Molecular Study of Extended Spectrum -Lactamases Genes (Blashv, Blactxm) in Klebsiella Pneumoniae Isolated from Patients Infected with Pneumonia
Keywords:
Klebsiella pneumonia; -lactamases genes; PneumoniaAbstract
This study aimed for isolation and identification of Klebsiella pneumoniae from clinical samples and detection the prevalence of some extended spectrum -lactamases (ESBLs) genes (bla^y, blacm-M) in pneumoniae Samples collected were clinical respiratory tract infections. A total of 210 sputum specimens during the period from December 2018 to February. Growth on blood agar, MacConkey agar was identified by cultural, morphological and biochemical tests which revealed that: 62 210 (51.66%) gave positive growth for K pneumoniae. All the 62 isolates of K. pneumoniae were screened for their antibiotic resistance against 21 antibiotics of different classes using disk diffusion method. The results showed that all the tested isolates were resistant to at least 6 antibiotics of which they were tested, hence the isolates were considered to be multidrug resistant. The results showed that all of the isolates were found to be resistant to -lactam antibiotic (amoxicillin-clavulanate acid) Disk approximation test and not production of ESBLs by these isolates. All the 62 isolates were submitted to molecular detection of some ESBLsgenes (bias™, W^cix-m) using PCR technique. The results showed that only 8(12.90%) isolates were carried blacrx-M gene and 7(11.29%) isolates were carried Wdwgene.
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References
Paczosa MK, Mecsas J. Klebsiella pneumoniae: Going on the Offense
with a Strong Defense. Microbiol Mol Biol Rev. 2016;80(3):629-
Published 2016 Jun 15. doi:10.1128/MMBR.00078-15
Shaikh S, Fatima J, Shakil S, Rizvi SM, Kamal MA. Antibiotic resistance
and extended spectrum beta-lactamases: Types, epidemiology and
treatment. Saudi J Biol Sei. 2015;22(l):90-101.
doi:10.1016/j.sjbs.2O14.08.002
Ferreira RL, da Silva BCM, Rezende GS, Nakamura-Silva R, PitondoSilva A, Campanini EB, Brito MCA, da Silva EML, Freire CCM,
Cunha AF and Pranchevicius MC (2019) High Prevalence of
Multidrug-Resistant Klebsiella pneumoniae Harboring Several
Virulence and P-Lactamase Encoding Genes in a Brazilian Intensive
Care Unit. Front. Microbiol. 9:3198. doi: 10.3389/fmicb.2018.03198
Pishtiwan AH, Khadija KM. Prevalence of blaTEM, blaSHV, and
blaCTX-M Genes among ESBL-Producing Klebsiella pneumoniae
and Escherichia coli Isolated from Thalassemia Patients in Erbil,
Iraq. Mediterr J Hematol Infect Dis. 2019;ll(l):e2019041.
Published 2019 Jul 1. doi:10.4084/MJHID.2019.041
Collee, J.G.; Marmion, B.P.; Fraser, A.G. and Simmons, A.
(1996).Mackie and McCartney Practical Medical Microbiology. (14
ed.) Churchill Livingstone, New York, pp: 263-298
MacFaddin, J.F. (2000). Biochemical tests for identification of medical
bacteria. (3rd edition).The Williams and Wilkins-Baltimor.USA.
Thairu Y, Nasir IA, Usman Y. Laboratory perspective of gram staining
and its significance in investigations of infectious diseases. SubSaharan Afr J Med 2014;1:168-74
Koneman, E.W.; Allen, S.D.; Janda, W.M.; Schreckenberger, P.C. and
Winn, W.C. (1994). The Enterobacteriaceae.In: Koneman, E.W.;
Allen, S.D.; Janda, W.M.; Schreckenberger, P.C. and Winn, W.C.
Introduction to diagnostic microbiology. Philadelphia: JB.
Lippincott; P.63.
Moges F, Eshetie S, Abebe W, et al. High prevalence of extendedspectrum beta-lactamase-producing Gram-negative pathogens
from patients attending Felege Hiwot Comprehensive Specialized
Hospital, Bahir Dar, Amhara region. PLoS One.
;14(4):e0215177. Published 2019 Apr 15.
doi:10.1371/journal.pone.0215177
Vishwanath S, Chawla K, Gopinathan A. Multidrug resistant Gram¬
negative bacilli in lower respiratory tract infections. Iran J
Microbiol. 2013;5(4):323-327.
Moradigaravand D, Martin V, Peacock SJ, Parkhill J. Population structure of
multidrumoradg resistant Klebsiella oxytoca within hospitals across the UK
and Ireland identifies sharing of virulence and resistance genes with K.
pneumoniae [published online ahead of print, 2017 Feb 8]. Genome Biol
Evol. 2017;9(3):574-584. doi:10.1093/gbe/evx019
Wasfi R, Elkhatib WF, Ashour HM. Molecular typing and virulence
analysis of multidrug resistant Klebsiella pneumoniae clinical
isolates recovered from Egyptian hospitals. Sci Rep. 2016;6:38929.
Published 2016 Dec 22. doi:10.1038/srep38929
Tamr Basaranoglu S, Ozsurekci Y, Aykac K, et al. A comparison of
blood stream infections with extended spectrum beta-lactamaseproducing and non-producing Klebsiella pneumoniae in pediatric
patients. Itai J Pediatr. 2017;43(l):79. Published 2017 Sep 12.
doi:10.1186/s13052-017-0398-0
Mahdi Yahya Mohsen S, Hamzah HA, Muhammad Imad Al-Deen M,
Baharudin R. Antimicrobial Susceptibility of Klebsiella pneumoniae
and Escherichia coli with Extended-Spectrum P-lactamase
associated Genes in Hospital Tengku Ampuan Afzan, Kuantan,
Pahang. Malays J Med Sci. 2016;23(2):14-20.
Martin RM, Bachman MA. Colonization, Infection, and the Accessory
Genome of Klebsiella pneumoniae. Front Cell Infect Microbiol.
;8:4. Published 2018 Jan 22. doi:10.3389/fcimb.2018.00004
Apondi OE, oduor oc, gye bk, kipkoech mk. high prevalence of multi¬
drug resistant klebsiella pneumoniae in a tertiary teaching hospital
in western kenya. afr j infect dis. 2016;10(2):89-95. published 2016
may 1. doi:10.21010/ajid.vl0i2.3
Moini AS, Soltani B, Taghavi Ardakani A, et al. Multidrug-Resistant
Escherichia coli and Klebsiella pneumoniae Isolated From Patients
in Kashan, Iran. Jundishapur J Microbiol. 2015;8(10):e27517.
Published 2015 Oct 25. doi:10.5812/jjm.27517
Koneman, E.W.; Allen, S.D.; Janda, W.M.; Schreckenberger, P.C. and Winn,
W.C. (1994). The EnterobacteriaceaeJn: Koneman, E.W.; Allen, S.D.;
Janda, WM.; Schreckenberger, P.C. and Winn, W.C. Introduction to
diagnostic microbiology. Philadelphia:JB. Lippincott; P.63.
Bharti, A. and. Arora, D.R. (2008). Practical Microbiology, Maharagja
Agrasen Medical Collage, Agroha, Hisar, Haryana (India). ISBN:
-81-239-1595-1.
Al-Mussawi Abdulameer Abdullah. (2015). Detection of Extended
Spectrum Beta Lactamase (ESBL) Producing Klebsiella pneumoniae
Associated with Tuberculosis Suspected Patients in Basra
Governorate, South of Iraq American Journal of Microbiological
Research3(2): 59-61.
Yayan J, Ghebremedhin B, Rasche K. No carbapenem resistance in
pneumonia caused by Klebsiella species. Medicine (Baltimore).
;94(6):e527. doi:10.1097/MD.0000000000000527
Clinical and Laboratory Standards Institute (CLSI). (2018)
“Performance standards for Antimicrobial Susceptibility Testing,
Twenty-fourth informational supplement. CLSI document, Ml GO-
,Wayne, Pennsylvania,34(1):1-226.
Mansury D, Motamedifar M, Sarvari J, Shirazi B, Khaledi A. Antibiotic
susceptibility pattern and identification of extended spectrum Plactamases (ESBLs) in clinical isolates of Klebsiella pneumoniae
from Shiraz, Iran. Iran J Microbiol. 2016;8(1):55-61.
Stock, I. and Widemann, B. (2001). Natural antibiotic susceptibility of
Klebsiella pneumoniae, K. oxyotoca, K. planticola, K.
ornithinolytica and K. terrigena strains. J. Med. Microbiol. 50: 396-
Bi W, Liu H, Dunstan RA, et al. Extensively Drug-Resistant Klebsiella
pneumoniae Causing Nosocomial Bloodstream Infections in China:
Molecular Investigation of Antibiotic Resistance Determinants,
Informing Therapy, and Clinical Outcomes. Front Microbiol.
;8:1230. Published 2017 Jun 30. doi:10.3389/fmicb.2017.01230
Rawat D, Nair D. Extended-spectrum p-lactamases in Gram Negative
Bacteria. J Glob Infect Dis. 2010;2(3):263-274. doi:10.4103/0974-
X.68531
Iroha, I.R.; Ezeifeka, G.O.; Amadei, E.S. and Umerzurike, C.R. (2009).
Occurance of extended spectrum beta lactamase producing resistant
Escherichia coli and Klebsiella pneumoniae in clinical isolates and
associated risk factors. Res J Biol.21:22-43.
McWilliams CS, Condon S, Schwartz RM, Ginocchio CC. Incidence of
extended-spectrum-P-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates that test susceptible to
cephalosporins and aztreonam by the revised CLSI breakpoints. J
Clin Microbiol. 2014;52(7):2653-2655. doi:10.1128/JCM.03613-13
Bonnet, R.; Recule, C. ; Baraduc, R.; Chanal, C. ; Sirot, D. ; Champs, C.
D. and Sirot , J. (2003). Effect of D240G substitution in a novel
ESBL CTX-M-27. J Antimicrobial Chemother. 52: 29-35.
Lin WP, Wang JT, Chang SC, et al. The Antimicrobial Susceptibility of
Klebsiella pneumoniae from Community Settings in Taiwan, a
Trend Analysis. Sci Rep. 2016;6:36280. Published 2016 Nov 8.
doi:10.1038/srep36280
Pai H.; Seo, M. R. and Choi, T. Y. (2012). Association of QnrB
Determinants and Production of Extended-Spectrum P-Lactamase
or Plasmid-Mediated AmpC P- Lactamase in Clinical Isolates of
Klebsiella pneumoniae. Antimi crobial Agents and Chemotherapy.
:366-368.
Kariuki S, Dougan G. Antibacterial resistance in sub-Saharan Africa: an
underestimated emergency. Ann N Y Acad Sci. 2014;1323(1):43-55.
doi:l0.1111/nyas.l2380
Chandel DS, Johnson JA, Chaudhry R, et al. Extended-spectrum betalactamase-producing Gram-negative bacteria causing neonatal
sepsis in India in rural and urban settings. J Med Microbiol.
;60(Pt 4):500-507. doi:10.1099/jmm.0.027375-0
Li, B., Li, M., Qu, L., Wang, M., and Guo, J. (2014). Prevalence and
characteristics of extended-spectrum beta-lactamase-producing
Klebsiella pneumoniae isolated from pediatric inpatients with
respiratory tract infections at a teaching hospital in China.
Scand. J. Infect. Dis. 46, 200-203. doi:
3109/00365548.2013.859393
Ahmed Ola Ibrahim , Soha A. El-Hady , Tamer M. Ahmed , Iman Z.
Ahmed.(2013). Detection of bla SHV and bla CTX-M genes in
ESBL producing Klebsiella pneumoniae isolated from Egyptian
patients with suspected nosocomial infections. The Egyptian
Journal of Medical Human Genetics.14: 277-283.
Sarojamma V, Ramakrishna V. Prevalence of ESBL-Producing
Klebsiella pneumoniae Isolates in Tertiary Care Hospital. ISRN
Microbiol. 2011;2011:318348. Published 2011 Dec 1.
doi:10.5402/2011/318348
Ali Abdel Rahim KA, Ali Mohamed AM. Prevalence of Extended
Spectrum P-lactamase-Producing Klebsiella pneumoniae in Clinical
Isolates. Jundishapur J Microbiol. 2014;7(ll):el7114.
doi:10.5812/jjm.l7114
Munita JM, Arias CA. Mechanisms of Antibiotic Resistance. Microbiol
Spectr. 2016;4(2):10.1128/microbiolspec.VMBF-0016-2015.
doi:10.1128/microbiolspec.VMBF-0016-2015
Kong KF, Schneper L, Mathee K. Beta-lactam antibiotics: from
antibiosis to resistance and bacteriology. APMIS. 2010;118(l):l-36.
doi:10.1111/j.1600-0463.2009.02563.X
Shakya P, Shrestha D, Maharjan E, Sharma VK, Paudyal R. ESBL
Production Among E. coli and Klebsiella spp. Causing Urinary
Tract Infection: A Hospital Based Study. Open Microbiol J.
;11:23-30. Published 2017 Apr 28.
doi:10.2174/1874285801711010023
Ye Q, Wu Q, Zhang S, et al. Characterization of Extended-Spectrum PLactamase-Producing Enterobacteriaceae From Retail Food in
China. Front Microbiol. 2018;9:1709. Published 2018 Aug 8.
doi:10.3389/fmicb.2018.01709
Khosravi Azar Dokht , Hajar Hoveizavi , Manijeh Mehdinejad .(2013).
Prevalence of Klebsiella pneumoniae Encoding Genes for Ctx-M-1,
Tem-1 and Shv-1 Extended-Spectrum Beta Lactamases (ESBL)
Enzymes in Clinical Specimens JundishapurJ Microbiol.6(10):8256.
Brolund A. Overview of ESBL-producing Enterobacteriaceae from a Nordic perspective. Infect Ecol Epidemiol. 2014;4:10.3402/iee.v4.24555. Published 2014 Oct 1. doi:10.3402/iee.v4.24555
Latifpour M, Gholipour A, Damavandi MS. Prevalence of ExtendedSpectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolates in Nosocomial and Community-Acquired Urinary Tract Infections. Jundishapur J Microbiol. 2016;9(3):e31179. Published 2016 Mar 12. doi:10.5812/jjm.31179
Bush K. Past and Present Perspectives on p-Lactamases. Antimicrob Agents Chemother. 2018;62(10):e01076-18. Published 2018 Sep 24. doi:10.1128/AAC.01076-18
B^dzichowska A, Przekora J, Stapihska-Syniec A, et al. Frequency of infections caused by ESBL-producing bacteria in a pediatric ward -single-center five-year observation. Arch Med Sci. 2019;15(3):688-693. doi:10.5114/aoms.2017.72407
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