Ghaffarian Fatemeh, Hedayati Mojtaba, Sedigh Ebrahim-Saraie Hadi, Atrkar Roushan Zahra, Mojtahedi Ali
Department of Microbiology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Cell Mol Biol (Noisy-le-grand). 2018 May 30;64(7):75-79.
The emergence of extended-spectrum beta-lactamases (ESBL) producing strains become a great concern, because few antimicrobial agents remain active against them. Due to the lack of data on the genotyping characteristics and antibiotics resistance of clinical isolates of Klebsiella pneumoniae in the north of Iran, this study aimed to determine the occurrence of ESBL-producing isolates and their molecular characteristics in order to analyses their epidemiological relationships. This cross-sectional study performed on 60 K. pneumoniae isolates which were recovered from different clinical specimens within May and November 2016. Isolates were identified by standard microbiologic tests and confirmed by API 20E strip. Antimicrobial susceptibility testing was carried out by disk diffusion method. The genetic relatedness among the isolates was assessed by RAPD-PCR. Totally, the lowest level of susceptibility was toward amoxicillin/clavulanat, and nalidixic acid. On the other hand, the highest level of susceptibility was toward imipenem (86.7%). The rate of ESBL-producing isolates was 45% (27/60). There was a significant association between production of ESBLs and higher antibiotic resistance in tested isolates. The RAPD-PCR dendrogram revealed 5 major clusters with a similarity of 80% which indicates the high relatedness of the studied isolates. Twenty-one isolates out of the 27 ESBL-producing isolates were clustered in cluster A. In summary, results showed the high prevalence of multiple-drug resistant and ESBL-producing K. pneumoniae isolates in our ICUs. Also, results revealed a significant similarity between ESBL-producing isolates that necessitate restricted infection control policies and rational prescription and use of antibiotics.
产超广谱β-内酰胺酶（ESBL）菌株的出现引起了极大关注，因为几乎没有抗菌药物对它们仍保持活性。由于伊朗北部肺炎克雷伯菌临床分离株的基因分型特征和抗生素耐药性数据匮乏，本研究旨在确定产ESBL分离株的发生率及其分子特征，以分析它们的流行病学关系。本横断面研究对2016年5月至11月期间从不同临床标本中分离出的60株肺炎克雷伯菌进行了检测。通过标准微生物学试验对分离株进行鉴定，并用API 20E试条进行确认。采用纸片扩散法进行药敏试验。通过RAPD-PCR评估分离株之间的遗传相关性。总体而言，对阿莫西林/克拉维酸和萘啶酸的敏感性最低。另一方面，对亚胺培南的敏感性最高（86.7%）。产ESBL分离株的比例为45%（27/60）。在受试分离株中，ESBL的产生与较高的抗生素耐药性之间存在显著关联。RAPD-PCR树状图显示有5个主要聚类，相似度为80%，这表明所研究的分离株具有高度相关性。27株产ESBL分离株中有21株聚集在聚类A中。总之，结果显示我们的重症监护病房中产多重耐药和产ESBL肺炎克雷伯菌分离株的患病率很高。此外，结果显示产ESBL分离株之间存在显著相似性，这就需要采取严格的感染控制政策以及合理处方和使用抗生素。
