Infect Chemother.
2023 Mar;55(1):90-98. 10.3947/ic.2022.0160.
High Frequency of bla OXA-48like Producing Klebsiella pneumoniae Isolated from Nosocomial Infection in Azerbaijan, Iran
- Affiliations
-
- 1Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- 2Central Laboratory of the Province, Tabriz University of Medical Sciences, Tabriz, Iran
- 3Razi Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- 4Division of Microbiology, Department of Pathobiology, School of Public Health, Tehran University of Medi- cal Sciences, Tehran, Iran
- 5Zanjan Applied Pharmacology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
- KMID: 2541535
- DOI: http://doi.org/10.3947/ic.2022.0160
Abstract
- Background
Klebsiella pneumoniae is one of the significant agents of hospital-acquired infections. In recent years, carbapenem-resistant K. pneumoniae (CRKP) isolates have been found in numerous epidemics of nosocomial infections. This study aimed to determine carbapenem resistance mechanisms and molecular epidemiological of CRKP infections in Azerbaijan, Iran.
Materials and Methods
A total of 50 non-duplicated CRKP from January 2020 to December 2020 were isolated form Sina and Imam Reza Hospitals in Tabriz, Iran. Antimicrobial susceptibility testing was performed by the diskdiffusion method. The carbapenem resistance mechanisms were determined by the phenotypic and PCR procedures. CRKP isolates were typed by the Random Amplified Polymorphic DNA PCR (RAPD-PCR) technique.
Results
Amikacin was the most effective antibiotics against CRKP isolates. AmpC overproduction was observed in five CRKP isolates. Efflux pump activity was found in one isolate by the phenotypic method. Carba NP test could find carbapenemases genes in 96% of isolates. The most common carbapenemases gene in CRKP isolates were bla OXA-48like (76%) followed by bla NDM (50%),bla IMP (22%), bla VIM(10%), andbla KPC (10%). The outer membrane protein genes (OmpK36 and OmpK35) were identified in 76% and 82% of CRKP isolates, respectively. RAPD-PCR analysis yielded 37 distinct RAPD-types. Most bla OXA-48like positive CRKP isolates were obtained from patients hospitalized in intensive care unit (ICU) wards with urinary tract infections.
Conclusion
The bla OXA-48like is the main carbapenemase among CRKP isolates in this area. Most bla OXA-48like producer CRKP strains were collected from the ICU ward and urine samples. To control infections due to CRKP, a strict control program in hospital settings is required.
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