Background and Objective: Klebsiella pneumoniae is one of the most important causative agents both in form of hospital acquired and community-acquired infections. This bacterium is one of the most prevalent pathogens that is isolated from hospitals and is associated with high mortality rates. The uprising trend of multi drug resistance among Klebsiella pneumoniae has limited the treatment options. The objective of this study was to detect Metallo-beta-Lactamases, Extended-spectrum beta-lactamases (ESBLs) and outer membrane porins among Klebsiella pneumoniae strains isolated from hospitalized patients in Taleghani and Mofid hospitals. Materials and Methods: This cross-sectional study was performed on 100 Klebsiella pneumoniae isolates from 2012 to 2013. Antibiotic susceptibility tests were performed via Kirby-Bauer disc diffusion and Broth Microdilution methods according to CLSI guidelines. Metallo-beta-Lactamases, Extended-spectrum beta-lactamases (ESBLs) producing strains were detected by phenotypic confirmatory test and Combination Disk Diffusion Test (CDDT), respectively. The blaAIM, blaSPM, blaDIM, blaIMP, blaVIM ، blaTEM، blaSHV and blaCTX-M genes were detected using PCR and sequencing method. The outer membrane porins including OmpK35 and OmpK36 were analysed throughSDS-PAGE, PCR and sequencing methods. Results: Out of 100 K. pneumoniae isolates, 48 (48%) and 3(3%) were ESBL and MBL positive, respectively. The presence of blaTEM-1, blaSHV and blaCTX-M-15 was detected in 24 (50%), 30(62.5%) and 28 (58.33%) isolates respectively, while other genes were not detected. Outer Membrane Porins, OmpK35, was detected among 30 (62.5%) of 48 ESBL-producing isolates while OmpK36 was found in 35(72.91%) of 48 ESBL-producing isolates. In this study, Fosfomycin and Tigecycline were more effective than other antibiotics. Conclusion: The high prevalence of ESBL-producing K. pneumoniae detected in this study is of great concern which requires infection control measures including antibacterial management and rapid detection of beta-lactamases-producing isolates. References 1- Amraei S, Eslami G, Taherpour A, Goudarzi H, Hashemi A. Detection of FOXMOX, and ACT genes in ESBL- producing Klebsiella Pneumoniae strains. J Mazandaran Univ Med Sci. 2014 24: 11-20. 2- Fallah F, Taherpour A, Vala MH, Hashemi A. Global spread of new delhi metalo-beta-lactamase-1 (NDM-1). Arch Clin Infect Dis. 2012 6: 171-7. 3- Fallah F, Vala MH, Goudarzi H, et al. Identification of extended-spectrum-beta-lactamases (ESBLs), metallo-beta-lactamases (MBLs), Amp-C and KPC ß-lactamases among Klebsiella pneumoniae isolated from adults and pediatric patients in Iran. Afr J Microbiol Res. 2013 7: 3254-61. 4- Fallah F, Borhan RS, Hashemi A. Detection of bla (IMP) and bla (VIM) metallo-beta-lactamases genes among Pseudomonas aeruginosa strains. Int J Burns Trauma. 2013 3: 122-4 5- Hakemi Vala M, Hallajzadeh M , Hashemi A , et al. Detection of ambler class A, B and D β-lactamases among Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolated from burn patients. Ann Burns Fire Disasters. 2014 27: 8-13. 6- Fallah F, Taherpour A, Borhan R, Hashemi A, Habibi M, Nia RS. Evaluation of Zataria MultiFlora Boiss and Carum copticum antibacterial activity on IMP-type metallo-beta-lactamase-producing Pseudomonas aeruginosa. Ann Burns Fire Disasters. 2013 26: 193. 7- Taherpour A, Hashemi A. Detection of OqxAB efflux pumps, OmpK35 and OmpK36 porins in ex-tended- spectrum-β- lactamase- producing Klebsiella pneumoniae isolates from Iran. Hippokratia. 2013 17: 355-8. 8- Hashemi A, Fallah F, Erfanimanesh S, Hamedani P, Alimehr S. Detection of β-lactamases and outer membrane porins among Klebsiella pneumoniae strains isolated in Iran. Scientifica. 2014 2014: 726179. 9- Tsai Y-K, Fung C-P, Lin J-C, et al. Klebsiella pneumoniae outer membrane porins OmpK35 and OmpK36 play roles in both antimicrobial resistance and virulence. Antimicrob Agents Chemother. 2011 55: 1485-93. 10- Landman D, Bratu S, Quale J. Contribution of OmpK36 to carbapenem susceptibility in KPC-producing Klebsiella pneumoniae. J Med Microbiol. 2009 58: 1303-8. 11- Hashemi A, Shams S, Kalantar D, Taherpour A, Barati M. Antibacterial effect of Methanolic extract of Camellia Sinensis L. on Pseudomonas aeruginosa strains producing β-lactamases. J Gorgan Uni Med Sci. 2012 14: 136-42. 12- Hashemi A, Shams S, Barati M, Samedani A. Antibacterial effects of methanolic extracts of Zataria multiflora, Myrtus communis and Peganum harmala on Pseudomonas aeruginosa producing ESBL. Arak Med Univ J. 2011 14: 104-12. 13- Shakibaei M, Shah CF, Hashemi A, ADELI N. Detection of TEM, SHV and PER type extended-spectrum β-lactamase gene among clinical strains of Pseudomonas aeruginosa isolated from burnt patients at Sbafa-Hospital, Kerman, Iran. Iran J Basic Med Sci. 2008 2: 104-111. 14- Jafari M, Fallah F, Borhan RS, et al. The first report of CMY, aac (6′)-Ib and 16S rRNA methylase genes among Pseudomonas aeruginosa isolates from Iran. Arch Pediatr Infect Dis. 2013 2: 109-12. 15- Vala MH, Nowroozi J, Ghazi F, Tabatabai PN, Haghighi S. Comparing invasive and non-invasive of isolated Shigella flexneri by electron microscopy of cell culture, SDS-Page and congo red method. Iran Biomed J. 2007 11: 47-52. 16- Mansouri S, Kalantar D, Asadollahi P, Taherikalani M, Emaneini M. Characterization of Klebsiella pneumoniae strains producing extended spectrum beta-lactamases and AMPC type beta-lactamases isolated from hospitalized patients in Kerman, Iran. Roum Arch Microbiol Immunol. 2012 71: 81-6. 17- Ghafourian S, Bin Sekawi Z, Sadeghifard N, et al. The prevalence of ESBLs producing Klebsiella pneumoniae isolates in some major hospitals, Iran. Open Microbiol J. 2011 5: 91-5. 18- Feizabadi MM, Delfani S, Raji N, et al. Distribution of bla TEM, bla SHV, bla CTX-M genes among clinical isolates of Klebsiella pneumoniae at Labbafinejad hospital, Tehran, Iran. Microb Drug Resist. 2010 16: 53-49. 19- Goudarzi H, Aghamohammad S, Hashemi A, Nikmanesh B, Noori M. Distribution of blaTEM, blaSHV and bla CTX-M genes among Escherichia coli isolates causing urinary tract infection in children. Arch Clin Infect Dis. 2013 8: e1b207. 20- Keramati N, Zeighami H, Haghi F. Frequency of class I and II integrons in metalobetalactamase producing clinical isolates of Pseudomonas Aeruginosa. J Zanjan Univ Med Sci. 2014 22: 111-9. 21- Hemmati F, Soroori Zanjani R, Haghi F, Zeighami H. Determination of Antibiotic Resistance Profile and Frequency of Metallo-Beta- Lactamases in Pseudomonas Aeruginosa Isolates. J Zanjan Univ Med Sci. 2014 22: 77-85. 22- Fallah F, Noori M, Hashemi A, et al. Prevalence of bla NDM, bla PER, bla VEB, bla IMP, and bla VIM genes among Acinetobacter baumannii isolated from two hospitals of Tehran, Iran. Scientifica. 2014 2014: 245162. 23- Hernández-Allés S, del Carmen Conejo M, Pascual A, Tomás JM, Benedí VJ, Martínez-Martínez L. Relationship between outer membrane alterations and susceptibility to antimicrobial agents in isogenic strains of Klebsiella pneumoniae. J Antimicrob Chemother. 2000 46: 273-7.
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |