Quinolone Susceptibility and Detection of qnr and aac (6’)-Ib-cr Genes in Community Isolates of Klebsiella pneumoniae

Seyedpour, Seyed Mohsen; Eftekhar, Fereshteh

doi:10.5812/jjm.11136

Cited by 21 publications

(15 citation statements)

References 21 publications

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“…Another finding indicated that rates of resistance to imipenem were 5.7% among ESBL producing Klebsiella isolates. In a study in Karaj all K. pneumoniae isolates were susceptible to imipenem ( 34 ). Du et al ( 29 ) reported 3.3% resistance to imipenem among Klebsiella pneumoniae isolates.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of CTX-M-Type and PER Extended-Spectrum β-Lactamases Among Klebsiella spp. Isolated From Clinical Specimens in the Teaching Hospital of Kashan, Iran

Amiri¹,

Firoozeh²,

Moniri³

et al. 2016

Iran Red Crescent Med J

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Background:Extended-spectrum β-lactamases (ESBLs) is one of the most important mechanisms of resistance to β-lactams especially among Enterobacteriaceae family including Klebsiella spp. Different types of extended-spectrum β-lactamases including CTX-M-type and PER enzymes are identified among gram negative bacteria.Objectives:The current study aimed to determine the prevalence of CTX-M-type and PER extended-spectrum β-lactamases among Klebsiella spp. isolated from clinical specimens in the teaching hospital of Kashan, Iran.Patients and Methods:One hundred Klebsiella spp. were isolated from clinical specimens of hospitalized patients at Shahid-Beheshti hospital from December 2012 to November 2013. Disk diffusion method was used to determine the susceptibility of these isolates to 14 different antimicrobial agents; disks were purchased from MAST company (United Kingdom). The phenotypic double disk synergy confirmatory test was used to screen the isolates to produce extended-spectrum β-lactamase. DNAs of isolates were extracted using boiling method and PCR assay was used to characterize the blaCTX-M type and blaPER genes. The purified PCR products were sent to Macrogen research company (Korea) for sequencing.Results:Of the total 100 Klebsiella isolates, %93 was susceptible to imipenem. Resistance to ampicillin, ceftazidime, ceftriaxone, aztreonam and cefotaxime was (92%), (67%), (65%), (64%) and (59%), respectively. The phenotypic confirmatory test (PCT) confirmed that 35% (n = 35) of the isolates were ESBL-producing Klebsiella strains. The prevalence of blaCTX-M type and blaRER genes among Klebsiella isolates were 28% (n = 28) and 9% (n = 9), respectively.Conclusions:The prevalence of ESBL-producing Klebsiella strains in Shahid-Beheshti hospital in Kashan has increased. The study concluded that there was a high prevalence of the blaCTX-M type gene among ESBL positive isolates.

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Section: Discussionmentioning

confidence: 99%

Prevalence of CTX-M-Type and PER Extended-Spectrum β-Lactamases Among Klebsiella spp. Isolated From Clinical Specimens in the Teaching Hospital of Kashan, Iran

Amiri¹,

Firoozeh²,

Moniri³

et al. 2016

Iran Red Crescent Med J

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“…Since the neighboring countries of Iran have a similar distribution of quinolone resistance genes studied in this survey, the geographical location can play a key role in spreading of these genes. Recent studies showed increase in the quinolone-resistant clinical isolates of E. coli and K. pneumoniae among hospitalized patients in Iran [22,23]. Much more investigations need to simplify the actual incidence rate of quinolones resistance encoding genes.…”

Section: Discussionmentioning

confidence: 99%

Detection of acrA, acrB, aac(6′)-Ib-cr, and qepA genes among clinical isolates of Escherichia coli and Klebsiella pneumoniae

Heidary

Bahramian

Hashemi

et al. 2016

Acta Microbiologica et Immunologica Hungarica

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Background: The distribution of drug resistance among clinical isolates of Escherichia coli and Klebsiella pneumoniae has limited the therapeutic options. The aim of this study was to report the prevalence of quinolone resistance genes among E. coli and K. pneumoniae clinical strains isolated from three educational hospitals of Tehran, Iran. Materials and methods: A total of 100 strains of E. coli from Labbafinejad and Taleghani Hospitals and 100 strains of K. pneumoniae from Mofid Children and Taleghani Hospitals were collected between January 2013 and May 2014. Antimicrobial susceptibility tests were done by disk diffusion method based on Clinical and Laboratory Standards Institute guidelines. Detection of qepA, aac(6′)-Ib-cr, acrA, and acrB genes was done by polymerase chain reaction (PCR). Results: In this study, fosfomycin and imipenem against E. coli and fosfomycin and tigecycline against K. pneumoniae had the best effect in antimicrobial susceptibility tests. PCR assay using specific primers demonstrated that the prevalence of qepA, aac(6′)-Ib-cr, acrA, and acrB genes among the 100 E. coli isolates was 0 (0%), 87 (87%), 92 (92%), and 84 (84%), respectively. The prevalence of qepA, aac(6′)-Ib-cr, acrA, and acrB genes among the 100 K. pneumoniae isolates was 4 (4%), 85 (85%), 94 (94%), and 87 (87%), respectively. Conclusion: The distribution of qepA, aac(6′)-Ib-cr, acrA, and acrB resistance determinants in E. coli and K. pneumoniae is a great concern. Therefore, infection control and prevention of spread of drug-resistant bacteria need careful management of medication and identification of resistant isolates.

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“…Here we identified qnr A , B and S in ESBL-producing K. pneumonia. The incidence rate of 15.6 % qnr in Kuwait compared to other countries in Asia such as Iran (30.4 %) [ 20 ]. Thailand (34.6 %) [ 21 ], Malaysia (37 %) [ 22 ], India (67 %) [ 23 ] and Saudi Arabia (44 %) [ 24 ] is considerably lower.…”

Section: Discussionmentioning

confidence: 99%

The emergence of plasmid mediated quinolone resistance qnrA2 in extended spectrum β-lactamase producing Klebsiella pneumoniae in the Middle East

et al. 2015

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BackgroundKlebsiella pneumoniae is one of the most important opportunistic pathogens causing serious complications in patients in hospitals and community. The clinical significance of K. pneumoniae is mainly due to its ability to acquire multiple antibiotic resistance genes. In this study we report the findings of a survey of plasmid mediated quinolone resistance in Extended-Spectrum β-lactamase (ESBL)-producing K. pneumoniae in Kuwait.MethodsClinical samples were collected from the microbiology laboratories of three major hospitals. Isolates were confirmed as ESBL-producers by disc diffusion method and PCR for the presence of bla genes. Antimicrobial susceptibility testing and genetic analysis were performed to detect the presence of a number of genes conferring resistance to β-lactam and fluoroquinolone antimicrobial agents including blaSHV, blaTEM, aac (6')-Ib-cr, qnrA, qnrB and qnrS. Pulsed-field gel electrophoresis (PFGE) was used for typing the isolates.ResultsIn total 173 ESBL-producing K. pneumoniae were detected. qnr genes were identified in 27 (15.6 %) isolates and aac(6′)-Ib Ib-cr gene in 26 (96 %). One (3.7 %) contained qnrA2, 21 harbored qnrB1 (78 %) and 5 (18.5 %) contained qnrS. Twenty one (78 %) isolates contained all three bla genes. PFGE showed diverse profiles.ConclusionWe identified for the first time the emergence of the mobile fluoroquinolone resistance qnrA2 in a clinical isolate in the middle east and also showed the dissemination of aac (6')-Ib-cr, qnrB, and qnrS genes among ESBL-producing K. pneumoniae in Kuwait. The abundance of plasmid mediated resistance to fluoroquinolones among ESBL-producing K. pneumoniae is alarming as it facilitates therapy failure. Preventing the spread of these isolates is crucial if we are to sustain the effectiveness of the limited choices we have left in antimicrobial therapy.

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Quinolone Susceptibility and Detection of qnr and aac (6’)-Ib-cr Genes in Community Isolates of Klebsiella pneumoniae

Cited by 21 publications

References 21 publications

Prevalence of CTX-M-Type and PER Extended-Spectrum β-Lactamases Among Klebsiella spp. Isolated From Clinical Specimens in the Teaching Hospital of Kashan, Iran

Prevalence of CTX-M-Type and PER Extended-Spectrum β-Lactamases Among Klebsiella spp. Isolated From Clinical Specimens in the Teaching Hospital of Kashan, Iran

Detection of acrA, acrB, aac(6′)-Ib-cr, and qepA genes among clinical isolates of Escherichia coli and Klebsiella pneumoniae

The emergence of plasmid mediated quinolone resistance qnrA2 in extended spectrum β-lactamase producing Klebsiella pneumoniae in the Middle East

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