Azadpour M, Soleimani Y, Rezaie F, Rezaeifar M
Razi Herbal Medicine Research Center, Lorestan University of Medical Science, Khorramabad, Iran.
Department of Microbiology, Qom Branch, Islamic Azad University, Qom, Iran.
Trop Biomed. 2017 Jun 1;34(2):412-418.
The present investigation is designed to evaluate antibiotic susceptibility pattern and identification of qnr strains of Klebsiella pneumoniae in clinical specimens isolated from general hospitals in Khorramabad, Iran. Total of 107 K. pneumoniae isolates were randomly collected since December 2011 until September 2012 from hospitalized patients at general hospitals in Khorramabad, Iran. The isolates were collected from different clinical samples including urine, sputum, lesion, and blood. Biochemical tests were performed for identification of isolates. Antibiotic susceptibility test was performed using disc diffusion method according to recommendations of Clinical and Laboratory Standards Institute using 13 antibiotic disks. K. pneumoniae isolates were screened by multiplex PCR amplification of qnrA, qnrB and qnrS using specific primers and sequence analysis of amplified regions of the isolates was also performed. Chi-square test was used to analysis and P value of < 0.05 was considered statistically significant. All clinical isolates were confirmed as K. pneumoniae by complete biochemical identification (gram staining, oxidase negative, indole positive, Simon's citrate positive and urease positive). Forty-three (40.2%) out of 107 isolates were multidrug-resistant (MDR). Ciprofloxacin (quinolone) susceptibility testing showed that 34 isolates (31.8%) were resistant, 7 isolates (6.5%) were intermediately resistant and 66 isolates (61.7%) were sensitive. Eighteen (16.8%) out of 107 K. pneumoniae clinical isolates were positive for qnr genes. Among all the qnr-positive isolates, 16 isolates (88.9%) carried qnrB, 1 isolate (5.55%) carried qnrS and the rest (5.55%) carried both qnrB and qnrS genes while no qnrA was detected in these clinical isolates. Qnr determinants were detected in 8 (23.5%) of the ciprofloxacinresistant isolates as well as 1 (14.3%) and 9 (13.6%) intermediate and sensitive isolates, respectively. No significant association was observed between ciprofloxacin resistance and presence of qnr genes (P>0.05). Findings of the present study indicated high frequency of qnr-positive K. pneumoniae in Lorestan province, Iran. However, there is no association between quinolone resistance and presence of qnr genes in isolates of K. pneumoniae.
本研究旨在评估伊朗霍拉马巴德综合医院临床标本中肺炎克雷伯菌的抗生素敏感性模式并鉴定qnr菌株。自2011年12月至2012年9月，从伊朗霍拉马巴德综合医院的住院患者中随机收集了107株肺炎克雷伯菌分离株。这些分离株取自不同的临床样本，包括尿液、痰液、病变组织和血液。进行生化试验以鉴定分离株。根据临床和实验室标准协会的建议，使用13种抗生素药敏纸片，采用纸片扩散法进行抗生素敏感性试验。使用特异性引物通过多重PCR扩增qnrA、qnrB和qnrS对肺炎克雷伯菌分离株进行筛选，并对分离株扩增区域进行序列分析。采用卡方检验进行分析，P值<0.05被认为具有统计学意义。所有临床分离株经完全生化鉴定（革兰氏染色、氧化酶阴性、吲哚阳性、西蒙氏柠檬酸盐阳性和脲酶阳性）确认为肺炎克雷伯菌。107株分离株中有43株（40.2%）为多重耐药（MDR）。环丙沙星（喹诺酮类）药敏试验显示，34株（31.8%）耐药,7株（6.5%）中介耐药，66株（61.7%）敏感。107株肺炎克雷伯菌临床分离株中有18株（16.8%）qnr基因呈阳性。在所有qnr阳性分离株中，16株（88.9%）携带qnrB，1株（5.55%）携带qnrS，其余（5.55%）同时携带qnrB和qnrS基因，而在这些临床分离株中未检测到qnrA。在8株（23.5%）环丙沙星耐药分离株以及1株（14.3%）中介耐药和9株（13.6%）敏感分离株中分别检测到Qnr决定簇。环丙沙星耐药与qnr基因的存在之间未观察到显著关联（P>0.05）。本研究结果表明，伊朗洛雷斯坦省qnr阳性肺炎克雷伯菌的频率较高。然而，肺炎克雷伯菌分离株中喹诺酮耐药与qnr基因的存在之间没有关联。
