Journal of Isfahan Medical School

Journal of Isfahan Medical School

Prevalence Study of Extended Spectrum Beta-Lactamase in Klebsiella Pneumonia Isolated from Patients with Ventilator-Associated Pneumonia in Kermanshah City, Iran

Document Type : Original Article (s)

Authors
Siavash Vaziri 1
Faizullah Mansouri 1
Ramin Abiri 2
Amirhooshang Alvandi 2
Seyed Hamidreza Mortazavi 3
Kamal Ahmadi 4
Maryam Mirzaei 5
Mohsen Azizi 4
1 Associate Professor, Department of Infectious Disease, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Associate Professor, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
3 Assistant Professor, Department of Pediatrics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
4 Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
5 Department of Biostatistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
Background: One of the most common infections in patients with high mortality rate is ventilator-dependent pneumonia. This study aimed to determine the frequency of extended spectrum beta-lactamase (ESBL) in Klebsiella pneumonia isolated from patients with ventilator-associated pneumonia in Kermanshah City, Iran.Methods: This study performed on tracheal tube samples of patients admitted to the intensive care units. After collecting specimens, 57 Klebsiella pneumonia isolates were confirmed via standard bacteriological and biochemical tests. After antibiotic susceptibility testing by using disk diffusion method, the presence of ESBL phenotype was determined via combined disk test. The frequency of ESBL genes was determined by using their specific primers and polymerase chain reaction (PCR) method.Findings: From 57 isolates of Klebsiella pneumonia, 22 (38.6%) were positive for ESBL, phenotypically. The highest genotype frequency was shv gene (31.6%) determined via PCR test. The highest resistance was to ceftriaxone and co-trimoxazole (78.9%), and the lowest resistance was to colistin (3.5%).Conclusion: Considering the high resistance of Klebsiella isolated from samples of patients with ventilator- associated pneumonia against third-generation cephalosporin and the prevalence of ESBL-producing strains among these patients, identification of isolates with ESBL and suitable antibiotic selection for the treatment of this patients seem to be necessary.
Keywords
Ventilator-associated pneumonia
Antibacterial drug resistance
Intensive Care Unit
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Journal of Isfahan Medical School
Volume 35, Issue 444 - Serial Number 444
July and August 2017
Pages 1113-1119

  • Receive Date 11 August 2017
  • Accept Date 06 April 2022