Frequency of bla CTX-M and bla TEM Virulence Genes and Antibiotic Resistance Profiles among Klebsiella pneumoniae Isolates in Urinary Tract Infection (UTI) Samples from Hashtgerd, Iran.

Ebrahim Babapour,Shirin Sarshar,Reza Mirnejad

doi:10.52547/rbmb.10.3.412

Abstract

Klebsiella pneumoniae (K. pneumoniae) is an opportunistic microorganism and one of the most important causes of urinary tract infection. This study aimed to evaluate the frequency of K. pneumoniae producing broad-spectrum beta-lactamase in urinary tract infection and to determine the pattern of drug resistance. This study was performed on 50 samples of K. pneumoniae isolated from patients with urinary tract infection referred to the Medical Diagnostic Laboratory in Hashtgerd city. The isolates were first evaluated for antibiotic susceptibility by disk diffusion method according to the method proposed by the Clinical and Laboratory Standards Institute (CLSI). Then phenotypic detection of ESBLS was carried out by the DDST method. The frequency of gene bla TEM and bla CTX-M was determined by PCR. The highest resistance was observed to ampicillin (94%) and the highest sensitivity was observed to gentamicin (84%). 22 isolates (44%) were positive for ESBLs production. Of the 50 isolates studied, 34% had bla CTX-M and 28% had bla TEM and 11 (22%) had both genes simultaneously. Also, more than 77% of positive ESBLs isolates had the bla CTX-M gene and approximately 63.64% of positive ESBLs isolates had the bla TEM gene. Given the high prevalence of antibiotic-resistant and ESBL-producing isolates, early identification of these resistant isolates and their follow-up is essential to prevent further outbreaks. It is also important to use appropriate therapeutic strategies and proper and rational administration of antibiotics by physicians.

Highlights

Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen and one of the most important bacteria involved in nosocomial infections [1, 2]
Frequency of blaCTX-M and blaTEM in K. pneumoniae pneumoniae is the selection of a highperformance and not expensive antibiotic but the main problem in the treatment of these infections is the resistance of bacteria to a large number of common antibiotics [4]
Double disk Synergy Test (DDST) Positive extended-spectrum beta-Lactamase (ESBLs) isolates were confirmed according to Clinical and Laboratory Standards Institute (CLSI) guidelines using Double

Summary

Introduction

Klebsiella pneumoniae (K. pneumoniae) is an opportunistic pathogen and one of the most important bacteria involved in nosocomial infections [1, 2]. Frequency of blaCTX-M and blaTEM in K. pneumoniae pneumoniae is the selection of a highperformance and not expensive antibiotic but the main problem in the treatment of these infections is the resistance of bacteria to a large number of common antibiotics [4]. Cefotaximases (CTX-M-ases) enzymes are a new family of broad-spectrum plasmid beta-lactamases produced by different genera of the Enterobacteriaceae family, including K. pneumoniae. These enzymes cause resistance to penicillin and a wide spectrum of third generation cephalosporins such as ceftazidime ceftriaxone, cefotaxime, and monobactams such as aztreonam. This study aimed to evaluate the frequency of K. pneumoniae producing broad-spectrum beta-lactamase in urinary tract infection and to determine the pattern of drug resistance. It is important to use appropriate therapeutic strategies and proper and rational administration of antibiotics by physicians

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Conclusion