Prevalence of carbapenemases and ESBL encoding genes among K. pneumoniae isolates obtained from an educational hospital in Ahvaz, Southwestern Iran

Sheikh, Ahmad Farajzadeh; Khoshnood, Saeed; Saki, Morteza; Shahi, Fatemeh; Seyed-Mohammadi, Sakine; Abdi, Mahtab; Moradi, Mostafa

doi:10.1016/j.genrep.2021.101128

Cited by 6 publications

(7 citation statements)

References 41 publications

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“…In a study conducted in Egypt, 50% of isolates were positive for bla TEM gene, which was consistent with our study results (36). On the other hand, the prevalence of bla NDM , bla IMP , bla OXA , and bla KPC carbapenemase genes were 75%, 50%, 8.3% and 8.3%, respectively, which is different from that reported by Farajzadeh Sheikh et al where bla NDM , bla OXA , and bla KPC were 1.7%, 64% and 10%, respectively (14). The report by David et al concerning the bla KPC (44.5%) and bla IMP (7.1%) genes were also different from our reports; similar to our study, however, they found no bla VIM gene in any carbapenemase producing isolates (12).…”

Section: Discussioncontrasting

confidence: 82%

“…Out of these 14 isolates, 66% were positive for metallobatalactamase production. Similarly, Farajzadeh Sheikh et al reported that 71% of isolates produced carbapenemase (14). In studies done by Ghotuslou et al and Islam et al, 15.8% and 17% metallobatalactamase producer isolates were reported to show a very low prevalence in comparison to our results (32,33).…”

Section: Discussioncontrasting

confidence: 50%

“…In our study, the prevalence of MDR isolates was 66.4%. Similarly, Fajrzadeh Sheikh et al and Pajand et al classified 61.5% of isolates as MDR (14,27). These findings sug-gested that there was a high prevalence of MDR isolates.…”

Section: Discussionmentioning

confidence: 87%

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Detection of Extended-spectrum Beta-lactamases (ESBLs), Carbapenemase, Metallo-β-lactamase Production Bacteria and Antibiotic Susceptibility Pattern in Hospitalized Patients with Ventilator-associated Pneumonia

Zaniani

Moazen

An'aam

2022

Jundishapur J Microbiol

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Background: Due to the increase in microbial resistance, nosocomial multidrug resistance infections, including ventilator-associated pneumonia (VAP), are presently one of the main causes of death in hospitals since they are difficult to treat. Objectives: This study aimed to investigate the bacterial etiology of VAP and their microbial resistance pattern in Dezful Hospital, southwest of Iran. Methods: In this cross-sectional study, 131 bacterial isolates were isolated from the respiratory secretions of the patients with VAP in ICU wards. Antibiotic susceptibility testing (AST) of all isolates was carried out after the identification. Then the extended-spectrum beta-lactamases (ESBLs), carbapenemase, and metallobetalactamase were identified by phenotyping and genotyping. Results: The most frequent isolates were Staphylococcus aureus (30.5%), Acinetobacter baumannii (25.2%), and Klebsiella pneumoniae (24.4%). All strains of S. aureus were sensitive to vancomycin, ticoplanin, quinupristin-dalfopristin, and linezolid. Escherichia coli and Klebsiella showed high resistance to cephalosporins. More than 93% of Acinetobacter isolates were resistant to carbapenem and quinolones. The overall prevalence of ESBLs and carbapenemase producing bacteria were 80.43% and 73.6%, respectively. The most frequent ESBLs gene was blaCTX-M gene (78.3%) followed by blaAMP-C gene (67.5%), blaSHV gene (64.8%), and blaTEM gene (54%). Conclusions: In sum, there was a possibility that the treatment of nosocomial multidrug resistant infections such as VAP would become a major challenge. Therefore, it was recommended that AST results should always be considered when selecting the appropriate treatment regimen. Furthermore, it was found important to emphasize the principles of antibiotic stewardship and to constantly monitor the pattern of microbial susceptibility.

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Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 50%

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Detection of Extended-spectrum Beta-lactamases (ESBLs), Carbapenemase, Metallo-β-lactamase Production Bacteria and Antibiotic Susceptibility Pattern in Hospitalized Patients with Ventilator-associated Pneumonia

Zaniani

Moazen

An'aam

2022

Jundishapur J Microbiol

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“…Klebsiella pneumoniae is an important nosocomial pathogen causing wide range of clinical infections in hospitalized and immune-compromised patients. Currently, the bacterium is acquiring/developing multi-resistance determining genes like bla NDM and becoming worldwide threats 17 as it was reported elsewhere in Netherland, 61 Thailand, 62 Pakistan 52 and Turkey 58 Klebsiella pneumoniae was the predominant Enterobacteriaceae producing bla NDM.…”

Section: Discussionmentioning

confidence: 74%

Prevalence and Molecular Characterization of Extended Spectrum β-Lactamase and Carbapenemase-Producing Enterobacteriaceae Isolates from Bloodstream Infection Suspected Patients in Addis Ababa, Ethiopia

Seman¹,

Mihret²,

Sebre³

et al. 2022

IDR

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Background Production of Extended spectrum beta-lactamase (ESBL) and Carbapenemase is the most common strategy for drug resistance in clinical isolates of Enterobacteriaceae . This study was conducted to determine the magnitude of ESBL and Carbapenemase production (CPE) among clinical isolates of Enterobacteriaceae causing bloodstream infections (BSI) in Ethiopia. Methods A cross-sectional study was performed from September 2018 to January 2019 in Ethiopia. A total of 2397 BSI suspected patients were enrolled and blood culture was performed using a BacT/Alert instrument in combination with conventional methods for identification. After antimicrobial susceptibility test, phenotypic confirmation of ESBLs was done by combined disc-diffusion. Meanwhile carbapenemase production was done by modified carbapenem inactivation method. Multiplex PCR was conducted to detect the presence of bla CTX-M , bla SHV, bla TEM , bla KPC and bla NDM genes. Results A total of 104 (4.3%) Enterobacteriaceae were isolated from 2397 BSI suspected patients. Klebsiella pneumoniae (55/104, 52%) was the predominant isolate followed by E. coli , (19.2%, 20/104) and K.oxytoca (17.3%, 18/104). ESBL and carbapenemase production were observed from 70 (67.3%, 57.4 −76.2% at 95% CI) and 8 (7.7%, 3.4–14.6% at 95% CI) isolates respectively. The highest frequency of ESBL and carbapenemase production was observed in K. pneumoniae 78.2% (43/55) and 9.1% (5/55), respectively. All the 70 isolates confirmed as ESBL producers harbored at least one of the ESBL genes and the majority of them carried multiple beta-lactamase genes (84.3%), where bla CTX-M, type was the most predominant (67.3%). Similarly, the entire eight isolates positive for carbapenemase carried bla NDM but none of them carried bla KPC. Conclusion In our study, the rate of ESBL production among BSI-causing Enterobacteriaceae was alarming and most of the isolates carried multiple types of ESBL genes. A significant magnitude of CPE isolates causing BSI was recorded.

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“…Alternately, the results suggest that cephamycins may be an alternative to carbapenems for the treatment of K. pneumoniae infections. Although cephamycins are very similar to cephalosporins and often included in the 2nd generation classification, they are resistant to degradation by ESBL enzymes, and it seems, to a certain extent, to CPN enzymes (especially CTT) [ 38 ]. However, they are reported not to be effective against AmpC cephalosporinases and porin mutations, and as noted, most cephamycin-resistant isolates in this work revealed AmpC genes [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal

Oliveira

Castro²,

Silva³

et al. 2022

Antibiotics

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While antibiotic resistance is rising to dangerously high levels, resistance mechanisms are spreading globally among diverse bacterial species. The emergence of antibiotic-resistant Klebsiella pneumoniae, mainly due to the production of antibiotic-inactivating enzymes, is currently responsible for most treatment failures, threatening the effectiveness of classes of antibiotics used for decades. This study assessed the presence of genetic determinants of β-lactam resistance in 102 multi-drug resistant (MDR) K. pneumoniae isolates from patients admitted to two central hospitals in northern Portugal from 2010 to 2020. Antimicrobial susceptibility testing revealed a high rate (>90%) of resistance to most β-lactam antibiotics, except for carbapenems and cephamycins, which showed antimicrobial susceptibility rates in the range of 23.5–34.3% and 40.2–68.6%, respectively. A diverse pool of β-lactam resistance genetic determinants, including carbapenemases- (i.e., blaKPC-like and blaOXA-48-like), extended-spectrum β-lactamases (ESBL; i.e., blaTEM-like, blaCTX-M-like and blaSHV-like), and AmpC β-lactamases-coding genes (i.e., blaCMY-2-like and blaDHA-like) were found in most K. pneumoniae isolates. blaKPC-like (72.5%) and ESBL genes (37.3–74.5%) were the most detected, with approximately 80% of K. pneumoniae isolates presenting two or more resistance genes. As the optimal treatment of β-lactamase-producing K. pneumoniae infections remains problematic, the high co-occurrence of multiple β-lactam resistance genes must be seen as a serious warning of the problem of antimicrobial resistance.

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Prevalence of carbapenemases and ESBL encoding genes among K. pneumoniae isolates obtained from an educational hospital in Ahvaz, Southwestern Iran

Cited by 6 publications

References 41 publications

Detection of Extended-spectrum Beta-lactamases (ESBLs), Carbapenemase, Metallo-β-lactamase Production Bacteria and Antibiotic Susceptibility Pattern in Hospitalized Patients with Ventilator-associated Pneumonia

Detection of Extended-spectrum Beta-lactamases (ESBLs), Carbapenemase, Metallo-β-lactamase Production Bacteria and Antibiotic Susceptibility Pattern in Hospitalized Patients with Ventilator-associated Pneumonia

Prevalence and Molecular Characterization of Extended Spectrum β-Lactamase and Carbapenemase-Producing Enterobacteriaceae Isolates from Bloodstream Infection Suspected Patients in Addis Ababa, Ethiopia

Exploring the Antibiotic Resistance Profile of Clinical Klebsiella pneumoniae Isolates in Portugal

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