pneumoniae in Zabol, Southeast of Iran

“…Different antibiotics such as aminoglycosides and betalactamases are commonly used to treat the infection caused by K. pneumoniae while the prevalence of antibiotic resistance has rapidly increased in recent years threatening global public health, especially in developing countries. 12,13 In fact, treating drug-resistant infections has become more challenging owing to the evolution of several antibiotic-resistance mechanisms resulted from widespread use and misuse of antibiotics. 12,13 In addition, based on the results of the present study, the isolates were mainly found to be susceptible to ertapenem, imipenem, meropenem, gentamicin, and amikacin.…”

“…12,13 In fact, treating drug-resistant infections has become more challenging owing to the evolution of several antibiotic-resistance mechanisms resulted from widespread use and misuse of antibiotics. 12,13 In addition, based on the results of the present study, the isolates were mainly found to be susceptible to ertapenem, imipenem, meropenem, gentamicin, and amikacin. Overall, 3 isolates were imipenem-resistant.…”

“…For instance, Fallah et al, in their study which was conducted in Tehran, reported that 59%, 36%, and 55.5% of the investigated K. pneumoniae isolates were resistant against ceftriaxone, cefepime, and ciprofloxacin, respectively. 13 In addition, the findings of a comprehensive meta-analysis showed that the resistance rate of K. pneumoniae against different antibiotics in different provinces of Iran was at an alarming level. 14 For example, based on a report, resistance to amikacin ranged from 6.1% in Qom province to 47% in Isfahan province.…”