Identification of Carbapenem-Resistant Klebsiella pneumoniae with Emphasis on New Delhi Metallo-Beta-Lactamase-1 (bla) in Bandar Abbas, South of Iran.

BACKGROUND AND OBJECTIVE

The spread of carbapenem-resistant Klebsiella pneumoniae especially bla-carrying isolates is a great concern worldwide. In this study we describe the molecular basis of carbapenem-resistant K. pneumoniae in three teaching hospitals at Bandar Abbas, south of Iran.

MATERIALS AND METHODS

A total of 170 nonduplicate clinical isolates of K. pneumoniae were investigated. Antimicrobial susceptibility test was performed by disc diffusion method. PCR was carried out for detection of carbapenemase (bla, bla, bla, bla, bla, bla, and bla) and extended-spectrum β-lactamase (bla, bla, bla, bla, bla, and bla). Clonal relatedness of bla-positive isolates was evaluated by multilocus sequence typing (MLST).

RESULTS

Tigecycline was the most effective antimicrobial agent with 96.5% susceptibility. In addition, 6.5% of the isolates were carbapenem resistant. Bla was identified in four isolates (isolate A-D) and all of them were multidrug-resistant. MLST revealed that bla-positive isolates were clonally related and belonged to two distinct clonal complexes, including sequence type (ST) 13 and ST 392. In addition to bla isolate A coharbored bla, bla, and bla, isolate B harbored bla and bla, and isolates C and D contained both bla and bla.

CONCLUSION

Our results indicate that NDM-1-producing K. pneumoniae ST 13 and ST 392 are disseminated in our region. Moreover, one of our major concerns is that these isolates may be more prevalent in the near future. Tracking and urgent intervention is necessary for control and prevention of these resistant isolates.