اخبار و اعلانات

 آمار

تعداد نشریات286
تعداد نشریات سازمان84
تعداد شماره‌ها3,022
تعداد مقالات33,775
تعداد مشاهده مقاله45,098,017
تعداد دریافت فایل اصل مقاله51,721,775
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 (655.72 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
مراجع
  1. Chen J, Wang D, Ding Y, Zhang L, Li X. Molecular epidemiology of plasmid-mediated fosfomycin resistance gene determinants in Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae isolates in China. Microbial Drug Resistance. 2019;25(2):251-7.
  2. Paczosa MK, Mecsas J. Klebsiella pneumoniae: going on the offense with a strong defense. Microbiology and Molecular Biology Reviews. 2016;80(3):629-61.
  3. Meletis G. Carbapenem resistance: overview of the problem and future perspectives. Ther Adv Infect Dis. 2016; 3 (1): 15-21. Epub 2016/02/11.
  4. Aurilio C, Sansone P, Barbarisi M, Pota V, Giaccari LG, Coppolino F, et al. Mechanisms of action of carbapenem resistance. Antibiotics. 2022;11(3):421.
  5. Ni W, Li G, Zhao J, Cui J, Wang R, Gao Z, et al. Use of Monte Carlo simulation to evaluate the efficacy of tigecycline and minocycline for the treatment of pneumonia due to carbapenemase-producing Klebsiella pneumoniae. Infectious Diseases. 2018;50(7):507-13.
  6. Papadimitriou-Olivgeris M, Bartzavali C, Spyropoulou A, Lambropoulou A, Sioulas N, Vamvakopoulou S, et al. Molecular epidemiology and risk factors for colistin-or tigecycline-resistant carbapenemase-producing Klebsiella pneumoniae bloodstream infection in critically ill patients during a 7-year period. Diagnostic Microbiology and Infectious Disease. 2018;92(3):235-40.
  7. Liu S, Ding Y, Xu Y, Li Z, Zeng Z, Liu J. An outbreak of extensively drug-resistant and hypervirulent Klebsiella pneumoniae in an intensive care unit of a teaching hospital in Southwest China. Frontiers in Cellular and Infection Microbiology. 2022;12:979219.
  8. Gyöngyösi M, Alcaide P, Asselbergs FW, Brundel BJ, Camici GG, da Costa Martins P, et al. Long COVID and the cardiovascular system-elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies: A joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial & Pericardial Diseases. Cardiovascular Research. 2022:cvac115.
  9. Cox MJ, Loman N, Bogaert D, O'Grady J. Co-infections: potentially lethal and unexplored in COVID-19. The Lancet Microbe. 2020;1(1):e11.
  10. Patel JB. Performance standards for antimicrobial susceptibility testing: Clinical and laboratory standards institute; 2017.
  11. Owais HM, Baddour MM, El-Metwally HAE-R, Barakat HS, Ammar NS, Meheissen MA. Assessment of the in vitro activity of azithromycin niosomes alone and in combination with levofloxacin on extensively drug-resistant Klebsiella pneumoniae clinical isolates. Brazilian Journal of Microbiology. 2021;52:597-606.
  12. Magiorakos A-P, Srinivasan A, Carey RB, Carmeli Y, Falagas M, Giske C, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection. 2012;18(3):268-81.
  13. Mohd Khari FI, Karunakaran R, Rosli R, Tee Tay S. Genotypic and phenotypic detection of AmpC β-lactamases in Enterobacter spp. isolated from a teaching hospital in Malaysia. PloS one. 2016;11(3):e0150643.
  14. Rebelo AR, Bortolaia V, Kjeldgaard JS, Pedersen SK, Leekitcharoenphon P, Hansen IM, et al. Multiplex PCR for detection of plasmid-mediated colistin resistance determinants, mcr-1, mcr-2, mcr-3, mcr-4 and mcr-5 for surveillance purposes. Eurosurveillance. 2018;23(6):17-00672.
  15. Bakht M, Alizadeh SA, Rahimi S, Kazemzadeh Anari R, Rostamani M, Javadi A, et al. Phenotype and genetic determination of resistance to common disinfectants among biofilm-producing and non-producing Pseudomonas aeruginosa strains from clinical specimens in Iran. BMC microbiology. 2022;22(1):124.
  16. Russo TA, Olson R, Fang C-T, Stoesser N, Miller M, MacDonald U, et al. Identification of biomarkers for differentiation of hypervirulent Klebsiella pneumoniae from classical K. pneumoniae. Journal of clinical microbiology. 2018;56(9):e00776-18.
  17. Jafari Z, Harati AA, Haeili M, Kardan-Yamchi J, Jafari S, Jabalameli F, et al. Molecular epidemiology and drug resistance pattern of carbapenem-resistant Klebsiella pneumoniae isolates from Iran. Microbial Drug Resistance. 2019;25(3):336-43.
  18. Mostafavi SN, Rostami S, Nokhodian Z, Ataei B, Cheraghi A, Ataabadi P, et al. Antibacterial resistance patterns of Acinetobacter baumannii complex: The results of Isfahan Antimicrobial Resistance Surveillance-1 Program. Asian Pacific Journal of Tropical Medicine. 2021;14(7):316.
  19. Xie J, Wang T, Sun J, Chen S, Cai J, Zhang W, et al. Optimal tigecycline dosage regimen is urgently needed: results from a pharmacokinetic/pharmacodynamic analysis of tigecycline by Monte Carlo simulation. International Journal of Infectious Diseases. 2014;18:62-7.
  20. Lee C-R, Lee JH, Park KS, Kim YB, Jeong BC, Lee SH. Global dissemination of carbapenemase-producing Klebsiella pneumoniae: epidemiology, genetic context, treatment options, and detection methods. Frontiers in microbiology. 2016:895.
  21. Gheitani L, Fazeli H. Prevalence of bla VIM, bla IMP, and bla KPC genes among carbapenem-resistant Klebsiella pneumoniae (CRKP) isolated from Kurdistan and Isfahan hospitals, Iran. Research in Molecular Medicine. 2018;6(2):12-20.
  22. Saeidi S, Alavi-Naini R, Shayan S. Antimicrobial susceptibility and distribution of tem and ctx-m genes among esbl-producing Klebsiella pneumoniae and Pseudomonas aeruginosa causing urinary tract infections. Zahedan Journal of Research in Medical Sciences. 2014;16(4):1-5.
  23. Dehshiri M, Khoramrooz SS, Zoladl M, Khosravani SA, Parhizgari N, Motazedian MH, et al. The frequency of Klebsiella pneumonia encoding genes for CTX-M, TEM-1 and SHV-1 extended-spectrum beta lactamases enzymes isolated from urinary tract infection. Annals of clinical microbiology and antimicrobials. 2018;17(1):1-7.
  24. 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. Mediterranean journal of hematology and infectious diseases. 2019;11(1).
  25. Sader HS, Castanheira M, Flamm RK, Mendes RE, Farrell DJ, Jones RN. Tigecycline activity tested against carbapenem-resistant Enterobacteriaceae from 18 European nations: results from the SENTRY surveillance program (2010–2013). Diagnostic Microbiology and Infectious Disease. 2015;83(2):183-6.
  26. Zhou Y-F, Liu P, Zhang C-J, Liao X-P, Sun J, Liu Y-H. Colistin Combined with Tigecycline: A Promising Alternative Strategy to Combat Escherichia coli Harboring bla NDM–5 and mcr-1. Frontiers in Microbiology. 2020;10:2957.
  27. Fan B, Wang C, Song X, Ding X, Wu L, Wu H, et al. Bacillus velezensis FZB42 in 2018: the gram-positive model strain for plant growth promotion and biocontrol. Frontiers in microbiology. 2018;9:2491.
  28. Kuş H, Arslan U, Fındık D. Investigation of various virulence factors of Klebsiella pneumoniae strains isolated from nosocomial infections. Mikrobiyoloji bulteni. 2017;51(4):329-39.
  29. Dauga C. Evolution of the gyrB gene and the molecular phylogeny of Enterobacteriaceae: a model molecule for molecular systematic studies. International Journal of Systematic and Evolutionary Microbiology. 2002;52(2):531-47.
آمار
تعداد مشاهده مقاله: 303
تعداد دریافت فایل اصل مقاله: 267


counter
سامانه مدیریت نشریات علمی. طراحی و پیاده سازی از سیناوب