Antibiotic Resistance Pattern of Klebsiella Pneumoniae from Patients in Qaem Teaching Hospital, Mashhad University of Medical Sciences
Subject Areas : environmental HealthAli Shamsazar 1 , Arshid Yousefi-Avarvand 2 , Farzad Khademi 3
1 - Department of Biochemistry, Payame Noor University, Tehran Shargh Branch, Tehran, Iran
2 - Ph.D Student of Bacteriology, Department of Microbiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran*(Corresponding Author)
3 - Ph.D Student of Bacteriology, Department of Microbiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Keywords: Antibiotic resistance, Modified Disk Diffusion Method, Klebsiella pneumonia,
Abstract :
Klebsiella pneumoniae is a gram-negative, non-motile and capsular gram-negative bacillus. It is one of the most important human pathogens and is an important factor in causing nosocomial infections. The bacterium is inherently resistant to a number of antimicrobial agents. The aim of this study was to evaluate the antibiotic resistance pattern of Klebsiella pneumoniae isolated from patients referred to Ghaem hospital in Mashhad. A total of 274 Klebsiella pneumoniae isolates were collected from April to October 2013 from Qaem teaching hospital of Mashhad University of Medical Sciences. Identification of these isolates was performed using microbiological methods such as hot staining and differential media. Modified disk diffusion method (MDDM) was used to determine the susceptibility of bacteria to the antibiotics amoxicillin, nalidixic acid, cefotaxime, ceftizoxime, ceftriaxone, ceftazidime, ciprofloxazine, imipenem, and nitrofurantoin. In this study 175 isolates (87.63%) were from urine sample and 99 isolates (13.36%) were from different samples (blood, cerebrospinal fluid, ulcer, ascites, and secretions). Resistance of Klebsiella pneumoniae isolates to ciprofloxacin, imipenem, nitrofurantoin and gentamicin antibiotics were 71.46%, 9.56%, 3.39% and 30%, respectively. The results of this study indicate that resistance of Klebsiella pneumoniae isolates to different antibiotics is higher than previous studies. Further studies in this area could help guide us to better understand the antibiotic resistance of these infectious bacteria.
1- Mehrgan, H., Rahbar, M. and Arab-Halvaii, Z., 2009. High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran. The Journal of infection in developing countries, Vol. 4(03), pp.132-138.
2- Ghotaslou, R., Ghorashi, Z. and Nahaei, M., 2007. Klebsiella pneumoniae in Neonatal Sepsis: A 3-Year-Study in the Pediatric Hospital of Tabriz Iran. Japanese journal of infectious diseases, 60(2/3), p.126.
3- Raha, B.K., Baki, M.A., Begum, T., Nahar, N., Jahan, N. and Begum, M., 2014. Clinical, Bacteriological Profile & Outcome of Neonatal Sepsis in a Tertiary Care Hospital. Medicine Today, 26(1), pp.18-21.
4- Hlophe, S.T. and McKerrow, N.H., 2014. Hospital-acquired Klebsiella pneumoniae infections in a paediatric intensive care unit. South African Journal of Child Health, 8(4), pp.125-128.
5- Karbasizaed, V., Badami, N. and Emtiazi, G., 2003. Antimicrobial, heavy metal resistance and plasmid profile of coliforms isolated from nosocomial infections in a hospital in Isfahan, Iran. African Journal of Biotechnology, Vol. 2(10), pp.379-383.
6- Ghafourian, S., bin Sekawi, Z., Sadeghifard, N., Mohebi, R., Kumari Neela, V., Maleki, A., Hematian, A., Raftari, M. and Ranjbar, R., 2011. The prevalence of ESBLs producing Klebsiella pneumoniae isolates in some major hospitals, Iran. The open microbiology journal, 5(1).
7- Gangoue-Pieboji, J., Koulla-Shiro, S., Ngassam, P., Adiogo, D. and Ndumbe, P., 2006. Antimicrobial activity against gram negative bacilli from Yaounde Central Hospital, Cameroon. African health sciences, Vol. 6(4).
8- Bencic, I. and Baudoin, D.V., 2001. Imipenem consumotion and gram-negative pathogen resistance to imipenem at Sestre Milosrdnice University Hospital. Acta clin croat, Vol. 40(1), pp.185-9.
9- Nashibi, R., Mogehi, S., Seidi-Nejad, H. and Izadpour, F., 2015. Determining antibiotic resistance pattern of the bacteria isolated from urine samples of patients attending Imam Khomeini Hospital in the City of Ahvaz, Iran in 2013. Journal of Pure and Applied Microbiology, Vol. 9(3), pp.2005-2011.
10- McPherson, R., Pincus, M.R. and Henry, J.B., 2007. Henry's clinical diagnosis and management by laboratory methods.
11- Clinical and Laboratory Standard Institute. Performance Standards for Antimicrobial Disk Susceptibility Tests. Available at: http://isoforlab.com/phocadownload/csli/M2-A9.pdf. 2005.
12- Soltan Dalal, M.M., Miremadi, S.A., Sharify Yazdi, M.K., Rastegar Lari, A., Rajabi, Z. and Avadis Yans, S., 2012. Antimicrobial resistance trends of Klebsiella Spp. isolated from patients in Imam Khomeini hospital. Journal of Payavard Salamat, Vol. 6(4), pp.275-281.
13- Forbes BA, Sahm DF, Weissfeld AS. Bailey and Scott's diagnostic microbiology. 11th ed. St. Louis: Mosby; 2002.
14- Hanberger, H., Nilsson, L.E., Claesson, B., Kärnell, A., Larsson, P., Rylander, M., Svensson, E., Sörberg, M. and Sörén, L., 1999. New species-related MIC breakpoints for early detection of development of resistance among Gram-negative bacteria in Swedish intensive care units. Journal of Antimicrobial Chemotherapy, Vol. 44(5), pp.611-619.
15- Sikarwar, A.S. and Batra, H.V., 2011, May. Challenge to healthcare: Multidrug resistance in Klebsiella pneumoniae. In 2011 International Conference on Food Engineering and Biotechnology IPCBEE (Vol. 9, pp. 130-134).
16- Khaneja, M., Naprawa, J., Kumar, A. and Piecuch, S., 1999. Successful treatment of late-onset infection due to resistant Klebsiella pneumoniae in an extremely low birth weight infant using ciprofloxacin. Journal of Perinatology, Vol. 19(4).
17- Feizabadi, M.M., Etemadi, G., Yadegarinia, D., Rahmati, M., Shabanpoor, S. and Bokaei, S., 2006. Antibiotic-resistance patterns and frequency of extended-spectrum b-lactamase-producing isolates of Klebsiella pneumoniae in Tehran. Medical science monitor, 12(11), pp.BR362-BR365.
18- Campos, A., Albiero, J., Ecker, AB., Kuroda, CM., Meirelles, LE., Polato, A., Tognim, M., Wingeter, MA., Teixeira, J., 2016. Outbreak of Klebsiella pneumoniae carbapenemase producing K pneumoniae: A systematic review. American Journal of Infection Control, Vol. (44), pp1374-80.
19- Mohammadi-Mehr, M. and Feizabadi, M.M., 2011. Antimicrobial resistance pattern of Gram- negative bacilli isolated from patients at ICUs of Army hospitals in Iran. Iranian journal of microbiology, Vol. 3(1), pp.26-30.
20- Feiz Sardhar, M.H., Akya, A., 2014. The Frequency of Extended Spectrum β-Lactamase Genes of SHV-2a, SHV-5 and SHV-12 in Clinical Isolates of Klebsiella Pneumoniae Isolated Kermanshah Medical Centers in 2014. Arak Medical University Journal,Vol,19, pp.59- 67.
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1- Mehrgan, H., Rahbar, M. and Arab-Halvaii, Z., 2009. High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran. The Journal of infection in developing countries, Vol. 4(03), pp.132-138.
2- Ghotaslou, R., Ghorashi, Z. and Nahaei, M., 2007. Klebsiella pneumoniae in Neonatal Sepsis: A 3-Year-Study in the Pediatric Hospital of Tabriz Iran. Japanese journal of infectious diseases, 60(2/3), p.126.
3- Raha, B.K., Baki, M.A., Begum, T., Nahar, N., Jahan, N. and Begum, M., 2014. Clinical, Bacteriological Profile & Outcome of Neonatal Sepsis in a Tertiary Care Hospital. Medicine Today, 26(1), pp.18-21.
4- Hlophe, S.T. and McKerrow, N.H., 2014. Hospital-acquired Klebsiella pneumoniae infections in a paediatric intensive care unit. South African Journal of Child Health, 8(4), pp.125-128.
5- Karbasizaed, V., Badami, N. and Emtiazi, G., 2003. Antimicrobial, heavy metal resistance and plasmid profile of coliforms isolated from nosocomial infections in a hospital in Isfahan, Iran. African Journal of Biotechnology, Vol. 2(10), pp.379-383.
6- Ghafourian, S., bin Sekawi, Z., Sadeghifard, N., Mohebi, R., Kumari Neela, V., Maleki, A., Hematian, A., Raftari, M. and Ranjbar, R., 2011. The prevalence of ESBLs producing Klebsiella pneumoniae isolates in some major hospitals, Iran. The open microbiology journal, 5(1).
7- Gangoue-Pieboji, J., Koulla-Shiro, S., Ngassam, P., Adiogo, D. and Ndumbe, P., 2006. Antimicrobial activity against gram negative bacilli from Yaounde Central Hospital, Cameroon. African health sciences, Vol. 6(4).
8- Bencic, I. and Baudoin, D.V., 2001. Imipenem consumotion and gram-negative pathogen resistance to imipenem at Sestre Milosrdnice University Hospital. Acta clin croat, Vol. 40(1), pp.185-9.
9- Nashibi, R., Mogehi, S., Seidi-Nejad, H. and Izadpour, F., 2015. Determining antibiotic resistance pattern of the bacteria isolated from urine samples of patients attending Imam Khomeini Hospital in the City of Ahvaz, Iran in 2013. Journal of Pure and Applied Microbiology, Vol. 9(3), pp.2005-2011.
10- McPherson, R., Pincus, M.R. and Henry, J.B., 2007. Henry's clinical diagnosis and management by laboratory methods.
11- Clinical and Laboratory Standard Institute. Performance Standards for Antimicrobial Disk Susceptibility Tests. Available at: http://isoforlab.com/phocadownload/csli/M2-A9.pdf. 2005.
12- Soltan Dalal, M.M., Miremadi, S.A., Sharify Yazdi, M.K., Rastegar Lari, A., Rajabi, Z. and Avadis Yans, S., 2012. Antimicrobial resistance trends of Klebsiella Spp. isolated from patients in Imam Khomeini hospital. Journal of Payavard Salamat, Vol. 6(4), pp.275-281.
13- Forbes BA, Sahm DF, Weissfeld AS. Bailey and Scott's diagnostic microbiology. 11th ed. St. Louis: Mosby; 2002.
14- Hanberger, H., Nilsson, L.E., Claesson, B., Kärnell, A., Larsson, P., Rylander, M., Svensson, E., Sörberg, M. and Sörén, L., 1999. New species-related MIC breakpoints for early detection of development of resistance among Gram-negative bacteria in Swedish intensive care units. Journal of Antimicrobial Chemotherapy, Vol. 44(5), pp.611-619.
15- Sikarwar, A.S. and Batra, H.V., 2011, May. Challenge to healthcare: Multidrug resistance in Klebsiella pneumoniae. In 2011 International Conference on Food Engineering and Biotechnology IPCBEE (Vol. 9, pp. 130-134).
16- Khaneja, M., Naprawa, J., Kumar, A. and Piecuch, S., 1999. Successful treatment of late-onset infection due to resistant Klebsiella pneumoniae in an extremely low birth weight infant using ciprofloxacin. Journal of Perinatology, Vol. 19(4).
17- Feizabadi, M.M., Etemadi, G., Yadegarinia, D., Rahmati, M., Shabanpoor, S. and Bokaei, S., 2006. Antibiotic-resistance patterns and frequency of extended-spectrum b-lactamase-producing isolates of Klebsiella pneumoniae in Tehran. Medical science monitor, 12(11), pp.BR362-BR365.
18- Campos, A., Albiero, J., Ecker, AB., Kuroda, CM., Meirelles, LE., Polato, A., Tognim, M., Wingeter, MA., Teixeira, J., 2016. Outbreak of Klebsiella pneumoniae carbapenemase producing K pneumoniae: A systematic review. American Journal of Infection Control, Vol. (44), pp1374-80.
19- Mohammadi-Mehr, M. and Feizabadi, M.M., 2011. Antimicrobial resistance pattern of Gram- negative bacilli isolated from patients at ICUs of Army hospitals in Iran. Iranian journal of microbiology, Vol. 3(1), pp.26-30.
20- Feiz Sardhar, M.H., Akya, A., 2014. The Frequency of Extended Spectrum β-Lactamase Genes of SHV-2a, SHV-5 and SHV-12 in Clinical Isolates of Klebsiella Pneumoniae Isolated Kermanshah Medical Centers in 2014. Arak Medical University Journal,Vol,19, pp.59- 67.