Extended-spectrum beta-lactamases detection and prevalence of blaTEM gene in clinical isolates of Klebsiella pneumoniae from hospitals in North of Iran

Abstract

Klebsiella pneumoniae is a member of the Enterobacteriaceae family which plays an important role in creating various infections in the community. These strains are resistant to multiple β-lactam antibiotics due to the production of β-lactamases enzyme (ESBL). The purpose of this study was to  assess the phenotypic and genotypic characteristics of ESBL-producing K. pneumoniae strains from clinical specimens in three hospitals in Mazandaran, Iran. In this cross-sectional study, K. pneumoniae samples (N = 100) were identified from different clinical specimens after standard biochemical and microbiological tests. Disc agar diffusion test was applied for antibiotic-resistant examinations. Phenotypic detection of ESBL-producing isolates was performed using mixed disk method. The presence of blaTEM gene was investigated in ESBL-producing isolates using PCR method. The ESBL test analysis was positive for 40 isolates (40%) of K. pneumoniae. The prevalence of blaTEM gene in ESBL-producing K. pneumoniae isolates was 55%. Tetracycline, tobramycin, and ampicillin were the most active antibiotics against K. pneumoniae isolates, showing 85%, 81% and 73% sensitivity, respectively. The highest antibiotic resistance in isolated K. pneumoniae was found for ceftriaxone (48%) and cefotaxime (46%) antibiotics. There was a significant correlation between ESBL production and K. pneumoniae isolates resistance to cefotaxime (p = 0.000), ceftazidime (p = 0.001), ciprofloxacin (p = 0.001), tobramycin (p = 0.044), and ceftriaxone (p = 0.000). The prevalence of ESBL-producing K. pneumoniae was high and increasing. The high prevalence of blaTEM gene in these isolates may be a reason for their pathogenesis and multiple-antibiotic resistance. Therefore, there is a need to develop the strategies to manage antibiotic resistance in these isolates.