Parmaceutical Sciences Research Center, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz Iran.
Asian Pac J Trop Med. 2013 Sep;6(9):703-8. doi: 10.1016/S1995-7645(13)60122-4.
To identify three common genes (blaTEM, blaSHV and blaCTX-M) responsible for ESBL production in Klebsiella pneumoniae (K. pneumoniae)isolated from Intensive Care Units of Namazi Hospital, Shiraz, Iran.
A total of 60 non-repetitive nosocomial isolates from 60 patients were selected during 2009-2010. The phenotypic identification of ESBL production was confirmed by Double Disk Synergy Test (DDST) according to CLSI guidelines. The ESBL's genotype was then analyzed by multiplex PCR of blaTEM, blaSHV and blaCTX-M genes and DNA sequencing.
The primary susceptibility tests of K. pneumoniae showed that among 10 examined antibiotics, the most resistant and susceptible antibiotics identified in this study were ampicillin and imipenem, respectively. The phenotypic determination of ESBL by DDST showed that 60% (n=36) of isolates produced ESBL. Multiplex PCR of genes among K. pneumoniae isolates showed that 39% (n=18) of them have TEM, 39% (n=18) of them have both CTX-M and TEM and 13% (n=8) of them have TEM, SHV, CTX-M.
Our findings reveal the high prevalence (60%) of ESBL producing K. pneumoniae from ICU patients along with a new pattern of blaTEMdistribution differ from other countries.
鉴定导致伊朗设拉子 Namazi 医院重症监护病房分离的肺炎克雷伯菌（K. pneumoniae）产生 ESBL 的 3 个常见基因（blaTEM、blaSHV 和 blaCTX-M）。
在 2009 年至 2010 年期间，从 60 名患者中选择了 60 个非重复的医院分离株。根据 CLSI 指南，通过双碟协同试验（DDST）确认 ESBL 产生的表型鉴定。然后通过 blaTEM、blaSHV 和 blaCTX-M 基因的多重 PCR 和 DNA 测序分析 ESBL 的基因型。
肺炎克雷伯菌的初步药敏试验表明，在所检查的 10 种抗生素中，本研究中鉴定出的最耐药和最敏感的抗生素分别是氨苄西林和亚胺培南。通过 DDST 进行的 ESBL 表型测定显示，60%（n=36）的分离株产生 ESBL。对肺炎克雷伯菌分离株基因的多重 PCR 显示，39%（n=18）的分离株具有 TEM，39%（n=18）的分离株同时具有 CTX-M 和 TEM，13%（n=8）的分离株具有 TEM、SHV、CTX-M。
我们的研究结果显示，来自 ICU 患者的产 ESBL 肺炎克雷伯菌（60%）的流行率很高，并且 blaTEM 分布模式与其他国家不同。
