Abstract

Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes capable of hydrolyzing beta-lactams. The aim of this study was to describe the prevalence of TEM- and SHV-type ESBL-producing Klebsiella pneumoniae strains in Zahedan, Southeast Iran. A total of 170 non-repetitive K. pneumoniae strains were collected from patients referred to three teaching hospitals of Zahedan. Antibiotic susceptibility testing was determined for 17 antibiotics using the Kirby-Bauer disc diffusion method. The frequency of ESBL-producing strains was calculated, and minimum inhibitory concentrations of ESBL-producing strains were determined for cefotaxime, ceftazidime, ceftriaxone, and cefpodoxime. The presence of bla TEM and bla SHV genes was tested in all ESBL-producing strains using polymerase chain reaction and DNA sequencing. Among the 170 K. pneumoniae clinical isolates, 55 (32.4%) were ESBL producers; 92.7% (n=51) and 72.7% (n=40) of the isolates carried the bla SHV and bla TEM genes, respectively, and 67.3% (n=37) carried both genes. The sequencing results showed that all bla TEM types were bla TEM-1, except for two isolates that were bla TEM-104. The bla SHV types were bla SHV-1, bla SHV-11, bla SHV-12, bla SHV-99, bla SHV-108, and bla SHV-110. The percentage of bla TEM and bla SHV among ESBL-producing K. pneumoniae isolates from Zahedan is relatively high, indicating the need for further surveillance and consideration in antibiotic use. To the best of our knowledge, this is the first report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-type ESBLs among clinical isolates of K. pneumoniae from Iran, and TEM-1, SHV-1, SHV-11, and SHV-12 appear to be the dominant ESBLs in this region.

Highlights

  • Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes capable of hydrolyzing beta-lactams

  • We identified an overall frequency of 32.4% ESBL producers, which is less than those reported in Turkey (69%)(10), Taiwan (97%)(11), India (97%)(19), Saudi Arabia (55%)(20), and Nepal (62.7%)(21), but higher than those reported in Lebanon (20%)(22), the United States (7.6%), and Canada (4.9%)(23)

  • Al-Agamy showed that the rates of resistance of ESBL-producing isolates to cefotaxime, ceftazidime, aztreonam, cefepime, gentamicin, amikacin, and ciprofloxacin were 97.7%, 95.5%, 97.7%, 47.8%, 88.9%, 77.3%, and 11.4%, respectively, which supports our findings for cefotaxime, but indicates a higher resistance rate to the other antibiotics

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Summary

Introduction

Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes capable of hydrolyzing beta-lactams. The aim of this study was to describe the prevalence of TEM- and SHV-type ESBL-producing Klebsiella pneumoniae strains in Zahedan, Southeast Iran. Klebsiella pneumoniae is an important opportunistic nosocomial pathogen responsible for a variety of infections, including urinary tract infections, pneumonia, septicemia, wound infections, and infections in intensive care units(1) This bacterium is one of the leading causes of community-acquired and nosocomial infections and is associated with high mortality rates(2). Shahraki-Zahedani S et al.- TEM- and SHV-type ESBLs in Zahedan, Iran site and are commonly associated with K. pneumoniae. The aim of the present study was to evaluate the prevalence of TEM- and SHVtype ESBL-producing K. pneumoniae in Zahedan, Southeast Iran, using phenotypic and genotypic methods

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