High prevalence of carbapenem resistance and clonal expansion of blaNDM gene in Klebsiella pneumoniae isolates in an Iranian referral pediatric hospital

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gut Pathogens Pub Date : 2024-03-28 DOI:10.1186/s13099-024-00611-1

Babak Pourakbari, Setareh Mamishi, Shiva Poormohammadi, Reihaneh Hosseinpour Sadeghi, Shima Mahmoudi

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引用次数: 0

Abstract

The increasing global concern regarding antibiotic resistance necessitates in-depth studies to comprehend the phenotypic and genotypic characteristics of resistant bacterial strains. This study aimed to investigate the prevalence, antibiotic resistance profiles, and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates in an Iranian referral pediatrics hospital. Methods: In this study, we examined CRKP isolates collected from hospitalized pediatric patients across various wards. The isolates underwent antimicrobial susceptibility testing, the polymerase chain reaction (PCR) analysis for carbapenemase genes (blaNDM, blaVIM and blaIMP), and genetic relatedness assessment using pulsed-field gel electrophoresis (PFGE). Among 166 K. pneumoniae isolates, 54 (32.5%) exhibited resistance to carbapenems. Notably, all these resistant isolates were resistant to imipenem, with 35 (65%) displaying resistance to both imipenem and meropenem. Of the 54 CRKP isolates, 24 (44%) were metallo-β-lactamases (MBL)-producing. The prevalence of the blaNDM gene among CKCP and MBL-producing isolates was 20% (n = 11) and 44% (n = 24), respectively. The blaVIM and blaIMP genes were not detected in any of the isolates. Twenty-six CRKP isolates (48%) were recovered from ICUs. PFGE analysis of CRKP isolates revealed 20 clusters, with cluster S being the most prevalent, comprising 24% of the total (n = 13). Our study reveals a concerning prevalence of carbapenem resistance in K. pneumoniae isolates. Specifically, the detection of the blaNDM gene in 20% of CRKP isolates, with a significant proportion (82%) observed in isolated CRKP from the ICUs and emergency departments, underscores the potential clonal expansion of these resistant strains within these critical hospital wards.

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伊朗一家儿科转诊医院分离出的肺炎克雷伯菌对碳青霉烯类抗生素的高耐药性和 blaNDM 基因的克隆扩增

全球对抗生素耐药性的关注与日俱增，因此有必要进行深入研究，以了解耐药菌株的表型和基因型特征。本研究旨在调查伊朗一家儿科转诊医院中耐碳青霉烯类抗生素肺炎克雷伯菌（CRKP）分离菌株的流行率、抗生素耐药性特征和分子特征。方法：在这项研究中，我们检测了从不同病房的住院儿科患者中采集的 CRKP 分离物。对分离株进行了抗菌药敏感性测试、碳青霉烯酶基因（blaNDM、blaVIM 和 blaIMP）聚合酶链反应（PCR）分析，并使用脉冲场凝胶电泳（PFGE）进行了遗传相关性评估。在 166 个肺炎克雷伯菌分离株中，有 54 个（32.5%）对碳青霉烯类产生耐药性。值得注意的是，所有这些耐药分离株都对亚胺培南耐药，其中 35 株（65%）同时对亚胺培南和美罗培南耐药。在 54 个 CRKP 分离物中，有 24 个（44%）产生金属-β-内酰胺酶（MBL）。在 CKCP 和产 MBL 的分离株中，blaNDM 基因的流行率分别为 20%（11 例）和 44%（24 例）。没有在任何分离物中检测到 blaVIM 和 blaIMP 基因。26 株 CRKP 分离物（48%）从重症监护病房中检出。CRKP 分离物的 PFGE 分析显示有 20 个群集，其中 S 群集最普遍，占总数的 24% （n = 13）。我们的研究揭示了肺炎克雷伯菌分离株对碳青霉烯类耐药的普遍性。特别是，在20%的CRKP分离株中检测到了blaNDM基因，而在重症监护室和急诊科分离出的CRKP中观察到的blaNDM基因占了相当大的比例（82%），这突显了这些耐药菌株在这些重症病房中的潜在克隆扩增。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gut Pathogens GASTROENTEROLOGY & HEPATOLOGY-MICROBIOLOGY

CiteScore

7.70

自引率

2.40%

发文量

期刊介绍： Gut Pathogens is a fast publishing, inclusive and prominent international journal which recognizes the need for a publishing platform uniquely tailored to reflect the full breadth of research in the biology and medicine of pathogens, commensals and functional microbiota of the gut. The journal publishes basic, clinical and cutting-edge research on all aspects of the above mentioned organisms including probiotic bacteria and yeasts and their products. The scope also covers the related ecology, molecular genetics, physiology and epidemiology of these microbes. The journal actively invites timely reports on the novel aspects of genomics, metagenomics, microbiota profiling and systems biology. Gut Pathogens will also consider, at the discretion of the editors, descriptive studies identifying a new genome sequence of a gut microbe or a series of related microbes (such as those obtained from new hosts, niches, settings, outbreaks and epidemics) and those obtained from single or multiple hosts at one or different time points (chronological evolution).