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Klebsiella pneumoniae carbapenemase production among K. pneumoniae isolates and its concern on antibiotic susceptibility

  • Azam Shahi
  • , Alka Hasani
  • , Mohammad Ahangarzadeh Rezaee
  • , Mohammad Asghari Jafarabadi
  • , Akbar Hasani
  • , Hossein Samadi Kafil
  • , Mohammad Yosef Memar
  • , Elgar Soltani

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The emergence of Klebsiella pneumo-niae carbapenemase (KPC) resistance has led to the countdown of activity of carbapen-ems, which were considered as drugs of last resort for infections caused by Enterobacteriaceae. The aims of the present study were the detection of KPC-production among K. pneumoniae isolates, select the appropriate method for its detection and assess the consequence of KPC production on the antibiotics susceptibility. One hundred and four non-duplicated K. pneumoniae iso-lates were collected from University teach-ing hospitals of Tabriz, Iran. The disk diffu-sion, E-test, and Modified Hodge test were performed for the determination of antibiotic susceptibility pattern, Minimum Inhibitory Concentrations (MICs) determination and the production of carbapenemase, respec-tively. Bla KPC-2 gene was detected by using PCR. High levels of resistance were observed towards co-trimoxazole (69.2%), followed by cefazolin (66.3%), ceftriaxone (65.4%), ofloxacin and ciprofloxacin (54.8%), gentamicin (50%), and amikacin (39.4%). According to the disk diffusion method, the frequency of imipenem and meropenem resistance was 31.7% and 32.7%, respectively. Colistin was the most effective antibiotic among panels of antibi-otics tested. Imipenem MICs range, MIC 50 and MIC 90 were 0.19-32 µg/ml, 4µg/ml, and 16µg/ml, respectively. Modified Hodge test was positive in 24 (63.2%) isolate however, bla KPC-2 gene was detected in 8 (21.1%) car-bapenem-resistant isolates. Results of the present study revealed a high rate of car-bapenem-resistance in K. pneumoniae by phenotypic method, however the presence of one of the molecular, namely bla KPC-2 was not found as predominant cause. Therefore, their reliable detection should be the first priority to combat the infections. Being a simple test, the imipenem disk diffusion could be consid-ered as an appropriate method for the detec-tion of carbapenem-resistant isolates in the routine diagnosis.

Original languageEnglish
Article number7587
Number of pages4
JournalMicrobiology Research
Volume10
Issue number1
DOIs
Publication statusPublished - 29 Jan 2019
Externally publishedYes

Keywords

  • BlaKPC2
  • Carbapenemase
  • Klebsiella pneumoniae
  • Modified Hodge test

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