Analysis of carbapenemases genes of carbapenem-resistant Klebsiella pneumoniae isolated from Tehran heart center

Leyla Pourgholi; Hadi Farhadinia; Maryam Hosseindokht; Shayan Ziaee; Rahim Nosrati; Marjan Nosrati; Mohammadali Boroumand

doi:10.18502/ijm.v14i1.8799

Leyla Pourgholi Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Hadi Farhadinia Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Maryam Hosseindokht Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Shayan Ziaee Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Rahim Nosrati Cellular and Molecular Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Marjan Nosrati Department of Infection Control, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
Mohammadali Boroumand Department of Pathology and Laboratory Medicine, Tehran Heart Center, Tehran University of Medical

DOI: https://doi.org/10.18502/ijm.v14i1.8799

Keywords: Carbapenem-resistance; Klebsiella pneumoniae; bla ; bla ; bla NDM ; bla OXA-48

Abstract

Background and Objectives: Emerging of carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the major con- cerns among healthcare systems. This study aimed to investigate the antibiotic susceptibility pattern and carbapenemase genes of carbapenemase-producing K. pneumoniae isolates obtained from Iranian hospitalized patients.

Materials and Methods: This study was performed on 71 CRKP strains isolated from different clinical specimens collected in Tehran Heart Center (Tehran, Iran). A Modified Hodge test (MHT) was done for the detection of carbapenemase-producing K. pneumoniae. The presence of bla method. KPC , bla VIM , bla IMP , bla , and bla OXA-48 -type carbapenemases was evaluated by the PCR

Results: We identified 8.82% (71/805) of K. pneumoniae isolates as CRKP by MHT test. The antibiotic susceptibility indi- cated that all isolates were resistant to imipenem, meropenem, cefotaxime, ceftazidime, cefepime, ceftriaxone, cephalothin, ciprofloxacin, and augmentin, and then mostly resistant to aztreonam, cefoxitin, gentamicin, and trimethoprim/sulfamethox- azole with 98.6%, 98.6%, 97.2%, and 94.4%, respectively. The lowest resistance was related to amikacin with 46.5% (33/71 isolates). The level of imipenem MIC for all carbapenem-resistant isolates was estimated ≥32 µg/mL. Among positive iso- lates for carbapenemase genes, the most frequent gene was bla . It was found in 48 (67.6%) isolates followed by bla VIM in 28 (39.4%) isolates. bla IMP, bla , and bla KPC genes were identified in 19 (26.8%), 13 (18.3%) and 5 (7.0%) isolates, respectively. These genes were not detected in nine isolates.

Conclusion: The relatively high frequency of some carbapenemase genes suggests major concern about the emergence of isolates containing carbapenem resistance genes as a potential health threat.