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:: Volume 21, Issue 3 (Bimonthly 2017) ::
Feyz 2017, 21(3): 232-239 Back to browse issues page
Molecular identification of CTX-M, TEM and SHV β-lactamases in ‌Klebsiella pneumoniae isolated from respiratory system of patients in the ICU of educational hospitals in Tehran
Zahra Soroush, Maryam Ghane *
Department of Microbiology, Faculty of Basic Science, Islamic Azad University, Islamshahr Branch, Islamshahr, I. R. Iran. , maryamghaneh@yahoo.com
Abstract:   (3652 Views)
Background: Extended-spectrum beta-lactamases (ESBL) producing isolates of Klebsiella pneumoniae which have been increased in the hospitals were resulting in limitation of therapeutic options. The aims of this study were to evaluate the antibiotic susceptibility pattern and presence of ESBL genes in clinical isolates of Klebsiella pneumoniae from patients admitted to the intensive care units (ICUs).
Materials and Methods: In this descriptive cross-sectional study, a total of 65 Klebsiella pneumoniae strains were isolated from ICUs of educational hospitals in Tehran. Identification was performed using biochemical tests and the antimicrobial susceptibility was performed as recommended by the Clinical and Laboratory Standards Institute (CLSI). Molecular analysis of the ESBL genes was performed by Multiplex PCR (M-PCR).
Results: Most of the isolates were resistant to Cotrimoxazole (72.3%), Gentamicin (67.7%) and Ampicillin (69.2%) and the highest susceptibility was seen for Ciprofloxacin (50.8%) Tetracycline (49.2%), Imipenem (46.3%) and Ceftriaxone (43.1%). Among the ESBL-producing genes, blaCTX-M (55.3 %) was the most prevalent, followed by blaTEM (41.5 %) and blaSHV (10.7 %). The results showed that 1.5 % of the isolates had concurrently blaTEM/ blaSHV and blaSHV/ blaCTX-M genes and 21.6% of isolates the blaTEM/ blaCTX-M genes.
Conclusion: These findings reveal the high prevalence of multi drug resistant and ESBL-producing Klebsiella pneumoniae in patients hospitalized in ICUs and emphasize the need for appropriate infection control policies.
Keywords: Klebsiella pneumoniae, Anti-bacterial agents, Intensive care units, Beta-lactamases, Multiplex polymerase chain reaction
Full-Text [PDF 316 kb]   (1261 Downloads)    
Type of Study: Research | Subject: medicine, paraclinic
Received: 2017/02/3 | Accepted: 2017/05/15 | Published: 2017/07/30
1. Talbot GH, Bradley J, Edwards JE, Gilbert D, Scheld M, Bartlett JG. Bad bugs need drugs: an update on the development pipeline from the antimicrobial availability task force of the Infectious Diseases society of America. Clin Infect Dis 2006; 42(5): 657–68.
2. Livermore DM, Hawkey PM. CTX-M: changing the face of ESBLs in the UK. J Antimcrob Chemother 2005; 56: 451–4.
3. Yezli S, Shibl AM, Memish ZA. The molecular basis of β-lactamase production in gram-negative bacteria from Saudi Arabia. J Med Microbiol 2015; 64(2): 127–36.
4. Brolund A. Overview of ESBL-producing Enterobacteriaceae from a Nordic perspective. Infect Ecol Epidemiol 2014; 4: 1-9.
5. Malloy AM, Campos JM. Extended-spectrum beta-lactamases: a brief clinical update. Pediatr Infect Dis J 2011; 30(12): 1092–3.
6. Lewis JS 2nd, Herrera M, Wickes B, Patterson JE, Jorgensen JH. First report of the emergence of CTX-M-type extended-spectrum beta-lactamases (ESBLs) as the predominant ESBL isolated in a U.S. health care system. Antimicrob Agents Chemother 2007; 51(11): 4015–21.
7. Nakamura T, Komatsu M, Yamasaki K, Fukuda S, Miyamoto Y, Higuchi T, et al. Epidemiology of Escherichia coli, Klebsiella Species, and Proteus mirabilis strains producing extended-spectrum β-lactamases from clinical samples in the Kinki region of Japan. Am J Cli Pathol 2012; 137(4): 620–6.
8. Bradford PA. Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology and detection of this important resistance threat. Clin Microbiol Rev 2001; 14(4): 933–51.
9. Colodner R. Extended spectrum beta lactamase: a challenge for clinical microbiologists and infection control specialists. Am J Infect Control 2005; 33(2): 104-7.
10. Sid Ahmed MA, Bansal D, Acharya A, Elmi AA, Hamid JM, Sid Ahmed AM. Antimicrobial susceptiblity and molecular epidemiology of extended spectrum beta lactamse producing Enterobacteriaceae from intensive care units at Hamad Medical Corporation, Qatat. Antimicrob Resist Infect Control 2016; 5(4): 1-6.
11. Ahmed OI, El-Hady SA, Ahmed TM, Ahmed IZ. Detection of blaSHV and blaCTX-M genes in ESBL producing Klebsiella pneumoniae isolated from Egyption patients with suspected nosocomial infections. Egypt J Med Hum Genet 2013; 14(3): 277-83.
12. Mirsalehian M, Akbari-Nakhjavani F, Peymani A, Kazemi B, Jabal Ameli F, Mirafshari SM. Prevalence of extended spectrum beta lactamase producing Enterobacteriaceae by phenotypic and genitypic methods in intensive care units in tehran, Iran. Daru 2008; 16(3): 169-73.
13. Archin T, Afzalian E, Kargar M, Ghasemi Y. β lactamases genes and antibiotics resistance pattern of K. pneumoniae isolates collected from ICU patients of Namazi Hospital, Shiraz, Iran. Armaghan-e-Danesh 2014; 18(10): 816-25. [in Persian]
14. Sambrok J, Russell DW, Maniatis T. Molecular cloning a laboratory manual. 4th ed. New York: Cold Spring Harbor Laboratory Press; 2001. p. 470.
15. Bauer AW, Kirby WM, Sherris JC, Truck M. Antibiotic susceptibility testing by a standardized single disc method. Am J Clin Pathol 1996; 45(4): 493-6.
16. Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing. Twenty Fifth Informational Supplement M100-S25, CLSI, Wayne, PA, USA; 2015.
17. Paterson DL, Hujer KM, Hujer AM, Yeiser B, Bonomo MD, Rice LB, et al. Extended-spectrum beta-lactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and widespread prevalence of SHV and CTX-M-type beta-lactamases. Antimicrob agents Chemother 2003; 47(11): 3554-60.
18. Monstain HJ, Ostholm-Balkhed A, Nilsson MV, Nilsson M, Dornbusch K, Nilsson LE. Multiplex amplification assay for detection of blaSHV, blaTEM and blaCTX-M genes in Enterobacteriaceae. APMIS 2007; 115(12): 1400-8.
19. Boyd DA, Tyler S, Christianson S, McGeer A, Muller MP, Willey BM, et al. Complete nucleotide sequence of the 92 kilibase plasmid harbouring the CTX-M-15 extended spectrum beta lactamase involved in an outbreak in long term care facilities in Toronto, Canada. Antimicrob Agents Chemother 2004; 48(10): 3758-64.
20. Seyedjavadi SS, Goudarzi M, Sabzehali F. Relation between blaTEM, blaSHV and blaCTX-M genes and acute urinary tract infections. J Acute Dis 2016; 5(1): 71–6.
21. Girish N, Saileela K, Mohanty SK. Extended-Spectrum bata-Lactamase producing Klebsiella Pneumoniae and Escherichia coli in neonatal intensive care unit. J Bacteriol Parasitol 2012; 3(4): e1000141.
22. Mobin H, Nahaie MR, Amir mozafari N, Sadeghi J, Rasouli M. Enterobacteriaceae producing Extended-spectrum beta-lactamases (ESBL) and plasmid patterns in intensive care unit of children's hospital in Tabriz. Med J Tabriz Univ Med Sci 2007; 28: 95-101.
23. Talebi Taher M, Golestanpour A. Symptomatic nosocomial urinary tract infectin in ICU patiant: identification of antimicrobial resistance pattern. Iran J Clin Infect Dis 2009; 4(1): 25-9.
24. Derakhshan S, Najar peerayeh F, Fallah F, Bakhshi B, Rahbar M, Mohammad-Zadeh M. Identification of expended spectrum betalactamase producing Klebsiella pneumonia isolated from intensive care unit (ICU) patiants in three hospitals in Iran. Infect Epidemiol Med 2013; 1(1): 9-13.
25. Soltan Dalal MM, Miremadi SA, Sharify Yazdi MK, Rastegar Lari A, Rajabi Z, Avadis Yans S. Antimicrobial resistance trends of Klebsiella spp. isolated from patients in Imam Khomeini hospital. Payavard Salamat 2012; 6(4): 275-81. [in Persian]
26. Amin A, Ghumro PB, Hussain S, Hameed A. Prevalence of antibiotic resistance among clinical isolates of Klebsiella pneumoniae isolated from a tertiary care hospital in Pakistan. Malays J Microbiol 2009; 5(2): 81-6.
27. Al-Shara MA. Emerging antimicrobial resistant of Klebsiella pneumoniae strains isolated from pediatric patients in Jordan. New Iraqi J Med 2011; 7(2): 81-7.
28. Ishii Y, Alba J, Kimura S, Shiroto K, Yamaguchi K. Evaluation of antimicrobial activity of β-lactam antibiotics using E-test against clinical isolates from 60 medical centres in Japan. Int J Antimicrob Agents 2005; 25(4): 296-301.
29. Bratu S, Tolaney P, Karumudi U, Quale J, Mooty M, Nichani S, et al. Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: molecular epidemiology and in vitro activity of polymyxin B and other agents. J Antimicrob Chemother 2005; 56(1): 128–32.
30. Feizabadi MM, Delfani S, Raji N, Majnooni A, Aligholi M, Shahcheraghi F, et al. Distribution of bla(TEM), bla(SHV), bla(CTX-M) genes among clinical isolates of Klebsiella pneumoniae at Labbafinejad hospital, Tehran, Iran. Microb Drug Resist 2010; 16(1): 49-53.
31. Peymami A, Moeini-Rad M, Naserpour T, Sanikhani R, Pahlevan AA. Frequency of extended spectrum beta lactamase and TEM and SHV genotypes in Klebsiella pneumoniae. Iran J Infectious Dis Tropical Med 2013; 18(60): 15-20. [in Persian]
32. Ranjbar R, Memariani H, Sorouri R. Molecular epidemiology of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strains isolated from children with urinary tract infections. Arch Pediatr Infect Dis 2017; 5(2): e 39000.
33. Latifpour M, Gholipour A, Damavandi MS. Prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates in nosocomial and community-acquired urinary tract infections. Jundishapur J Microbiol 2016; 9(3): e31179.
34. Bali BE, Açik L, Sultan N. Phenotypic and molecular characterization of SHV, TEM, CTX-M and extended-spectrum–lactamase produced by Escherichia coli, Acinobacter baumannii and Klebsiella isolates in a Turkish hospital. Afr J Microbiol Res 2010; 4(8): 650-4.
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Soroush Z, Ghane M. Molecular identification of CTX-M, TEM and SHV β-lactamases in ‌Klebsiella pneumoniae isolated from respiratory system of patients in the ICU of educational hospitals in Tehran. Feyz. 2017; 21 (3) :232-239
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