Ghayaz Fatemeh, Kelishomi Fatemeh Zeynali, Amereh Samira, Aali Ehsan, Javadi Amir, Peymani Amir, Nikkhahi Farhad
Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
Curr Microbiol. 2023 Feb 24;80(4):115. doi: 10.1007/s00284-023-03208-0.
With the emergence of multi-drug resistant strains among Klebsiella isolates, the use of old drugs such as fosfomycin has been considered. In this context, we investigated the effect of fosfomycin on biofilm-producing Klebsiella pneumoniae and Klebsiella oxytoca strains isolated from ICU patients. A total of 90 isolates of Klebsiella pneumoniae and 30 isolates of Klebsiella oxytoca were collected from the ICU ward. All isolates were confirmed by biochemical and genotypic methods. Antibiotic susceptibility testing was performed by disc diffusion method and for fosfomycin and colistin, minimum inhibitory concentration (MIC) was done using micro broth dilution. The presence of the beta-lactamase encoding genes, biofilm-related genes, and fosfomycin resistance-related genes was detected by PCR. Finally, for fosfomycin-resistant isolates, we determined the sequence type by the MLST method. Sensitivity rate to fosfomycin in Klebsiella pneumoniae and Klebsiella oxytoca isolates was 92.2% and 100%, respectively. Fosfomycin was the most active antimicrobial agent with 96% sensitivity among all tested antibiotics. All tested isolates could produce biofilm. The frequency of biofilm-related genes for Klebsiella pneumoniae was as follows: 95.5% fimH, 86.6% mrkD, 77.7% mrkA, and 50% wcaG. The frequency of these genes for Klebsiella oxytoca was as follows: 56.6% fimA, 46.6% mrkA, 93.3% matB, and 90% pilQ. Only 4.4% of Klebsiella pneumoniae isolates showed resistance to fosfomycin, and the fosA gene was detected in all of them. Our results showed that fosfomycin effectively inhibits multidrug-resistant (MDR) strains of Klebsiella pneumoniae and Klebsiella oxytoca.
随着克雷伯菌分离株中多重耐药菌株的出现，人们开始考虑使用磷霉素等老药。在此背景下，我们研究了磷霉素对从重症监护病房（ICU）患者中分离出的产生物膜的肺炎克雷伯菌和产酸克雷伯菌菌株的作用。从ICU病房共收集了90株肺炎克雷伯菌分离株和30株产酸克雷伯菌分离株。所有分离株均通过生化和基因分型方法进行确认。采用纸片扩散法进行药敏试验，对于磷霉素和黏菌素，使用微量肉汤稀释法测定最低抑菌浓度（MIC）。通过聚合酶链反应（PCR）检测β-内酰胺酶编码基因、生物膜相关基因和磷霉素耐药相关基因的存在。最后，对于耐磷霉素的分离株，我们采用多位点序列分型（MLST）方法确定序列类型。肺炎克雷伯菌和产酸克雷伯菌分离株对磷霉素的敏感率分别为92.2%和100%。在所有测试抗生素中，磷霉素是活性最高的抗菌剂，敏感性为96%。所有测试分离株均可产生生物膜。肺炎克雷伯菌生物膜相关基因的频率如下：fimH为95.5%，mrkD为86.6%，mrkA为77.7%，wcaG为50%。产酸克雷伯菌这些基因的频率如下：fimA为56.6%，mrkA为46.6%，matB为93.3%，pilQ为90%。仅4. / 4%的肺炎克雷伯菌分离株对磷霉素耐药，且所有耐药株均检测到fosA基因。我们的结果表明，磷霉素可有效抑制肺炎克雷伯菌和产酸克雷伯菌的多重耐药（MDR）菌株。
