Evaluation and Identification of Carbapenem Resistant Klebsiella pneumoniae Isolated from Hospitalized Patients in Qom City, (Iran)

Abstract

Background and Objectives: Klebsiella pneumonia is a facultative anaerobe bacterium from enterobacteriaceae family, which causes a wide range of diseases, such as urinary tract infections, cystitis, pneumonia, surgical wounds infections, infectious endocarditis, and diffused infections, especially in patients with HIV infection and immunosuppression. The aim of this study was to identify carbapenem resistance genes in K. pneumonia strains isolated from hospitalized patients in Qom city. Methods: In this cross-sectional study, using phenotypic methods, such as DDST and Modified Hodge Test, 79 carbapenem resistant isolates were identified and presence of resistance related genes, including IMP, VIM, NDM, OXA-48 and KPC, was investigated by molecular methods, such as PCR. Relation between the results of phenotypic and PCR methods, was determined using Chi squared test. Results: In this study, 69 isolates had IMP, VIM, NDM, OXA-48, and KPC genes, which the highest carbapenem resistant isolates were urinary strains and the lowest resistant was from cerebrospinal fluid samples. The most frequent isolated gene was VIM with 66.66% frequency, and KPC and NDM genes had lowest frequency with of 7.24%. One isolate contained all studied genes. Conclusion: Considering drug-resistant infections cause failure of treatment, especially higher mortality rate in patients in the intensive care unit, thus, the need for a codified program for screening and reporting ESBL strains is necessary for the assessment and monitoring the treatment, as well as determining an effective guidelines for treatment of resistant infections.

Keywords

• klebsiella pneumoniae
• carbapenem
• carbapenem resistance