Department of Basic Medical Sciences, Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran.
Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Trop Med Int Health. 2024 Oct;29(10):875-881. doi: 10.1111/tmi.14043. Epub 2024 Aug 2.
The global emergence of carbapenem-resistant Klebsiella pneumoniae is considered a significant contemporary concern., as carbapenems are the last resort for treating infections caused by multidrug-resistant Gram-negative bacteria. This study aimed to investigate the carbapenem-resistance genes in extended-spectrum β-lactamase producing K. pneumoniae isolates.
Seventy-five non-duplicate clinical K. pneumoniae strains were isolated from urine, blood, sputum, and wound samples. Antimicrobial susceptibility tests for 12 different antibiotics were performed using the disk diffusion method, followed by determining minimum inhibitory concentrations of imipenem and meropenem. Phenotypic detection of extended-spectrum β-lactamase and carbapenemase enzymes was performed by double-disc synergy test and modified Hodge test, respectively. PCR assay further investigated resistant isolates for extended-spectrum β-lactamase and carbapenemase-encoding genes.
The highest and lowest resistance rates were observed against ampicillin (93.3%) and tigecycline (9.3%). According to phenotypic tests, 46.7% of isolates were positive for extended-spectrum β-lactamase enzymes and 52.8% for carbapenemase. A total of 11 isolates contained carbapenemase genes, with bla (19.4%; 7/36) being the predominant gene, followed by bla (8.3%; 3/36).
The study's findings reveal the alarming prevalence of beta-lactamase enzymes in K. pneumoniae strains. Early detection of carbapenem-resistant isolates and effective infection control measures are necessary to minimise further spread, as carbapenem resistance has become a public health concern.
碳青霉烯类耐药肺炎克雷伯菌的全球出现被认为是当代的一个重大关注点,因为碳青霉烯类是治疗多重耐药革兰氏阴性菌引起感染的最后手段。本研究旨在研究产超广谱β-内酰胺酶的肺炎克雷伯菌分离株中的碳青霉烯类耐药基因。
从尿液、血液、痰液和伤口样本中分离出 75 株非重复的临床肺炎克雷伯菌。采用纸片扩散法对 12 种不同抗生素进行药敏试验,然后测定亚胺培南和美罗培南的最低抑菌浓度。通过双碟协同试验和改良 Hodge 试验分别对产超广谱β-内酰胺酶和碳青霉烯酶的表型进行检测。PCR 检测进一步对耐药株进行超广谱β-内酰胺酶和碳青霉烯酶编码基因的检测。
对氨苄西林(93.3%)和替加环素(9.3%)的耐药率最高和最低。根据表型试验,46.7%的分离株产超广谱β-内酰胺酶,52.8%产碳青霉烯酶。共有 11 株分离株含有碳青霉烯酶基因,其中 bla (19.4%;7/36)是主要基因,其次是 bla (8.3%;3/36)。
本研究结果显示,肺炎克雷伯菌中β-内酰胺酶的流行率令人震惊。需要早期检测碳青霉烯类耐药分离株,并采取有效的感染控制措施,以减少进一步传播,因为碳青霉烯类耐药已成为一个公共卫生关注点。