Dissemination pattern of multidrug resistant Carbapenemase Producing Klebsiella pneumoniae Isolates in Nemazee and Faghihi Referral hospitals in Shiraz, Southwestern Iran

Introduction and Objectives: K. pneumonia is one of the most important causes of health care associated infection. Carbapenemases have increasingly been reported in Enterobacteriaceae, especially in K. pneumonia. The objective of this study was to determine antibiotic resistance patterns, and molecular epidemiology of multi-drug resistant K. pneumoniae isolates obtained from hospitalized patients in Shiraz, Iran. Materials and Methods: In this study, 60 K. pneumonia isolates were collected from Nemazee and Faghihi referral hospitals. Antibiotic susceptibility testing and MIC were performed by disk diffusion test and E-test, respectively. Carbapenemases genes were identified by polymerase chain reaction and sequencing. Then, clonal relationships were analyzed using PFGE. Result: 33 out of 60 K. pneumonia isolates were resistant to carbapenems. Among the isolates, 86.6% were MDR (Multi Drug Resistant). Polymyxin B (18.3%) and tigecycline (23.3%) was shown to be the most active agent against K. pneumonia isolates. In our study, the high prevalence of blaNDM (45%) and blaOXA48 (10%) was detected. PFGE analysis showed 11 clusters and 45 pulsotypes (PTs) based on an 80% similarity level. Conclusion: The results of this study revealed that the carbapenemase genes are often located on the plasmids, so it may be the reason of the spread of them. Also, PFGE analysis showed that there we similar genetic patterns among K. pneumonia isolates and these patterns were responsible for dissemination of infection in hospitals.

کلیدواژه ها:

Klebsiella pneumonia ، pulsed field gel electrophoresis (PFGE) ، Carbapenemases.