Prevalence of OXA-type Class D β-lactamases Among Clinical Isolates of Klebsiella Pneumoniae in Multiple Centers of Tehran, Iran

Abstract

Background: Drug- and multidrug-resistant Klebsiella pneumoniae isolates have been found worldwide. Treatment failures against carbapenems and extended-spectrum cephalosporins, the currently recommended drugs, contribute to consider K. pneumoniae infections as untreatable infections. The emergence and spread of oxacillinases (OXAs) with carbapenem-hydrolysing properties are a major concern and seriously become a public health problem worldwide. The present study was aimed to explore the blaOXA genes among clinical isolates of K. pneumoniae in some clinical settings in Tehran, Iran. Methods: Ninety K. pneumoniae isolates were collected from different clinical samples at hospitals in Tehran during 2016 and 2018. Antimicrobial susceptibility testing was performed on bacterial isolates using the Kirby-Bauer disc diffusion method on Mueller Hinton agar plates. PCR experiments were carried out to detect the presence of the blaOXA genes, including blaOXA-1, blaOXA-2, blaOXA-4, blaOXA10, and blaOXA-48-like, using specific primers. Results: The antibiotics susceptibility results showed that 41% of the K. pneumoniae isolates were resistant to imipenem and meropenem. Resistance rates for cephalosporin agents, including cefpodoxime, ceftazidime, cefuroxime, cefotaxime, and cefepime were measured as 72.3%, 67.8%, 67.7%, 65.5%, and 60%, respectively. In the present study, 51.1% of isolates were classified as multidrug-resistant K. pneumoniae strains. The molecular assays showed that 56.6% of isolates harbored blaOXA-2. In addition, blaOXA-4, blaOXA-1, blaOXA-10, blaOXA-48-like genes were also found in 16.7%, 5.6%, 1.1%, and 1.1% of isolates, respectively. Conclusions: The spread of blaOXAs, especially blaOXA-48-like among K. pneumoniae isolates indicated the inadequate dissemination control of multidrug-resistant bacteria in the Iranian hospital environment. There is reason to assume that OXA producing K. pneumoniae will limit clinical therapeutic options in the future and pose threats to national public health among the Iranian population.

Eugenol eliminates carbapenem-resistant Klebsiella pneumoniae via reactive oxygen species mechanism

“…Multidrug-resistant bacteria (MDR) infections, featuring high incidence and fatality rates, are a threat to public health ( Liu et al, 2020 ; Yu et al, 2020 ; Mei et al, 2021 ). Among them, carbapenem-resistant Klebsiella pneumoniae (CRKP) has been listed as one of the most critical drug-resistant pathogens by the World Health Organization, because its carbapenemases product, capable of hydrolyzing and inactivating carbapenems and β-lactams antibiotics, can result in the dramatical infection occlusion in bloodstream, urinary tract, surgical-site, and lung ( Broberg et al, 2014 ; Escolà-Vergé et al, 2020 ; Mehrbakhsh et al, 2020 ; Han et al, 2022 ; Liu et al, 2022 ). To treat the bacterial infections, extensive efforts have been devoted and remarkable progresses have been made using various antibiotics ( Ji et al, 2021 ; Zong et al, 2022 ).…”

The distribution characteristics of global blaOXA-carrying Klebsiella pneumoniae

“…Molecular studies displayed a frequent distribution of blaOXA including blaOXA-1 , blaOXA-2 , blaOXA-48 etc. among K. pneumoniae [ 9 ]. Among the blaOXA-48 -like CHβLs group, blaOXA-48 , blaOXA-181 , blaOXA-232 , blaOXA-204 , blaOXA-162 , and blaOXA-244 are the most common enzymes identified, and some of them showed an epidemic state, for example, it has been reported that blaOXA-48 is endemic in Europe and Asia [ 5 , 6 ].…”

Elevated Mortality Risk from CRKp Associated with Comorbidities: Systematic Review and Meta-Analysis

“…ESBLs are commonly detected in strains of Klebsiella pneumoniae, qualified as an opportunistic pathogen, the etiologic agent of serious infections in hospitalized patients, with emphasis on patients with compromised immunity to serious diseases. K. pneumoniae capable of producing β-lactamase was first detected in Germany in 1983, and there has been a steady increase worldwide in subsequent decades [1,2]. Nosocomial infections are usually caused by K. pneumoniae, Acinetobacter baumanie, and other gram-negative microorganisms.…”

“…The biggest problem is that the pharmaceutical industry does not have enough new drugs to complement the growth of resistance of these microorganisms, such as K. pneumoniae . The growing number of cases of antibiotic-resistant Klebsiella pneumoniae infections stands out as a worldwide health problem, presenting as a clinically important bacterium causing pneumonia in hospital environments [ 1 ].…”

“…Several infectious diseases are associated with adjacent diseases, increasing the risk of infection and complications. Epidemiological information shows that the increased incidence of nosocomial infections and some community-acquired infections is related to those patients with preexisting comorbidities, such as diabetes, immunosuppressant, lung diseases, and nephropathies [ 1 , 14 , 15 ].…”