An Outbreak of ESBL-producing Klebsiella pneumoniae in an Iranian Referral Hospital: Epidemiology and Molecular Typing

Shima Mahmoudi; Babak Pourakbari; Aliakbar RahbarimaneshMohammad Reza AbdosalehiKeyghobad GhadiriSetareh Mamishi

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An Outbreak of ESBL-producing Klebsiella pneumoniae in an Iranian Referral Hospital: Epidemiology and Molecular Typing

机译：An Outbreak of ESBL-producing Klebsiella pneumoniae in an Iranian Referral Hospital: Epidemiology and Molecular Typing

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Introduction: Klebsiella pneumoniae is a common cause of nosocomialinfections; however, there is limited information in Iran regarding nosocomial outbreaksdue to extended-spectrum β–lactamase (ESBL) producing K pneumoniaestrains, particularly using molecular methods. The present study focused on the molecularmechanism of ESBL resistance and genetic relatedness in K. pneumoniaeisolates causing nosocomial infections in an Iranian referral hospital.Material and Methods: This study evaluated the antimicrobial resistance and molecularepidemiology of K. pneumoniae causing nosocomial infections in childrenbetween October 2013 and March 2014. The ESBL detection was carried out for allthe isolates by the CLSI method and PCR was carried out for the detection of theblaSHV, blaTEM, and blaCTX-M genes among ESBL-producing K. pneumonia. Moleculartyping of the K. pneumoniae was performed using random amplification ofpolymorphic DNA-polymerase chain reaction (RAPD-PCR).Results: A total of 30 isolates of K. pneumoniae were used for epidemiologicalanalysis. High rates of resistance to cefotaxime (n=29, 97%), cefazolin (n=29, 97%),cefepime (n=25, 83%) and gentamicin (n=23, 77%) were observed. A total of 29strains (97%) produced ESBLs. The frequency of blaSHV, blaCTX-M and blaTEM genesamong these isolates was 83% (n=25), 70% (n=21) and 57% (n=17), respectively.Surprisingly 11 isolated (37%) carried blaSHV, blaCTX-M and blaTEM genessimultaneously. Moreover, the concurrent presence of “blaSHV and blaCTX-M” and“blaSHV and blaTEM” was seen in 8 (27%) and 4 (13%) isolates, respectively. RAPDPCRanalyses revealed that K. pneumoniae isolates belonged to 2 RAPD-PCRtypes among which one cluster counted for 28 isolates.Conclusion: To our knowledge, this is the first published report of a nosocomialoutbreak of ESBL-producing K. pneumoniae in children in Iran. Although the epidemiologyof nosocomial infections with ESBL-producing organisms has not yetbeen explored in depth in Iran, our findings suggest that ESBL-producing organismsare already an established public health threat in our country.

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《Infectious disorders drug targets》 |2019年第1期|46-54|共9页
作者
Shima Mahmoudi; Babak Pourakbari; Aliakbar RahbarimaneshMohammad Reza AbdosalehiKeyghobad GhadiriSetareh Mamishi;
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Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran;

Department of Pediatric Infectious Diseases, Bahrami Children Hospital, Tehran University of;

Department of Infectious Diseases, Pediatrics Center of Excellence, Children's Medical CenterKermanshah University of Medical Sciences, Nosocomial Infections Research Center, Kermanshah, Iran;

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原文格式 PDF
正文语种英语
中图分类药学;
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Klebsiella pneumoniae; extended-spectrum β-lactamase; molecular typing; nosocomial infection;

An Outbreak of ESBL-producing Klebsiella pneumoniae in an Iranian Referral Hospital: Epidemiology and Molecular Typing

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