Ghafourian Sobhan, Sekawi Zamberi, Neela Vasanthakumari, Khosravi Afra, Rahbar Mohammad, Sadeghifard Nourkhoda
Ilam University of Medical Sciences, Ilam, Iran.
Sao Paulo Med J. 2012;130(1):37-43. doi: 10.1590/s1516-31802012000100007.
Resistant bacteria are emerging worldwide as a threat to favorable outcomes from treating common infections in community and hospital settings. The present investigation was carried out to study the incidence of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in patients with urinary tract infection in different seasons of the year, in order to determine the prevalence of the genes blaTEM, blaSHV and blaCTX-M, which are responsible for ESBL production among ESBL-producing K. pneumoniae, in three cities in Iran, and to investigate the antimicrobial susceptibility pattern of K. pneumoniae in different seasons.
Retrospective study carried out among patients with urinary tract infections in five hospitals in Iran.
Two hundred and eighty-eight clinical isolates of K. pneumoniae were collected between March 2007 and April 2008 from five hospitals in three cities in Iran. ESBLs were identified by phenotypic and genotypic methods. ESBL-producing Klebsiella pneumoniae were evaluated against non-beta-lactam antibiotics. Genes coding for ESBLs (blaSHV, TEM and CTX-M) were screened.
Among the 288 clinical isolates of K. pneumoniae, 37.7%, 46.7% and 15.6% were obtained from hospitals in Ilam, Tehran and Tabriz, respectively, of which 39.4%, 50.7% and 45.8% were ESBL-producing K. pneumoniae in Ilam, Milad and Emam Reza hospitals, respectively.
According to the results from this study, resistance to third-generation cephalosporins is higher during the cold months than during the warm months.
耐药菌在全球范围内不断出现，对社区和医院环境中常见感染的治疗效果构成威胁。本研究旨在调查一年中不同季节尿路感染患者中产超广谱β-内酰胺酶（ESBL）的肺炎克雷伯菌的发生率，以确定负责产ESBL的肺炎克雷伯菌中ESBL产生的blaTEM、blaSHV和blaCTX-M基因在伊朗三个城市的流行情况，并调查不同季节肺炎克雷伯菌的抗菌药敏模式。
对伊朗五家医院的尿路感染患者进行回顾性研究。
2007年3月至2008年4月期间，从伊朗三个城市的五家医院收集了288株肺炎克雷伯菌临床分离株。通过表型和基因型方法鉴定ESBL。对产ESBL的肺炎克雷伯菌进行非β-内酰胺类抗生素评估。筛选编码ESBL的基因（blaSHV、TEM和CTX-M）。
在288株肺炎克雷伯菌临床分离株中，分别有37.7%、46.7%和15.6%来自伊拉姆、德黑兰和大不里士的医院，其中在伊拉姆医院、米拉德医院和伊玛目礼萨医院产ESBL的肺炎克雷伯菌分别占39.4%、50.7%和45.8%。
根据本研究结果，寒冷月份对第三代头孢菌素的耐药性高于温暖月份。
