Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

The Occurrence of blaCTX-M-15 extended-spectrum β-lactamase Among Clinical Isolates of Klebsiella pneumoniae in Khorramabad, Iran

Author(s): Gholamreza Goudarzi and Pegah Shakib*

Volume 20, Issue 4, 2020

Page: [506 - 510] Pages: 5

DOI: 10.2174/1871526519666191119122059

Price: $65

conference banner
Abstract

Objective: During the recent decade, CTX-M-type enzymes, primarily CTX-M-15 extended- spectrum β-lactamase (ESBL) have strikingly developed throughout the world. The objective of this study was to investigate the frequency of CTX-M-type β-lactamases, as well as blaCTXM- 15 among Klebsiella pneumoniae isolates in Khorramabad, Iran.

Methods: In this cross-sectional study, 60 isolates of K. pneumoniae were collected from selected teaching hospitals in Khorramabad, Iran. ESBLs producing isolates were identified using phenotypic double-disk synergy test. The presence of blaCTX-M-types, as well as blaCTX-M-15 gene, were investigated by PCR method.

Results: While the highest resistance rates of isolates were found to nalidixic acid (65%) and trimethoprim/sulfamethoxazole (60%) antibiotics, the least resistance was to imipenem (15%). Moreover, 31(51.7%) isolates were resistant to at least three classes of antibiotics and designated as multidrug resistance (MDR). Fifty-two (86.7%) of 60 isolates were ESBLs positive. Thirty-five (58.3%) isolates harbored CTX-M-type β-lactamases, and also 29 (48.3%) isolates carried blaCTX-M-15.

Conclusions: This study presents the first report on the frequency of blaCTX-M-15 in the west of Iran, so that our results showed ESBL of CTX-M-15 may partly account for hydrolyzing thirdgeneration cephalosporins.

Keywords: Extended-spectrum β-lactamase, Klebsiella pneumoniae, blaCTX-M-15, clinical isolates, cephalosporins, CTX-M-15.

[1]
Navon-Venezia, S.; Kondratyeva, K.; Carattoli, A. Klebsiella pneumoniae: a major worldwide source and shuttle for antibiotic resistance. FEMS Microbiol. Rev., 2017, 41(3), 252-275.
[http://dx.doi.org/10.1093/femsre/fux013] [PMID: 28521338]
[2]
Martin, R.M.; Bachman, M.A. Colonization, Infection, and the Accessory Genome of Klebsiella pneumoniae. Front. Cell. Infect. Microbiol., 2018, 8, 4.
[http://dx.doi.org/10.3389/fcimb.2018.00004] [PMID: 29404282]
[3]
Fallah, F.; Taherpour, A.; Hakemi Vala, M.; Hashemi, A. Global spread of New Delhi metallo-beta-lactamase-1 (NDM-1). Iran. J. Clin. Infect. Dis., 2011, 6(4), 171-177.
[4]
Seki, L.M.; Pereira, P.S.; de Souza Conceição, M.; Souza, M.J.; Marques, E.A.; Carballido, J.M.; de Carvalho, M.E.; Assef, A.P.; Asensi, M.D. Molecular epidemiology of CTX-M producing Enterobacteriaceae isolated from bloodstream infections in Rio de Janeiro, Brazil: emergence of CTX-M-15. Braz. J. Infect. Dis., 2013, 17(6), 640-646.
[http://dx.doi.org/10.1016/j.bjid.2013.03.012] [PMID: 24055309]
[5]
Bush, K.; Jacoby, G.A. Updated functional classification of β-lactamases. Antimicrob. Agents Chemother., 2010, 54(3), 969-976.
[http://dx.doi.org/10.1128/AAC.01009-09] [PMID: 19995920]
[6]
Rahman, s; Ali, T; Ali, I The Growing Genetic and Functional Diversity of Extended Spectrum Beta-Lactamases. BioMed Res. Int., 2018. 9519718
[7]
Barrios, H.; Garza-Ramos, U.; Mejia-Miranda, I.; Reyna-Flores, F.; Sánchez-Pérez, A.; Mosqueda-García, D.; Silva-Sanchez, J. Bacterial Resistance Consortium. ESBL-producing Escherichia coli and Klebsiella pneumoniae: The most prevalent clinical isolates obtained between 2005 and 2012 in Mexico. J. Glob. Antimicrob. Resist., 2017, 10, 243-246.
[http://dx.doi.org/10.1016/j.jgar.2017.06.008] [PMID: 28739224]
[8]
Bradford, P.A. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin. Microbiol. Rev., 2001, 14(4), 933-951.
[http://dx.doi.org/10.1128/CMR.14.4.933-951.2001] [PMID: 11585791]
[9]
Rossolini, G.M.; D’Andrea, M.M.; Mugnaioli, C. The spread of CTX-M-type extended-spectrum β-lactamases. Clin. Microbiol. Infect., 2008, 14(Suppl. 1), 33-41.
[http://dx.doi.org/10.1111/j.1469-0691.2007.01867.x] [PMID: 18154526]
[10]
Livermore, D.M.; Canton, R.; Gniadkowski, M.; Nordmann, P.; Rossolini, G.M.; Arlet, G.; Ayala, J.; Coque, T.M.; Kern-Zdanowicz, I.; Luzzaro, F.; Poirel, L.; Woodford, N. CTX-M: changing the face of ESBLs in Europe. J. Antimicrob. Chemother., 2007, 59(2), 165-174.
[http://dx.doi.org/10.1093/jac/dkl483] [PMID: 17158117]
[11]
Nogueira, Kda. S.; Conte, D.; Maia, F.V.; Dalla-Costa, L.M. Distribution of extended-spectrum β-lactamase types in a Brazilian tertiary hospital. Rev. Soc. Bras. Med. Trop., 2015, 48(2), 162-169.
[http://dx.doi.org/10.1590/0037-8682-0009-2015] [PMID: 25992930]
[12]
Cantón, R.; Coque, T.M. The CTX-M β-lactamase pandemic. Curr. Opin. Microbiol., 2006, 9(5), 466-475.
[http://dx.doi.org/10.1016/j.mib.2006.08.011] [PMID: 16942899]
[13]
Olson, A.B.; Silverman, M.; Boyd, D.A.; McGeer, A.; Willey, B.M.; Pong-Porter, V.; Daneman, N.; Mulvey, M.R. Identification of a progenitor of the CTX-M-9 group of extended-spectrum beta-lactamases from Kluyvera georgiana isolated in Guyana. Antimicrob. Agents Chemother., 2005, 49(5), 2112-2115.
[http://dx.doi.org/10.1128/AAC.49.5.2112-2115.2005] [PMID: 15855541]
[14]
Walker, K.E.; Mahon, C.R.; Lehman, D.C.; Manuselis, G. Enterobacteriaceae. In: Textbook of Diagnostic Microbiology, 5th ed; Mahon, C.R.; Lehman, DC.; Manuselis, G., Eds.; Saunders, Elsevier: Maryland Heights, Missouri; , 2015; pp. 420-454.
[15]
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; (M 100S); Clinical and Laboratory Standards Institute: Wayne, PA, 2016.
[16]
Ghasemi, Y.; Archin, T.; Kargar, M.; Mohkam, M. A simple multiplex PCR for assessing prevalence of extended-spectrum β-lactamases producing Klebsiella pneumoniae in Intensive Care Units of a referral hospital in Shiraz, Iran. Asian Pac. J. Trop. Med., 2013, 6(9), 703-708.
[http://dx.doi.org/10.1016/S1995-7645(13)60122-4] [PMID: 23827147]
[17]
Mendonça, N.; Louro, D.; Castro, A.P.; Diogo, J.; Caniça, M. CTX-M-15, OXA-30 and TEM-1-producing Escherichia coli in two Portuguese regions. J. Antimicrob. Chemother., 2006, 57(5), 1014-1016.
[http://dx.doi.org/10.1093/jac/dkl062] [PMID: 16531434]
[18]
Coque, T.M.; Baquero, F.; Canton, R. Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill., 2008, 13(47), 19044.
[PMID: 19021958]
[19]
Demirdag, K.; Hosoglu, S. Epidemiology and risk factors for ESBL-producing Klebsiella pneumoniae: a case control study. J. Infect. Dev. Ctries., 2010, 4(11), 717-722.
[http://dx.doi.org/10.3855/jidc.778] [PMID: 21252449]
[20]
Bevan, E.R.; Jones, A.M.; Hawkey, P.M. Global epidemiology of CTX-M β-lactamases: temporal and geographical shifts in genotype. J. Antimicrob. Chemother., 2017, 72(8), 2145-2155.
[http://dx.doi.org/10.1093/jac/dkx146] [PMID: 28541467]
[21]
Bedenić, B.; Vraneš, J.; Bošnjak, Z.; Marijan, T.; Mlinarić-Džepina, A.; Kukovec, T. Emergence of CTX-M group 1 ESBL– producing Klebsiella pneumoniae strains in the communityIn: Medicinski glasnik Ljekarske komore Zeničko-dobojskog kantona; ; , 2010, 7, p. (1)32.
[22]
Vranic-Ladavac, M.; Bosnjak, Z.; Beader, N.; Barisic, N.; Kalenic, S.; Bedenic, B. Clonal spread of CTX-M-15-producing Klebsiella pneumoniae in a Croatian hospital. J. Med. Microbiol., 2010, 59(Pt 9), 1069-1078.
[http://dx.doi.org/10.1099/jmm.0.019778-0] [PMID: 20576749]
[23]
Amin, A.; Ghumro, P.B.; Hussain, S.; Hameed, A. Prevalence of antibiotic resistance among clinical isolates of Klebsiella pneumoniae isolated from a Tertiary Care Hospital in Paki-stan. Malays. J. Microbiol., 2009, 5(2), 81-86.
[24]
Al Shara, M.A. Emerging antimicrobial resistance of klebsiella pneumonia strains isolated from pediatric patients in jordan. New Iraqi J. Med., 2011, 7(2), 29-32.
[25]
Soltan Dalal, M.M.; Miremadi, S.A.; Sharify Yazdi, M.K.; Rastegar Lari, A.; Rajabi, Z.; Avadis Yans, S. Antimicrobial resistance trends of Klebsiella spp. isolated from patients in Imam Khomeini hospital. Journal of Payavard Salamat., 2012, 6(4), 275-281.
[26]
Mirsalehian, A.; Akbari-Nakhjavani, F.; Peymani, A.; Kazemi, B.; Jabal Ameli, F.; Mirafshar, S.M. Prevalence of extended spectrum β-lactamase-producing Enterobacteriaceae by phe-notypic and genotypic methods in intensive care units in Teh-ran, Iran. Daru, 2008, 16(3), 169-173.
[27]
Lahlaoui, H.; Ben Haj Khalifa, A.; Ben Moussa, M. Epidemiology of Enterobacteriaceae producing CTX-M type extended spectrum β-lactamase (ESBL). Med. Mal. Infect., 2014, 44(9), 400-404.
[http://dx.doi.org/10.1016/j.medmal.2014.03.010] [PMID: 25234380]
[28]
Kiratisin, P.; Apisarnthanarak, A.; Laesripa, C.; Saifon, P. Molecular characterization and epidemiology of extended-spectrum-β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates causing health care-associated infection in Thailand, where the CTX-M family is endemic. Antimicrob. Agents Chemother., 2008, 52(8), 2818-2824.
[http://dx.doi.org/10.1128/AAC.00171-08] [PMID: 18505851]
[29]
Ensor, V.M.; Jamal, W.; Rotimi, V.O.; Evans, J.T.; Hawkey, P.M. Predominance of CTX-M-15 extended spectrum β-lactamases in diverse Escherichia coli and Klebsiella pneumoniae from hospital and community patients in Kuwait. Int. J. Antimicrob. Agents, 2009, 33(5), 487-489.
[http://dx.doi.org/10.1016/j.ijantimicag.2008.10.011] [PMID: 19097760]
[30]
Peerayeh, S.N.; Rostami, E.; Siadat, S.D.; Derakhshan, S. High rate of aminoglycoside resistance in CTX-M-15 producing Klebsiella pneumoniae isolates in Tehran, Iran. Lab. Med., 2014, 45(3), 231-237.
[http://dx.doi.org/10.1309/LMDQQW246NYAHHAD] [PMID: 25051075]
[31]
Eckert, C.; Gautier, V.; Arlet, G. DNA sequence analysis of the genetic environment of various blaCTX-M genes. J. Antimicrob. Chemother., 2006, 57(1), 14-23.
[http://dx.doi.org/10.1093/jac/dki398] [PMID: 16291869]
[32]
Coelho, A.; González-López, J.J.; Miró, E.; Alonso-Tarrés, C.; Mirelis, B.; Larrosa, M.N.; Bartolomé, R.M.; Andreu, A.; Navarro, F.; Johnson, J.R.; Prats, G. Characterisation of the CTX-M-15-encoding gene in Klebsiella pneumoniae strains from the Barcelona metropolitan area: plasmid diversity and chromosomal integration. Int. J. Antimicrob. Agents, 2010, 36(1), 73-78.
[http://dx.doi.org/10.1016/j.ijantimicag.2010.03.005] [PMID: 20392607]
[33]
Lee, M.Y.; Ko, K.S.; Kang, C-I.; Chung, D.R.; Peck, K.R.; Song, JH. High prevalence of CTX-M-15-producing Klebsiella pneumoniae isolates in Asian countries: diverse clones and clonal dissemination. Int. J. Antimicrob. Agents, 2011, 38(2), 160-163.
[http://dx.doi.org/10.1016/j.ijantimicag.2011.03.020] [PMID: 21605960]
[34]
Chen, L.F.; Freeman, J.T.; Nicholson, B.; Keiger, A.; Lancaster, S.; Joyce, M.; Woods, C.W.; Cook, E.; Adcock, L.; Louis, S.; Cromer, A.L.; Sexton, D.J.; Anderson, D.J. Widespread dissemination of CTX-M-15 genotype extended-spectrum-β-lactamase-producing enterobacteriaceae among patients presenting to community hospitals in the southeastern United States. Antimicrob. Agents Chemother., 2014, 58(2), 1200-1202.
[http://dx.doi.org/10.1128/AAC.01099-13] [PMID: 24247126]
[35]
Sidjabat, H.E.; Paterson, D.L.; Adams-Haduch, J.M.; Ewan, L.; Pasculle, A.W.; Muto, C.A.; Tian, G.B.; Doi, Y. Molecular epidemiology of CTX-M-producing Escherichia coli isolates at a tertiary medical center in western Pennsylvania. Antimicrob. Agents Chemother., 2009, 53(11), 4733-4739.
[http://dx.doi.org/10.1128/AAC.00533-09] [PMID: 19687234]
[36]
Nogueira, Kda. S.; Paganini, M.C.; Conte, A.; Cogo, L.L.; Taborda de Messias Reason, I.; da Silva, M.J.; Dalla-Costa, L.M. Emergence of extended-spectrum β-lactamase producing Enterobacter spp. in patients with bacteremia in a tertiary hospital in southern Brazil. Enferm. Infecc. Microbiol. Clin., 2014, 32(2), 87-92.
[http://dx.doi.org/10.1016/j.eimc.2013.02.004] [PMID: 23587705]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy