Evaluation of Antibiotic Resistance Pattern and Efficacy of Modified Hodge Test for Detection of Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated From Clinical Samples

Abstract

Background and Objectives: Klebsiella pneumoniae is a gram negative opportunistic pathogen that causes different infections, but in recent years the emergence of resistance to carbapenem antibiotic among these isolates causes failure in the treatment of these infections. The aim of this study was to evaluate the prevalence of carbapenemase producing Klebsiella pneumoniae strains among different wards and various clinical specimens in Isfahan. Material and Method: In this cross sectional study, 100 different clinical samples were collected from different wards of teaching hospitals in Isfahan. K. pneumonia isolates were identified by different standard biochemical tests. Antimicrobial susceptibility tests were performed as standard disk-diffusion based on the instructions of Clinical Laboratory Standards Institute (CLSI). For detection of KPC-producing strains, isolates were investigated by The Modified Hodge Test based on CLSI instruction. Results: The population study was included 62% females and 38% males (p=0.01). The highest and the lowest rate of resistance were observed for piperacillin (84%) and ertapenem (50%) respectively. The Modified Hodge Test was positive for 68 (68%) isolates that the highest rate of resistance was observed for piperacillin (91/2%) and cefotaxime (83/8%) . Conclusion: This study demonstrates the high prevalence of carbapenemase producing Klebsiella pneumoniae isolates ,Which shows an urgent need to review and modify the pattern of antibiotic consumption. In addition, In the later studies genotypic methods for all carbapenemase genes should be performed to determine the cause of the resistance.