Esmaeilnia Mohammad, Saffari Mahmood, Rashki Somaye, Marzhoseyni Zeynab, Khaledi Azad, Moosavi Gholam Abbas, Atoof Fatemeh, Alani Behrang
Department of Microbiology and Immunology, Faculty of Medicine, Kashan University of Medical Science, Kashan, Iran.
Infectious Diseases Research Center, Kashan University of Medical Science, Kashan, Iran.
Iran J Basic Med Sci. 2022 Feb;25(2):208-213. doi: 10.22038/IJBMS.2022.58445.12981.
is the common cause of pneumonia in hospitalized patients, particularly in intensive care units (ICU). The infection can transfer by medical equipment such as mechanical ventilators. This study aimed to investigate the molecular typing of the extended-spectrum beta-lactamase-producing isolates recovered from Beheshti Hospital, Kashan, Iran.
isolates producing ESBLs have been collected from the samples obtained from Shahid Beheshti hospital, Kashan, Iran. Antimicrobial susceptibility was determined using the Kirby Bauer disk diffusion method. The presence of ESBLs was evaluated using CLSI for ESBL screening by the double-disk diffusion method. Molecular typing was conducted by pulsed-field gel electrophoresis (PFGE). In total, 89 K. pneumoniae isolates were recovered, of which 47.1% were ESBL producers.
Results showed that all of the clinical and environmental isolates were resistant to ceftriaxone, meropenem, cefazolin, cefotaxime, cephalothin, and piperacillin-tazobactam. All isolates were grouped under four clusters (A-D). The major cluster was related to the C cluster with 22 isolates (19 clinical and 3 environmental). Seventy-two percent of isolates were from the ICU ward. There was no correlation between antibiotic resistance patterns and PFGE clusters (=0.2).
We observed a common molecular signature among both clinical and environmental isolates, indicating a similar genotype and likely a common origin for ESBL producer isolates found in different hospital wards. Therefore, hospitals need to implement an effective infection control system to decrease the spreading of ESBL strains within the hospitals and subsequently the transmission of the infection to patients.
是住院患者肺炎的常见病因，尤其是在重症监护病房（ICU）。感染可通过机械通气机等医疗设备传播。本研究旨在调查从伊朗卡尚贝赫什提医院分离出的产超广谱β-内酰胺酶菌株的分子分型。
从伊朗卡尚沙希德·贝赫什提医院采集的样本中收集产ESBLs的菌株。采用 Kirby Bauer 纸片扩散法测定抗菌药物敏感性。使用 CLSI 通过双纸片扩散法进行 ESBLs 筛查评估。通过脉冲场凝胶电泳（PFGE）进行分子分型。共分离出89株肺炎克雷伯菌，其中47.1%为产ESBLs菌株。
结果显示，所有临床和环境分离株均对头孢曲松、美罗培南、头孢唑林、头孢噻肟、头孢噻吩和哌拉西林-他唑巴坦耐药。所有分离株分为四个簇（A - D）。主要簇与C簇相关，有22株（19株临床株和3株环境株）。72%的分离株来自ICU病房。抗生素耐药模式与PFGE簇之间无相关性（=0.2）。
我们在临床和环境分离株中观察到共同的分子特征，表明在不同医院病房发现的产ESBLs分离株具有相似的基因型，可能有共同的来源。因此，医院需要实施有效的感染控制体系，以减少ESBL菌株在医院内的传播，进而减少感染向患者的传播。
