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Rahimi, Sara, Khakpour, Mohadeseh, Bakht, Mehdi, Ehteram, Hasan, Nikkhahi, Farhad, Saghi Sarabi, Hediyeh. (1404). Assessment of the last-resort antibiotics against Extended Spectrum Beta-Lactamase/carbapenemase and biofilm producer Klebsiella pneumoniae isolated from hospitalized patients in intensive care units (ICUs), Iran. سامانه مدیریت نشریات علمی, 80(2), 551-562. doi: 10.32592/ARI.2025.80.2.551
Sara Rahimi; Mohadeseh Khakpour; Mehdi Bakht; Hasan Ehteram; Farhad Nikkhahi; Hediyeh Saghi Sarabi. "Assessment of the last-resort antibiotics against Extended Spectrum Beta-Lactamase/carbapenemase and biofilm producer Klebsiella pneumoniae isolated from hospitalized patients in intensive care units (ICUs), Iran". سامانه مدیریت نشریات علمی, 80, 2, 1404, 551-562. doi: 10.32592/ARI.2025.80.2.551
Rahimi, Sara, Khakpour, Mohadeseh, Bakht, Mehdi, Ehteram, Hasan, Nikkhahi, Farhad, Saghi Sarabi, Hediyeh. (1404). 'Assessment of the last-resort antibiotics against Extended Spectrum Beta-Lactamase/carbapenemase and biofilm producer Klebsiella pneumoniae isolated from hospitalized patients in intensive care units (ICUs), Iran', سامانه مدیریت نشریات علمی, 80(2), pp. 551-562. doi: 10.32592/ARI.2025.80.2.551
Rahimi, Sara, Khakpour, Mohadeseh, Bakht, Mehdi, Ehteram, Hasan, Nikkhahi, Farhad, Saghi Sarabi, Hediyeh. Assessment of the last-resort antibiotics against Extended Spectrum Beta-Lactamase/carbapenemase and biofilm producer Klebsiella pneumoniae isolated from hospitalized patients in intensive care units (ICUs), Iran. سامانه مدیریت نشریات علمی, 1404; 80(2): 551-562. doi: 10.32592/ARI.2025.80.2.551

Assessment of the last-resort antibiotics against Extended Spectrum Beta-Lactamase/carbapenemase and biofilm producer Klebsiella pneumoniae isolated from hospitalized patients in intensive care units (ICUs), Iran

Archives of Razi Institute
مقاله 20، دوره 80، شماره 2، خرداد و تیر 2025، صفحه 551-562    اصل مقاله (482.86 K)
نوع مقاله: Original Articles
شناسه دیجیتال (DOI): 10.32592/ARI.2025.80.2.551
نویسندگان
Sara Rahimi1؛ Mohadeseh Khakpour1؛ Mehdi Bakht1؛ Hasan Ehteram2؛ Farhad Nikkhahi* 1؛ Hediyeh Saghi Sarabi1
1Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
2Department of pathology. Kashan University of medical sciences Kashan. Iran;
چکیده
Pneumonia caused by Klebsiella pneumoniae (K. pneumoniae) is considered one of the most common causes of hospital-acquired infections. We aimed to investigate the activity of tigecycline, azithromycin, and colistin against K. pneumoniae isolated from bronchoalveolar lavage (BAL) samples of suspected cases of ventilator-associated pneumonia (VAP) in COVID-19 patients.
In the current study phenotypic and genotypic screening of ESBLs, AmpC beta-lactamases, and carbapenemase enzymes was investigated. the activity of tigecycline, azithromycin, and colistin against ESBL/carbapenemase producer K. pneumoniae. Also, assessment of the ability of biofilm formation was performed. Finally, virulence genes were detected by the PCR method.
By phenotypic detection tests 27 (29.6%) out of 91 K. pneumoniae isolates were classified as ESBL/carbapenemase-producing K. pneumoniae strains. Also, molecular methods showed, all 27 K. pneumoniae isolates harbored at least 1 of the ESBL/carbapenemase-related genes. ESBL-associated genes (19.7% blaTEM, 29.6% blaSHV, and 19.7% blaCTX-M) were detected in 91 K. pneumoniae isolates. Carbapenemase-related genes were detected in 17.5% of these isolates (blaOXA-48-like 15.4%, and blaNDM1 2.1%). All of the 27 selected isolates, exhibited biofilm formation ability. In this study, 92.59%, 92.59%, 81.48%, 88.8%, 40.74%, 11.1 %, 22.22%, 18.5%, 14.81% and 33.33% of the ESBL/carbapenemase producer K. pneumoniae isolates carried entB, mrkD, fimH, Irp2, wcaG, mrkA, rmpA, iutA and magA genes, respectively. But iucA gene was not present in any of isolates. Tigecycline and colistin were more effective against these isolates. Multilocus sequence typing (MLST) results for four colistin-resistant isolates showed three different sequence types ‌‌ST: ST3500, ST273, and 2 cases of ST2558.
The rapid emergence and spread of colistin-resistant and Beta-lactamase producer K. pneumoniae has resulted in an alarming situation worldwide. The effective antimicrobial activity of tigecycline against K. pneumoniae that produce these enzymes may be efficient in hospitalized patients in ICUs with suspected cases of VAP.
کلیدواژه‌ها
K. pneumoniae؛ Carbapenem resistance؛ Extended-spectrum beta-lactamases؛ IRAN
عنوان مقاله [English]
ارزیابی آخرین خط درمانی آنتی بیوتیکی علیه کلبسیلا پنومونیه تولید کننده بتا-لاکتاماز/کارباپنماز با طیف گسترده و تولید کننده بیوفیلم جدا شده از بیماران بستری در بخش های مراقبت ویژه (ICU)، ایران
چکیده [English]
پنومونی ناشی از کلبسیلا پنومونیه (K. pneumoniae) یکی از شایع ترین علل عفونت های بیمارستانی در نظر گرفته می شود. هدف ما بررسی فعالیت تیجیسیکلین، آزیترومایسین و کولیستین در برابر کلبسیلا پنومونیه جدا شده از نمونه‌های لاواژ برونش آلوئولار (BAL) موارد مشکوک به پنومونی مرتبط با ونتیلاتور (VAP)در بیماران COVID-19 بود.
در مطالعه حاضر، غربالگری فنوتیپی و ژنوتیپی ESBL ها، بتالاکتامازهای AmpC و آنزیم های کارباپنماز مورد بررسی قرار گرفت. فعالیت تیجیسیکلین ، آزیترومایسین و کولیستین در برابر تولیدکننده ESBL/carbapenemase کلبسیلا پنومونیه همچنین ارزیابی توانایی تشکیل بیوفیلم انجام شد. در نهایت ژن های حدت با روش PCR شناسایی شدند.
با آزمایش‌های تشخیص فنوتیپی، 27 (6/29%) از 91 جدایه کلبسیلا پنومونیه به عنوان سویه‌های مولد ESBL/carbapenemae طبقه‌بندی شدند. همچنین، روش‌های مولکولی نشان داد، همه 27 جدایه دارای حداقل 1 ژن مربوط به ESBL/carbapenemase بودند. ژن های مرتبط با ESBL 19.7٪ blaTEM)، 29.6٪ blaSHV، و 19.7٪ (blaCTX-M در 91 جدایه کلبسیلا پنومونیه شناسایی شد. ژن‌های مرتبط با کارباپنماز در 17.5 درصد از این جدایه‌ها شناسایی شد (blaOXA-48-like 15.4 درصد و blaNDM-12.1 درصد). همه 27 جدایه انتخاب شده، توانایی تشکیل بیوفیلم را نشان دادند. در این مطالعه 92.59٪، 92.59٪، 81.48٪، 88.8٪، 40.74٪، 11.1٪، 22.22٪، 18.5٪، 14.81٪ و 33.33٪ از تولیدکننده ESBL/carbapenemase ،دارای ژن های
entB, mrkD, fimH, Irp2, wcaG, mrkA, rmpA, iutA and magA به ترتیب بودند. اما ژن iucA در هیچ یک از جدایه ها وجود نداشت. تیجیسیکلین و کولیستین در برابر این ایزوله ها موثرتر بودند. نتایج تایپ توالی چند لوکوس(MLST) برای چهار جدایه مقاوم به کولیستین، سه نوع توالی مختلفST را نشان داد: ST3500، ST273، و 2 مورد ST2558.
ظهور و گسترش سریع کلبسیلا پنومونیه تولید کننده بتالاکتاماز و مقاوم به کولیستین منجر به وضعیت نگران کننده ای در سراسر جهان شده است. فعالیت ضد میکروبی موثر تیجیسیکلین علیه کلبسیلا پنومونیه که این آنزیم ها را تولید می کند ممکن است در بیماران بستری در بخش مراقبت های ویژه با موارد مشکوک به VAP موثر باشد
کلیدواژه‌ها [English]
کلبسیلا پنومونیه, کارباپنم مقاوم, بتالاکتامازهای وسیع الطیف, ایران
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