Nosocomial emerging of (VIM1) carbapenemase-producing isolates of Klebsiella pneumoniae in North of Iran
Abstract
Background and Objectives: The rapid emergence and dissemination of carbapenemase-producing Klebsiella pneumoniae strains and other members of the Enterobacteriaceae poses a considerable threat to the care of hospitalized patients and to public health. The aim of this study was to determine the frequency of metallo-β-lactamases (MBL) and VIM-1 gene in multidrug-resistant strains of K. pneumoniae.
Methods: 50 isolates of non – duplicated K. pneumoniae cultured from patients at intensive care units were tested for their susceptibilities to 13 different antibiotics using microbroth dilution assay. Isolates showing resistance to at least one of the carbapenems were checked for production of metallo-β-lactamase (MBLs) using imipenem–EDTA synergy tests. PCR was used to detect the gene encoding VIM-1 metallo-β-lactamase (MBL).
Results: Of 50 clinical isolates, 26 (52%) were resistant to imipenem in disk diffusion method. Using imipenem–EDTA synergy tests, production of MBL was detected in 15 (30%) isolates. PCR assay showed that 15 isolates were positive for VIM and these included 10 and 5 isolates showing positive and negative results in phenotypic method of MBL detection test respectively. Amikacin was found as the most effective antibiotic against the MBL producers in this study.
Conclusion: The emergence of bla(VIM-1) producing K. pneumoniae in North of Iran is concerning. Microorganisms producing bla(VIM-1) constitute the prevalent multidrug-resistant population of K. pneumoniae in that region.
Salimizand H, Shahcheraghi F, Kalantar E, Badmas- ti F, Mousavi SF. Molecular characterization of class 1 integrons and gene cassettes in multidrug resistant (MDR) Klebsiella spp. isolated from hospitalized and outpatients in Iran, 2009. Iran J Microbiol 2013;5:48-55.
Doyle D, Peirano G, Lascols C, Lloyd T, Church DL, Pitout JD. Laboratory detection of Enterobacteria- ceae that produce carbapenemases. J Clin Microbiol 2012;50:3877-3880.
Akhi MT, Asghari B, Nahaei MR, Memar MY, Lari AR, Naghili B, et al. Comparison of in vitro activities of meropenem productions on Klebsiella pneumoniae isolated from hospitalized patients. GMS Hyg Infect Control 2014;9(2):Doc12. doi: 10.3205/dgkh000232.
Bazzaz BS, Naderinasab M, Mohamadpoor AH, Far- shadzadeh Z, Ahmadi S, Yousefi F. The prevalence of extended-spectrum beta-lactamase-producing Esche- richia coli and Klebsiella pneumoniae among clinical isolates from a general hospital in Iran. Acta Microbiol Immunol Hung 2009;56:89-99.
Ramazanzadeh R, Chitsaz M Fau - Bahmani N, Bah- mani N. Prevalence and antimicrobial susceptibility of extended-spectrum beta-lactamase-producing bacte- ria in intensive care units of Sanandaj general hospital (Kurdistan, Iran). Chemotherapy 2009;55: 287-292.
Jean SS, Lee Ws Fau - Lam C, Lam C Fau - Hsu C-W, Hsu Cw Fau - Chen R-J, Chen Rj Fau - Hsueh P-R, Hsueh PR. Carbapenemase-producing Gram-nega- tive bacteria: current epidemics, antimicrobial sus- ceptibility and treatment options. Future Microbiol 2015;10:407-425.
Nordmann P, Naas T, Poirel L. Global spread of Car- bapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2011;17:1791-1798.
Carmeli Y, Akova M, Cornaglia G, Daikos GL, Ga- rau J, Harbarth S, et al. Controlling the spread of car- bapenemase-producing Gram-negatives: therapeutic approach and infection control. Clin Microbiol Infect 2010;16:102-11.
Falcone M, Mezzatesta ML, Perilli M, Forcella C, Giordano A, Cafiso V, et al. Infections with VIM-1 metallo-{beta}-lactamase-producing enterobacter clo- acae and their correlation with clinical outcome. J Clin Microbiol 2009;47(11):3514-9. Epub 2009/09/11.
Cornaglia G, Giamarellou H, Rossolini GM. Metal- lo-beta-lactamases: a last frontier for beta-lactams? Lancet Infect Dis 2011;11(5):381-393.
Docquier JD, Lamotte-Brasseur J, Galleni M, Am- icosante G, Frere JM, Rossolini GM. On functional and structural heterogeneity of VIM-type metallo-be- ta-lactamases. J Antimicrob Chemother 2003;51:257-66.
Psichogiou M, Tassios PT, Avlamis A, Stefanou I, Kos- midis C, Platsouka E, et al. Ongoing epidemic of blaVIM-1-positive Klebsiella pneumoniae in Athens, Greece: a prospective survey. J Antimicrob Chemother 2008;61(1):59-63.
Miriagou V, Tzelepi E, Daikos GL, Tassios PT, Tzouvelekis LS. Panresistance in VIM-1-producing Klebsiella pneumoniae. J Antimicrob Chemother.2005;55(5):810-1. Epub 2005/03/18.
Franklin R. Cockerill, Matthew A. Wikler, Jeff Alder, Michael N. Dudley. Methods for Dilution Antimicro- bial Susceptibility Tests for Bacteria That Grow Aero- bically; Approved Standard—Ninth Edition 2012.
Asthana S, Mathur P, Tak V. Detection of Carbapen- emase Production in Gram-negative Bacteria. J Lab Physicians 2014;6:69-75.
Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis. 2009;9(4):228-36. Epub 2009/03/28.
Rastegar Lari A, Azimi L, Rahbar M, Fallah F, Ala- ghehbandan R. Phenotypic detection of Klebsiella pneumoniae carbapenemase among burns patients: First report from Iran. Burns 2013;39:174-176.
Japoni-Nejad A, Ghaznavi-Rad E, van Belkum A.Characterization of Plasmid-Mediated AmpC and Carbapenemases among Iranain Nosocomial Isolates of Klebsiella pneumoniae Using Phenotyping and Ge- notyping Methods. Osong Public Health Res Perspect 2014;5:333-338.
Tzouvelekis LS, Markogiannakis A Fau - Psichogiou M, Psichogiou M Fau - Tassios PT, Tassios Pt Fau - Daikos GL, Daikos GL. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: an evolv- ing crisis of global dimensions. Clin Microbiol Rev 2012; 25: 682-707.
Nucleo E, Spalla M Fau - Piazza A, Piazza A Fau - Caltagirone MS, Caltagirone Ms Fau - Asticcioli S, Asticcioli S Fau - Debiaggi M, Debiaggi M Fau - Matti C, et al. Emergence of a VIM-1 MBL and CTX-M-15ESbL-producing Klebsiella pneumoniae clone from acute and rehabilitation hospitals in Italy. New Micro- biologica 2013; 36:279-282.
Giani T, Pini B Fau - Arena F, Arena F Fau - Conte V, Conte V Fau - Bracco S, Bracco S Fau - Migliavacca R, Migliavacca R, et al. Epidemic diffusion of KPC carbapenemase-producing Klebsiella pneumoniae in Italy: results of the first countrywide survey, 15 May to 30 June 2011.Eurosurveillance 2013: 18, LID - 20489 [pii]. (1560-7917 (Electronic)).
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Issue | Vol 7 No 2 (2015) | |
Section | Original Article(s) | |
Keywords | ||
Klebsiella pneumoniae metallo-beta-lactamases Imipenem-resistant bla(VIM-1)gene |
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