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Dissemination Pattern of Multidrug Resistant Carbapenemase Producing Klebsiella pneumoniae Isolates Using Pulsed-Field Gel Electrophoresis in Southwestern Iran

Authors Hashemizadeh Z, Hosseinzadeh Z, Azimzadeh N, Motamedifar M

Received 1 September 2019

Accepted for publication 23 January 2020

Published 30 March 2020 Volume 2020:13 Pages 921—929

DOI https://doi.org/10.2147/IDR.S227955

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Zahra Hashemizadeh,1 Zahra Hosseinzadeh,2 Negar Azimzadeh,3 Mohammad Motamedifar1,4

1Department of Bacteriology and Virology, Shiraz University of Medical Sciences, Shiraz, Iran; 2Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 3Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran; 4Shiraz HIV/Aids Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran

Correspondence: Mohammad Motamedifar
Department of Bacteriology and Virology, Shiraz University of Medical Science, Shiraz, Iran
Tel/Fax +98 71 3230 4356
Email motamedm@sums.ac.ir

Background: Klebsiella pneumoniae is an important cause of healthcare-associated infection. Carbapenemases have increasingly been reported in Enterobacteriaceae, especially in K. pneumoniae.
Propose: The objective of this study was to determine antibiotic resistance patterns, and the molecular epidemiology of multidrug resistant K. pneumoniae isolates, obtained from hospitalized patients in Shiraz, Iran.
Methods: In this study, 60 K. pneumoniaeisolates were collected from Nemazee and Faghihi referral hospitals. Antibiotic susceptibility testing and MIC were performed by disk diffusion test and Epsilometer (E)-test strips, respectively. Carbapenemase genes were identified by polymerase chain reaction and sequencing. Then, clonal relationships were analyzed, using PFGE.
Results: Thirty-three out of 60 K. pneumoniae isolates were resistant to carbapenems. Among the isolates, 86.6% were multidrug resistant (MDR). Polymyxin B (18.3%) and tigecycline (23.3%) were shown to be the most active agents against K. pneumoniae isolates. In our study, the high prevalence of blaNDM (45%) and blaOXA-48 (10%) was detected.
Conclusion: The results of this study revealed the widespread carbapenemase gene between different wards in hospitals as a risk factor for treatment options. PFGE analysis showed 11 clusters and 3 singletons based on an 80% similarity level. Also, PFGE analysis showed that there were similar genetic patterns among K. pneumoniae isolates and these patterns were responsible for the distribution of infection in hospitals.

Keywords: Klebsiella pneumoniae, pulsed-field gel electrophoresis, PFGE, carbapenemases


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