Prevalence and Antimicrobial Susceptibility of Extended-Spectrum Beta-Lactamase-Producing Bacteria in Intensive Care Units of Sanandaj General Hospitals (Kurdistan, Iran)

Ramazanzadeh, Rashid; Chitsaz, Mohsen; Bahmani, Nasrin

doi:10.1159/000224656

Cited by 27 publications

(24 citation statements)

References 51 publications

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“…DISCUSSION β-lactamase-producing K. pneumoniae was first identified in 1983 21 . Most infections caused by K. pneumoniae are due to multi-drug resistant strains such as β-lactamase producing isolates 22 . Recent studies have shown that the incidence of β-lactamase-producing K. pneumoniae is increasing in several countries such as Iran 22,23 , India 24,25 , and Italy…”

Section: Resultsmentioning

confidence: 99%

Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction

Sedighi

Halajzadeh

Ramazanzadeh

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction:Infections caused by β-lactamase-producing gram-negative bacteria, such as Klebsiella pneumoniae, are increasing globally with high morbidity and mortality. The aim of the current study was to determine antimicrobial susceptibility patterns and the prevalence of antibiotic resistance genes (β-lactamase and integron genes) using multiplex PCR. Methods: One-hundred K. pneumoniae isolates were collected from different clinical samples. Antibiotic susceptibility testing was performed with thirteen different antibiotics. Multiplex-PCR was used to detect β-lactamase (bla TEM , bla CTX-M, bla SHV, bla VEB , bla PER , bla GES , bla VIM, bla IMP, bla OXA , and bla KPC ) and integron genes (int I, int II, and int III). Results: The highest and lowest rate of resistance was exhibited against amikacin (93%) and imipenem (8%), respectively. The frequency of β-lactamase-positive K. pneumoniae was 37%, and the prevalence of the bla TEM , bla CTX-M, bla SHV, bla VEB , bla PER , bla GES , bla VIM, bla IMP, bla OXA , and bla KPC genes was 38%, 24%, 19%, 12%, 6%, 11%, 33%, 0%, 28%, and 23%, respectively. Of the 100 isolates, eight (8%) were positive for class I integrons; however, class II and III integrons were not detected in any of the strains. Conclusions: These results indicate co-carriage of a number of β-lactamase genes and antibiotic resistance integrons on the same plasmids harboring multi-drug resistance genes. It seems that these properties help to decrease treatment complications due to resistant bacterial infections by rapid detection, infection-control programs and prevention of transmission of drug resistance.

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Section: Resultsmentioning

confidence: 99%

Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction

Sedighi

Halajzadeh

Ramazanzadeh

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…Mechanisms of resistance to cefepime include the production of extended-spectrum β-lactamases and metalloenzymes, which hydrolyze cefepime [14,15,16]. These enzymes can spread within the community and in hospitals [17,18,19,20]. Therefore, cefepime-resistant pathogens are a major threat to infection treatment and control programs.…”

Section: Discussionmentioning

confidence: 99%

Cefepime Resistance and Associated Risk Factors among <i>Escherichia coli </i>Strains Isolated from Clinical Specimens

Mansouri

Ramazanzadeh²,

Norabadi³

2011

Chemotherapy

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Cefepime is active against bacteria producing chromosomally and plasmid-mediated extended broad-spectrum β-lactamase enzymes. The aim of this study was to evaluate risk factors for acquisition of cefepime resistance in Escherichia coli strains among hospitalized patients in a university hospital in Sanandaj, Iran. The study was a case-control investigation. A case patient was defined as a patient who had one isolate of a cefepime-resistant E. coli strain. A control patient was defined as a patient who had one isolate of a cefepime-sensitive E. coli strain. Cefepime resistance was determined by HiComb MIC tests (HIMEDIA, India). Out of the 255 total isolates, 73 (28.6%) were resistant to cefepime. The previous treatment of cefepime was a risk factor for acquisition of a cefepime-resistant isolate (OR = 6.32, 95% CI: 1.5–25.19, p < 0.007). The use of a ventilator was considered to be a risk for acquisition of a cefepime-resistant isolate (OR = 6.25, 95% CI: 1.86–21.02, p <0.002). The use of a catheter was also found to be a risk factor for acquisition of cefepime resistance (OR = 6.28, 95% CI: 1.86–21.02, p <0.001). There was a significant correlation between days of stay in hospital wards and cefepime resistance (p < 0.003). The main risk factors associated with cefepime resistance were previous treatment with cefepime, use of ventilator, use of catheter and days of stay in ward. More studies are needed to evaluate the role of these factors in order to control the spread of drug resistance.

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“…Over the past 10 years, there has been an increasing incidence of serious infections with antimicrobial-resistant Gram-negative bacilli [1][2][3][4][5] . These infections are becoming an important health-care issue, especially in intensive care units (ICUs) and hospitalized inpatients.…”

Section: Introductionmentioning

confidence: 99%

“…These infections are becoming an important health-care issue, especially in intensive care units (ICUs) and hospitalized inpatients. The most common organisms isolated are multidrugresistant (MDR) Pseudomonas aeruginosa, extendedspectrum beta-lactamase (ESBL)-producing and carbapenemase-producing Enterobacteriaceae and carbapenem-resistant Acinetobacter baumanii [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Emerging Resistant Gram-Negative Aerobic Bacilli in Hospital-Acquired Infections

2010

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The increasing emergence of serious multidrug-resistant (MDR) Gram-negative infections has led to a new health-care crisis. These infections predominately include MDR Pseudomonas aeruginosa, extended-spectrum beta-lactamase-producing Enterobacteriaceae and MDR Acinetobacter baumannii. These organisms are present in a variety of clinical settings, but there is a distinct paucity of antibiotics to effectively treat these infections. The increasing use of broad-spectrum antibiotics and lack of good stewardship have contributed to the increase in these MDR organisms. This review focuses on the main MDR Gram-negative infections contributing to the current crisis in health care, their mechanisms of resistance and various treatment options for empiric therapy.

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Prevalence and Antimicrobial Susceptibility of Extended-Spectrum Beta-Lactamase-Producing Bacteria in Intensive Care Units of Sanandaj General Hospitals (Kurdistan, Iran)

Cited by 27 publications

References 51 publications

Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction

Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction

Cefepime Resistance and Associated Risk Factors among <i>Escherichia coli </i>Strains Isolated from Clinical Specimens

Emerging Resistant Gram-Negative Aerobic Bacilli in Hospital-Acquired Infections

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