Evaluation of Phenotypic and Genotypic Carbapenemase Genes in Gram-Negative Bacteria Resistant to Carbapenem and Determining their Antibiotic Resistance

Document Type : Original Article (s)

Authors

1 PhD Student, Department of Medical Bacteriology, Division of Microbiology, Pasteur Institute of Iran, Tehran, Iran

2 Department of Microbiology, Saveh Research and Science Branch, Islamic Azad University, Saveh, Iran

3 Professor, Department of Microbiology, Division of Microbiology, Pasteur Institute of Iran, Tehran, Iran

Abstract

Background: Carbapenem antibiotics are often used as the last line of treatment for infections caused by resistant Gram-negative bacteria (GNB). The most important mechanism of resistance to carbapenems is production of carbapenemase. The prevalence of carbapenem-resistant Gram-negative bacteria is on the rise worldwide, posing a major public health threat. The aim of this study was to determine the antibiotic resistance patterns and to detect carbapenemase producing Gram-negative bacteria in clinical isolates.Methods: In this study, a total of 134 clinical isolates of Gram-negative bacteria were collected in Tehran city, Iran, during 2012-2013. Antimicrobial susceptibility testing was performed and resistance genes were characterized using polymerase chain reaction (PCR) amplification and sequencing. The modified Hodge test (MHT) and ethylenediaminetetraacetic acid (EDTA) double-disk diffusion test (DDST) were performed for the screening carbapenemases.Findings: The number and frequency of isolated bacteria were as Escherichia coli 57 (42.5%), Klebsiella pneumonia 26 (19.4%), Acinetobacter spp 21 (15.6%), Pseudomonas aeruginosa 17 (12.6%), Citrobacter spp 8 (5.9%), Proteus spp 3 (2.2%), and Enterobacter spp 2 (1.4%). These organisms showed the highest resistance to ertapenem, cefotaxime, aztreonam, ceftazidime, amikacin and kanamaycin (100%). Confirmatory tests showed that 44 isolates (32.8%) were DDST positive and 17 isolates (12.6%) were MHT positive. Most of MHT-positive (41.17%) and DDST-positive (39.13%) isolates were Acinetobacter spp. The PCR based screening revealed the presence of the blaIMP-1 gene in 4 isolates.Conclusion: Owing to the presentation of blaIMP-1 gene in Klebsiella, Citrobacter, Acinetobacter and Escherichia coli and feasibility of horizontal gene transfer among bacteria, changing in antibiotic prescription policies is required. Due to the importance of Metallo beta lactamase producting strains in hospital, early identification could play an effective role in prevention and treatment of these isolates.

Keywords

References

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Journal of Isfahan Medical School
Volume 34, Issue 405 - Serial Number 405
September and October 2017
Pages 1290-1296

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History

  • Receive Date: 05 October 2015
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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