Analysis of carbapenemases genes of carbapenem-resistant Klebsiella pneumoniae isolated from Tehran heart center
-
Leyla Pourgholi
,
Hadi Farhadinia
,
Maryam Hosseindokht
,
Shayan Ziaee
,
Rahim Nosrati
,
Marjan Nosrati
,
Mohammadali Boroumand
Abstract
Background and Objectives: Emerging of carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the major concerns among healthcare systems. This study aimed to investigate the antibiotic susceptibility pattern and carbapenemase genes of carbapenemase-producing K. pneumoniae isolates obtained from Iranian hospitalized patients.
Materials and Methods: This study was performed on 71 CRKP strains isolated from different clinical specimens collected in Tehran Heart Center (Tehran, Iran). A Modified Hodge test (MHT) was done for the detection of carbapenemase-producing K. pneumoniae. The presence of blaKPC, blaVIM, blaIMP, blaNDM, and blaOXA-48-type carbapenemases was evaluated by the PCR method.
Results: We identified 8.82% (71/805) of K. pneumoniae isolates as CRKP by MHT test. The antibiotic susceptibility indicated that all isolates were resistant to imipenem, meropenem, cefotaxime, ceftazidime, cefepime, ceftriaxone, cephalothin, ciprofloxacin, and augmentin, and then mostly resistant to aztreonam, cefoxitin, gentamicin, and trimethoprim/sulfamethoxazole with 98.6%, 98.6%, 97.2%, and 94.4%, respectively. The lowest resistance was related to amikacin with 46.5% (33/71 isolates). The level of imipenem MIC for all carbapenem-resistant isolates was estimated ≥32 µg/mL. Among positive isolates for carbapenemase genes, the most frequent gene was blaOXA-48. It was found in 48 (67.6%) isolates followed by blaVIM in 28 (39.4%) isolates. blaIMP, blaNDM, and blaKPC genes were identified in 19 (26.8%), 13 (18.3%) and 5 (7.0%) isolates, respectively. These genes were not detected in nine isolates.
Conclusion: The relatively high frequency of some carbapenemase genes suggests major concern about the emergence of isolates containing carbapenem resistance genes as a potential health threat.
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2. Giani T, Pini B, Arena F, Conte V, Bracco S, 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. Euro Surveill 2013;18:20489.
3. Nicolau DP. Carbapenems: a potent class of antibiotics. Expert Opin Pharmacother 2008; 9: 23-37.
4. Vardakas KZ, Tansarli GS, Rafailidis PI, Falagas ME. Carbapenems versus alternative antibiotics for the treatment of bacteraemia due to Enterobacteriaceae producing extended-spectrum beta-lactamases: a systematic review and meta-analysis. J Antimicrob Chemother 2012;67:2793-2803.
5. Arnold RS, Thom KA, Sharma S, Phillips M, Johnson JK, Morgan DJ. Emergence of Klebsiella pneumoniae Carbapenemase (KPC)-Producing Bacteria. South Med J 2011;104:40-45.
6. Munoz-Price LS, Poirel L, Bonomo RA, Schwaber MJ, Daikos GL, Cormican M, et al. Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis 2013;13:785-796.
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8. Falagas ME, Tansarli GS, Karageorgopoulos DE, Vardakas KZ. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis 2014;20:1170-1175.
9. Correa L, Martino MD, Siqueira I, Pasternak J, Gales AC, Silva CV, et al. A hospital-based matched case-control study to identify clinical outcome and risk factors associated with carbapenem-resistant Klebsiella pneumoniae infection. BMC Infect Dis 2013;13:80.
10. Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA. Carbapenems: past, present, and future. Antimicrob Agents Chemother 2011;55:4943-4960.
11. Nordmann P, Poirel L, Dortet L. Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2012;18:1503-1507.
12. Patel G, Bonomo RA. "Stormy waters ahead": global emergence of carbapenemases. Front Microbiol 2013;4:48.
13. Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 2009;9:228-236.
14. Tzouvelekis LS, Markogiannakis A, Psichogiou M, Tassios PT, Daikos GL. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: an evolving crisis of global dimensions. Clin Microbiol Rev 2012;25:682-707.
15. Vasaikar S, Obi L, Morobe I, Bisi-Johnson M. Molecular characteristics and antibiotic resistance profiles of Klebsiella isolates in Mthatha, Eastern Cape province, South Africa. Int J Microbiol 2017;2017:8486742.
16. Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis 2011;70:119-123.
17. Poirel L, Naas T, Nordmann P. Diversity, epidemiology, and genetics of class D β-lactamases. Antimicrob Agents Chemother 2010;54:24-38.
18. Tsai YK, Fung CP, Lin JC, Chen JH, Chang FY, Chen TL, et al. Klebsiella pneumoniae outer membrane porins OmpK35 and OmpK36 play roles in both antimicrobial resistance and virulence. Antimicrob Agents Chemother 2011;55:1485-1493.
19. Zhang Y, Jiang X, Wang Y, Li G, Tian Y, Liu H, et al. Contribution of beta-lactamases and porin proteins OmpK35 and OmpK36 to carbapenem resistance in clinical isolates of KPC-2-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2014;58:1214-1217.
20. Park SO, Liu J, Furuya EY, Larson EL. Carbapenem-Resistant Klebsiella pneumoniae infection in three New York city hospitals trended downwards from 2006 to 2014. Open Forum Infect Dis 2016;3:ofw222.
21. Hrabák J, Chudáčkova E, Papagiannitsis CC. Detection of carbapenemases in Enterobacteriaceae: a challenge for diagnostic microbiological laboratories. Clin Microbiol Infect 2014;20:839-853.
22. Grimont PA, Grimont F (2015). Klebsiella. In: Bergey's Manual of Systematics of Archaea and Bacteria. Ed, Trujillo ME, Dedysh S, DeVos P, Hedlund B, Kämpfer P, Rainey FA, et al. John Wiley & Sons, Inc. pp. 1-26.
23. Gomez-Simmonds A, Nelson B, Eiras DP, Loo A, Jenkins SG, Whittier S, et al. Combination regimens for treatment of carbapenem-resistant Klebsiella pneumoniae bloodstream infections. Antimicrob Agents Chemother 2016; 60: 3601-3607.
24. Amjad A, Mirza I, Abbasi S, Farwa U, Malik N, Zia F. Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iran J Microbiol 2011;3:189-193.
25. Sepehriseresht S, Boroumand MA, Pourgholi L, Anvari MS, Habibi E, Tabrizi MS, et al. Emergence of mupirocin-resistant MRSA among Iranian clinical isolates. Comp Clin Path 2013;22:717-721.
26. Azimi L, Nordmann P, Lari AR, Bonnin RA. First report of OXA-48-producing Klebsiella pneumoniae strains in Iran. GMS Hyg Infect Control 2014;9:Doc07.
27. Farajzadeh Sheikh A, Rostami S, Jolodar A, Tabatabaiefar MA, Khorvash F, Saki A, et al. Detection of metallo-beta lactamases among carbapenem-resistant Pseudomonas aeruginosa. Jundishapur J Microbiol 2014;7(11):e12289.
28. Bina M, Pournajaf A, Mirkalantari S, Talebi M, Irajian G. Detection of the Klebsiella pneumoniae carbapenemase (KPC) in K. pneumoniae isolated from the clinical samples by the phenotypic and genotypic methods. Iran J Pathol 2015;10:199-205.
29. Haji Hashemi B, Farzanehkhah M, Dolatyar A, Imani M, Farzami M, Rahbar M, et al. A study on prevalence of KPC producing from Klebsiella pneumoniae using Modified Hodge Test and CHROMagar in Iran. Ann Biol Res 2012;3:5659-5664.
30. Hosseinzadeh Z, Ebrahim-Saraie HS, Sarvari J, Mardaneh J, Dehghani B, Rokni-Hosseini SMH, et al. Emerge of bla NDM-1 and bla OXA-48-like harboring carbapenem-resistant Klebsiella pneumoniae isolates from hospitalized patients in southwestern Iran. J Chin Med Assoc 2017;81:536-540.
31. Ribeiro VB, Linhares AR, Zavascki AP, Barth AL. Performance of quantification of modified Hodge Test: an evaluation with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae isolates. Biomed Res Int 2014;2014:139305.
32. Yamada K, Kashiwa M, Arai K, Nagano N, Saito R. Comparison of the Modified-Hodge test, Carba NP test, and carbapenem inactivation method as screening methods for carbapenemase-producing Enterobacteriaceae. J Microbiol Methods 2016;128:48-51.
33. Poirel L, Héritier C, Tolün V, Nordmann P. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrob Agents Chemother 2004;48:15-22.
34. Shibl A, Al-Agamy M, Memish Z, Senok A, Khader SA, Assiri A. The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis 2013;17(12):e1130-e1133.
35. Zeighami H, Haghi F, Hajiahmadi F. Molecular characterization of integrons in clinical isolates of betalactamase-producing Escherichia coli and Klebsiella pneumoniae in Iran. J Chemother 2015;27:145-151.
36. Ma L, Wang JT, Wu TL, Siu LK, Chuang YC, Lin JC, et al. Emergence of OXA-48-producing Klebsiella pneumoniae in Taiwan. PLoS One 2015;10(9):e0139152.
37. Oteo J, Hernández JM, Espasa M, Fleites A, Sáez D, Bautista V, et al. Emergence of OXA-48-producing Klebsiella pneumoniae and the novel carbapenemases OXA-244 and OXA-245 in Spain. J Antimicrob Chemother 2013;68:317-321.
38. Al-Zahrani IA, Alsiri BA. The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the southern (Asir) province, Saudi Arabia. Saudi Med J 2018;39:23-30.
39. Celikbilek N, Unaldi O, Kirca F, Gozalan A, Acikgoz ZC, Durmaz R. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae species isolated from a tertiary hospital, Ankara, Turkey. Jundishapur J Microbiol 2017;10(10):e14341.
40. Zowawi HM, Sartor AL, Balkhy HH, Walsh TR, Al Johani SM, AlJindan RY, et al. Molecular characterization of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in the countries of the Gulf cooperation council: dominance of OXA-48 and NDM producers. Antimicrob Agents Chemother 2014;58:3085-3090.
41. Farajzadeh Sheikh A, Momeni SZ, Aslani S, Jomehzadeh N. Prevalence of carbapenem-resistant Klebsiella pneumoniae in patients admitted to Taleghani hospital of Abadan during 2014-2015. Jundishapur Sci Med J 2015;14:209-221.
42. Sedighi M, Halajzadeh M, Ramazanzadeh R, Amirmozafari N, Heidary M, Pirouzi S. Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction. Rev Soc Bras Med Trop 2017;50:321-328.
43. Khorvash F, Yazdani MR, Soudi AA, Shabani S, Tavahen N. Prevalence of acquired carbapenemase genes in Klebsiella Pneumoniae by Multiplex PCR in Isfahan. Adv Biomed Res 2017;6:41.
44. Nobari S, Shahcheraghi F, Rahmati Ghezelgeh F, Valizadeh B. Molecular characterization of carbapenem-resistant strains of Klebsiella pneumoniae isolated from Iranian patients: first identification of blaKPC gene in Iran. Microb Drug Resist 2014;20:285-293.
45. Jamal W, Rotimi VO, Albert MJ, Khodakhast F, Udo EE, Poirel L. Emergence of nosocomial New Delhi metallo-β-lactamase-1 (NDM-1)-producing Klebsiella pneumoniae in patients admitted to a tertiary care hospital in Kuwait. Int J Antimicrob Agents 2012;39:183-184.
46. Shahcheraghi F, Nobari S, Rahmati Ghezelgeh F, Nasiri S, Owlia P, Nikbin VS, et al. First report of New Delhi metallo-beta-lactamase-1-producing Klebsiella pneumoniae in Iran. Microb Drug Resist 2013;19:30-36.
47. Fazeli H, Norouzi-Barough M, Ahadi AM, Shokri D, Solgi H. Detection of New Delhi Metallo-Beta-Lactamase-1 (NDM-1) in carbapenem-resistant Klebsiella pneumoniae isolated from a university hospital in Iran. Hippokratia 2015;19:205-209.
48. Firoozeh F, Mahluji Z, Shams E, Khorshidi A, Zibaei M. New Delhi metallo-β-lactamase-1-producing Klebsiella pneumoniae isolates in hospitalized patients in Kashan, Iran. Iran J Microbiol 2017;9:283-287.
49. Shoja S, Ansari M, Faridi F, Azad M, Davoodian P, Javadpour S, et al. Identification of carbapenem-resistant Klebsiella pneumoniae with emphasis on New Delhi Metallo-Beta-Lactamase-1 (blaNDM-1) in Bandar Abbas, south of Iran. Microb Drug Resist 2018;24:447-454.
2. Giani T, Pini B, Arena F, Conte V, Bracco S, 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. Euro Surveill 2013;18:20489.
3. Nicolau DP. Carbapenems: a potent class of antibiotics. Expert Opin Pharmacother 2008; 9: 23-37.
4. Vardakas KZ, Tansarli GS, Rafailidis PI, Falagas ME. Carbapenems versus alternative antibiotics for the treatment of bacteraemia due to Enterobacteriaceae producing extended-spectrum beta-lactamases: a systematic review and meta-analysis. J Antimicrob Chemother 2012;67:2793-2803.
5. Arnold RS, Thom KA, Sharma S, Phillips M, Johnson JK, Morgan DJ. Emergence of Klebsiella pneumoniae Carbapenemase (KPC)-Producing Bacteria. South Med J 2011;104:40-45.
6. Munoz-Price LS, Poirel L, Bonomo RA, Schwaber MJ, Daikos GL, Cormican M, et al. Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis 2013;13:785-796.
7. Amraie H, Shakib P, Rouhi S, Bakhshandeh N, Zamanzad B. Prevalence assessment of magA gene and antimicrobial susceptibility of Klebsiella pneumoniae isolated from clinical specimens in Shahrekord, Iran. Iran J Microbiol 2014;6:311-316.
8. Falagas ME, Tansarli GS, Karageorgopoulos DE, Vardakas KZ. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis 2014;20:1170-1175.
9. Correa L, Martino MD, Siqueira I, Pasternak J, Gales AC, Silva CV, et al. A hospital-based matched case-control study to identify clinical outcome and risk factors associated with carbapenem-resistant Klebsiella pneumoniae infection. BMC Infect Dis 2013;13:80.
10. Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA. Carbapenems: past, present, and future. Antimicrob Agents Chemother 2011;55:4943-4960.
11. Nordmann P, Poirel L, Dortet L. Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2012;18:1503-1507.
12. Patel G, Bonomo RA. "Stormy waters ahead": global emergence of carbapenemases. Front Microbiol 2013;4:48.
13. Nordmann P, Cuzon G, Naas T. The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria. Lancet Infect Dis 2009;9:228-236.
14. Tzouvelekis LS, Markogiannakis A, Psichogiou M, Tassios PT, Daikos GL. Carbapenemases in Klebsiella pneumoniae and other Enterobacteriaceae: an evolving crisis of global dimensions. Clin Microbiol Rev 2012;25:682-707.
15. Vasaikar S, Obi L, Morobe I, Bisi-Johnson M. Molecular characteristics and antibiotic resistance profiles of Klebsiella isolates in Mthatha, Eastern Cape province, South Africa. Int J Microbiol 2017;2017:8486742.
16. Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis 2011;70:119-123.
17. Poirel L, Naas T, Nordmann P. Diversity, epidemiology, and genetics of class D β-lactamases. Antimicrob Agents Chemother 2010;54:24-38.
18. Tsai YK, Fung CP, Lin JC, Chen JH, Chang FY, Chen TL, et al. Klebsiella pneumoniae outer membrane porins OmpK35 and OmpK36 play roles in both antimicrobial resistance and virulence. Antimicrob Agents Chemother 2011;55:1485-1493.
19. Zhang Y, Jiang X, Wang Y, Li G, Tian Y, Liu H, et al. Contribution of beta-lactamases and porin proteins OmpK35 and OmpK36 to carbapenem resistance in clinical isolates of KPC-2-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2014;58:1214-1217.
20. Park SO, Liu J, Furuya EY, Larson EL. Carbapenem-Resistant Klebsiella pneumoniae infection in three New York city hospitals trended downwards from 2006 to 2014. Open Forum Infect Dis 2016;3:ofw222.
21. Hrabák J, Chudáčkova E, Papagiannitsis CC. Detection of carbapenemases in Enterobacteriaceae: a challenge for diagnostic microbiological laboratories. Clin Microbiol Infect 2014;20:839-853.
22. Grimont PA, Grimont F (2015). Klebsiella. In: Bergey's Manual of Systematics of Archaea and Bacteria. Ed, Trujillo ME, Dedysh S, DeVos P, Hedlund B, Kämpfer P, Rainey FA, et al. John Wiley & Sons, Inc. pp. 1-26.
23. Gomez-Simmonds A, Nelson B, Eiras DP, Loo A, Jenkins SG, Whittier S, et al. Combination regimens for treatment of carbapenem-resistant Klebsiella pneumoniae bloodstream infections. Antimicrob Agents Chemother 2016; 60: 3601-3607.
24. Amjad A, Mirza I, Abbasi S, Farwa U, Malik N, Zia F. Modified Hodge test: A simple and effective test for detection of carbapenemase production. Iran J Microbiol 2011;3:189-193.
25. Sepehriseresht S, Boroumand MA, Pourgholi L, Anvari MS, Habibi E, Tabrizi MS, et al. Emergence of mupirocin-resistant MRSA among Iranian clinical isolates. Comp Clin Path 2013;22:717-721.
26. Azimi L, Nordmann P, Lari AR, Bonnin RA. First report of OXA-48-producing Klebsiella pneumoniae strains in Iran. GMS Hyg Infect Control 2014;9:Doc07.
27. Farajzadeh Sheikh A, Rostami S, Jolodar A, Tabatabaiefar MA, Khorvash F, Saki A, et al. Detection of metallo-beta lactamases among carbapenem-resistant Pseudomonas aeruginosa. Jundishapur J Microbiol 2014;7(11):e12289.
28. Bina M, Pournajaf A, Mirkalantari S, Talebi M, Irajian G. Detection of the Klebsiella pneumoniae carbapenemase (KPC) in K. pneumoniae isolated from the clinical samples by the phenotypic and genotypic methods. Iran J Pathol 2015;10:199-205.
29. Haji Hashemi B, Farzanehkhah M, Dolatyar A, Imani M, Farzami M, Rahbar M, et al. A study on prevalence of KPC producing from Klebsiella pneumoniae using Modified Hodge Test and CHROMagar in Iran. Ann Biol Res 2012;3:5659-5664.
30. Hosseinzadeh Z, Ebrahim-Saraie HS, Sarvari J, Mardaneh J, Dehghani B, Rokni-Hosseini SMH, et al. Emerge of bla NDM-1 and bla OXA-48-like harboring carbapenem-resistant Klebsiella pneumoniae isolates from hospitalized patients in southwestern Iran. J Chin Med Assoc 2017;81:536-540.
31. Ribeiro VB, Linhares AR, Zavascki AP, Barth AL. Performance of quantification of modified Hodge Test: an evaluation with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae isolates. Biomed Res Int 2014;2014:139305.
32. Yamada K, Kashiwa M, Arai K, Nagano N, Saito R. Comparison of the Modified-Hodge test, Carba NP test, and carbapenem inactivation method as screening methods for carbapenemase-producing Enterobacteriaceae. J Microbiol Methods 2016;128:48-51.
33. Poirel L, Héritier C, Tolün V, Nordmann P. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrob Agents Chemother 2004;48:15-22.
34. Shibl A, Al-Agamy M, Memish Z, Senok A, Khader SA, Assiri A. The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis 2013;17(12):e1130-e1133.
35. Zeighami H, Haghi F, Hajiahmadi F. Molecular characterization of integrons in clinical isolates of betalactamase-producing Escherichia coli and Klebsiella pneumoniae in Iran. J Chemother 2015;27:145-151.
36. Ma L, Wang JT, Wu TL, Siu LK, Chuang YC, Lin JC, et al. Emergence of OXA-48-producing Klebsiella pneumoniae in Taiwan. PLoS One 2015;10(9):e0139152.
37. Oteo J, Hernández JM, Espasa M, Fleites A, Sáez D, Bautista V, et al. Emergence of OXA-48-producing Klebsiella pneumoniae and the novel carbapenemases OXA-244 and OXA-245 in Spain. J Antimicrob Chemother 2013;68:317-321.
38. Al-Zahrani IA, Alsiri BA. The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the southern (Asir) province, Saudi Arabia. Saudi Med J 2018;39:23-30.
39. Celikbilek N, Unaldi O, Kirca F, Gozalan A, Acikgoz ZC, Durmaz R. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae species isolated from a tertiary hospital, Ankara, Turkey. Jundishapur J Microbiol 2017;10(10):e14341.
40. Zowawi HM, Sartor AL, Balkhy HH, Walsh TR, Al Johani SM, AlJindan RY, et al. Molecular characterization of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in the countries of the Gulf cooperation council: dominance of OXA-48 and NDM producers. Antimicrob Agents Chemother 2014;58:3085-3090.
41. Farajzadeh Sheikh A, Momeni SZ, Aslani S, Jomehzadeh N. Prevalence of carbapenem-resistant Klebsiella pneumoniae in patients admitted to Taleghani hospital of Abadan during 2014-2015. Jundishapur Sci Med J 2015;14:209-221.
42. Sedighi M, Halajzadeh M, Ramazanzadeh R, Amirmozafari N, Heidary M, Pirouzi S. Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction. Rev Soc Bras Med Trop 2017;50:321-328.
43. Khorvash F, Yazdani MR, Soudi AA, Shabani S, Tavahen N. Prevalence of acquired carbapenemase genes in Klebsiella Pneumoniae by Multiplex PCR in Isfahan. Adv Biomed Res 2017;6:41.
44. Nobari S, Shahcheraghi F, Rahmati Ghezelgeh F, Valizadeh B. Molecular characterization of carbapenem-resistant strains of Klebsiella pneumoniae isolated from Iranian patients: first identification of blaKPC gene in Iran. Microb Drug Resist 2014;20:285-293.
45. Jamal W, Rotimi VO, Albert MJ, Khodakhast F, Udo EE, Poirel L. Emergence of nosocomial New Delhi metallo-β-lactamase-1 (NDM-1)-producing Klebsiella pneumoniae in patients admitted to a tertiary care hospital in Kuwait. Int J Antimicrob Agents 2012;39:183-184.
46. Shahcheraghi F, Nobari S, Rahmati Ghezelgeh F, Nasiri S, Owlia P, Nikbin VS, et al. First report of New Delhi metallo-beta-lactamase-1-producing Klebsiella pneumoniae in Iran. Microb Drug Resist 2013;19:30-36.
47. Fazeli H, Norouzi-Barough M, Ahadi AM, Shokri D, Solgi H. Detection of New Delhi Metallo-Beta-Lactamase-1 (NDM-1) in carbapenem-resistant Klebsiella pneumoniae isolated from a university hospital in Iran. Hippokratia 2015;19:205-209.
48. Firoozeh F, Mahluji Z, Shams E, Khorshidi A, Zibaei M. New Delhi metallo-β-lactamase-1-producing Klebsiella pneumoniae isolates in hospitalized patients in Kashan, Iran. Iran J Microbiol 2017;9:283-287.
49. Shoja S, Ansari M, Faridi F, Azad M, Davoodian P, Javadpour S, et al. Identification of carbapenem-resistant Klebsiella pneumoniae with emphasis on New Delhi Metallo-Beta-Lactamase-1 (blaNDM-1) in Bandar Abbas, south of Iran. Microb Drug Resist 2018;24:447-454.
| Files | ||
| Issue | Vol 14 No 1 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v14i1.8799 | |
| Keywords | ||
| Carbapenem-resistance; Klebsiella pneumoniae; blaVIM; blaIMP; blaNDM; blaOXA-48 | ||
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How to Cite
1.
Pourgholi L, Farhadinia H, Hosseindokht M, Ziaee S, Nosrati R, Nosrati M, Boroumand M. Analysis of carbapenemases genes of carbapenem-resistant Klebsiella pneumoniae isolated from Tehran heart center. Iran J Microbiol. 2022;14(1):38-46.
