High Frequency of blaOXA-48like Producing Klebsiella pneumoniae Isolated from Nosocomial Infection in Azerbaijan, Iran
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Background: Klebsiella pneumoniae is one of the significant agents of hospital-acquired infections. In recent years, carbapenem-resistant K. pneumoniae (CRKP) isolates have been found in numerous epidemics of nosocomial infections. This study aimed to determine carbapenem resistance mechanisms and molecular epidemiological of CRKP infections in Azerbaijan, Iran. Materials and Methods: A total of 50 non-duplicated CRKP from January 2020 to December 2020 were isolated form Sina and Imam Reza Hospitals in Tabriz, Iran. Antimicrobial susceptibility testing was performed by the disk-diffusion method. The carbapenem resistance mechanisms were determined by the phenotypic and PCR procedures. CRKP isolates were typed by the Random Amplified Polymorphic DNA PCR (RAPD-PCR) technique. Results: Amikacin was the most effective antibiotics against CRKP isolates. AmpC overproduction was observed in five CRKP isolates. Efflux pump activity was found in one isolate by the phenotypic method. Carba NP test could find carbapenemases genes in 96% of isolates. The most common carbapenemases gene in CRKP isolates were blaOXA-48-like (76%) followed by blaNDM (50%), blaIMP (22%), blaVIM (10%), and blaKPC (10%). The outer membrane protein genes (OmpK36 and OmpK35) were identified in 76% and 82% of CRKP isolates, respectively. RAPD-PCR analysis yielded 37 distinct RAPD-types. Most blaOXA-48-like positive CRKP isolates were obtained from patients hospitalized in intensive care unit (ICU) wards with urinary tract infections. Conclusion: The blaOXA-48-like is the main carbapenemase among CRKP isolates in this area. Most blaOXA-48-like producer CRKP strains were collected from the ICU ward and urine samples. To control infections due to CRKP, a strict control program in hospital settings is required.
Abstract
Background: Klebsiella pneumoniae is one of the significant agents of hospital-acquired infections. In recent years, carbapenem-resistant K. pneumoniae (CRKP) isolates have been found in numerous epidemics of nosocomial infections. This study aimed to determine carbapenem resistance mechanisms and molecular epidemiological of CRKP infections in Azerbaijan, Iran. Materials and Methods: A total of 50 non-duplicated CRKP from January 2020 to December 2020 were isolated form Sina and Imam Reza Hospitals in Tabriz, Iran. Antimicrobial susceptibility testing was performed by the disk-diffusion method. The carbapenem resistance mechanisms were determined by the phenotypic and PCR procedures. CRKP isolates were typed by the Random Amplified Polymorphic DNA PCR (RAPD-PCR) technique. Results: Amikacin was the most effective antibiotics against CRKP isolates. AmpC overproduction was observed in five CRKP isolates. Efflux pump activity was found in one isolate by the phenotypic method. Carba NP test could find carbapenemases genes in 96% of isolates. The most common carbapenemases gene in CRKP isolates were blaOXA-48-like (76%) followed by blaNDM (50%), blaIMP (22%), blaVIM (10%), and blaKPC (10%). The outer membrane protein genes (OmpK36 and OmpK35) were identified in 76% and 82% of CRKP isolates, respectively. RAPD-PCR analysis yielded 37 distinct RAPD-types. Most blaOXA-48-like positive CRKP isolates were obtained from patients hospitalized in intensive care unit (ICU) wards with urinary tract infections. Conclusion: The blaOXA-48-like is the main carbapenemase among CRKP isolates in this area. Most blaOXA-48-like producer CRKP strains were collected from the ICU ward and urine samples. To control infections due to CRKP, a strict control program in hospital settings is required.
참고문헌 (38)
- Martin RM, "Colonization, infection, and the accessory genome of Klebsiella pneumoniae", Front Cell Infect Microbiol, 8, pp.4~ (2018)
- Navon-Venezia S, "Klebsiella pneumoniae : a major worldwide source and shuttle for antibiotic resistance", FEMS Microbiol Rev, 41, pp.252~275 (2017)
- Podschun R, "Klebsiella spp. as nosocomial pathogens : epidemiology, taxonomy, typing methods, and pathogenicity factors", Clin Microbiol Rev, 11, pp.589~603 (1998)
- Tumbarello M, "Infections caused by KPC-producing Klebsiella pneumoniae : differences in therapy and mortality in a multicentre study", J Antimicrob Chemother, 70, pp.2133~2143 (2015)
- Piperaki ET, "Klebsiella pneumoniae : virulence, biofilm and antimicrobial resistance", Pediatr Infect Dis J, 36, pp.1002~1005 (2017)
- Tzouvelekis LS, "Treating infections caused by carbapenemase-producing Enterobacteriaceae", Clin Microbiol Infect, 20, pp.862~872 (2014)
- Bassetti M, "Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria", Intensive Care Med, 41, pp.776~795 (2015)
- Seo Hyeonji, "Risk Factors for Mortality in Patients with Klebsiella pneumoniae Carbapenemase-producing K. pneumoniae and Escherichia coli bacteremia", Infection and Chemotherapy, 53(3), pp.528~538 (2021), 대한감염학회[DOI]
- Alizadeh N, "Evaluation of resistance mechanisms in carbapenem-resistant Enterobacteriaceae", Infect Drug Resist, 13, pp.1377~1385 (2020)
- Li B, "Molecular pathogenesis of Klebsiella pneumoniae", Future Microbiol, 9, pp.1071~1081 (2014)
- Jarvis WR, "The epidemiology of nosocomial infections caused by Klebsiella pneumoniae", Infect Control, 6, pp.68~74 (1985)
- Moosavian M, "The first report of emerging mobilized colistin-resistance(mcr)genes and ERIC-PCR typing in Escherichia coli and Klebsiella pneumoniae clinical isolates in southwest Iran", Infect Drug Resist, 12, pp.1001~1010 (2019)
- Wasfi R, "Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals", Sci Rep, 6, pp.38929~ (2016)
- Clinical and Laboratory Standards Institute (CLSI), "Performance standards for antimicrobial susceptibility testing" (2019), CLSI
- Rodríguez-Martínez JM, "Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa", Antimicrob Agents Chemother, 53, pp.4783~4788 (2009)
- Nordmann P, "Rapid detection of carbapenemase-producing Enterobacteriaceae", Emerg Infect Dis, 18, pp.1503~1507 (2012)
- Chew KL, "Klebsiella pneumoniae in Singapore : hypervirulent infections and the carbapenemase threat", Front Cell Infect Microbiol, 7, pp.515~ (2017)
- Lee CR, "Antimicrobial resistance of hypervirulent Klebsiella pneumoniae : epidemiology, hypervirulence-associated determinants, and resistance mechanisms", Front Cell Infect Microbiol, 7, pp.483~ (2017)
- Paczosa MK, "Klebsiella pneumoniae : going on the offense with a strong defense", Microbiol Mol Biol Rev, 80, pp.629~661 (2016)
- Lin WP, "The antimicrobial susceptibility of Klebsiella pneumoniae from community settings in Taiwan, a trend analysis", Sci Rep, 6, pp.36280~ (2016)
- Akter J, "Study on prevalence and antibiotic resistance pattern of Klebsiella isolated from clinical samples in South East Region of Bangladesh", Am J Drug Discov Dev, 4, pp.73~79 (2014)
- Gao B, "Molecular epidemiology and risk factors of ventilator-associated pneumonia infection caused by carbapenem-resistant Enterobacteriaceae", Front Pharmacol, 10, pp.262~ (2019)
- Endimiani A, "Evaluation of updated interpretative criteria for categorizing Klebsiella pneumoniae with reduced carbapenem susceptibility", J Clin Microbiol, 48, pp.4417~4425 (2010)
- Saeed NK, "Epidemiology of carbapenem-resistant Enterobacteriaceae in a tertiary care center in the Kingdom of Bahrain", J Lab Physicians, 11, pp.111~117 (2019)
- Sekar R, "New Delhi metallo-β-lactamase and other mechanisms of carbapenemases among Enterobacteriaceae in rural South India", J Glob Antimicrob Resist, 18, pp.207~214 (2019)
- Mendes RE, "Characterization of β-lactamase content of ceftazidime-resistant pathogens recovered during the pathogendirected phase 3 REPRISE trial for ceftazidime-avibactam : correlation of efficacy against β-lactamase producers", Antimicrob Agents Chemother, 63, pp.e02655-18~ (2019)
- Ye Q, "Antibiotic-resistant extended spectrum ß-lactamase-and plasmid-mediated ampC-producing Enterobacteriaceae isolated from retail food products and the pearl river in Guangzhou, China", Front Microbiol, 8, pp.96~ (2017)
- van Hoek AH, "Molecular characteristics of extended-spectrum cephalosporin-resistant Enterobacteriaceae from humans in the community", PLoS One, 10, pp.e0129085~ (2015)
- Kumar N, "Modified Carba NP Test : Simple and rapid method to differentiate KPC-and MBLproducing Klebsiella species", J Clin Lab Anal, 32, pp.e22448~ (2018)
- Alizadeh N, "Detection of carbapenemresistant Enterobacteriaceae by chromogenic screening media", J Microbiol Methods, 153, pp.40~44 (2018)
- Wasfi R, "Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals", Sci Rep, 6, pp.38929~ (2016)
- Ranjbar R, "Molecular characterization, serotypes and phenotypic and genotypic evaluation of antibiotic resistance of the Klebsiella pneumoniae strains isolated from different types of hospital-acquired infections", Infect Drug Resist, 12, pp.603~611 (2019)
- Kim SY, "Characteristics of carbapenem-resistant Enterobacteriaceae isolates from Korea", Diagn Microbiol Infect Dis, 76, pp.486~490 (2013)
- Ranjbar R, "Molecular characterization, serotypes and phenotypic and genotypic evaluation of antibiotic resistance of the Klebsiella pneumoniae strains isolated from different types of hospital-acquired infections", Infect Drug Resist, 12, pp.603~611 (2019)
- Candan ED, "Klebsiella pneumoniae : characteristics of carbapenem resistance and virulence factors", Acta Biochim Pol, 62, pp.867~874 (2015)
- Lee CR, "Global dissemination of carbapenemase-producing Klebsiella pneumoniae : epidemiology, genetic context, treatment options, and detection methods", Front Microbiol, 7, pp.895~ (2016)
- Poirel L, "Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae", Antimicrob Agents Chemother, 48, pp.15~22 (2004)
- Ashayeri-Panah M, "Correlation of multi-drug resistance, integron and blaESBL gene carriage with genetic fingerprints of extended-spectrum β-lactamase producing Klebsiella pneumoniae", Jundishapur J Microbiol, 7, pp.e8747~ (2014)