ABSTRACT
The present investigation is designed to evaluate antibiotic susceptibility pattern and identification of qnr strains of Klebsiella pneumoniae in clinical specimens isolated from general hospitals in Khorramabad, Iran. Total of 107 K. pneumoniae isolates were randomly collected since December 2011 until September 2012 from hospitalized patients at general hospitals in Khorramabad, Iran. The isolates were collected from different clinical samples including urine, sputum, lesion, and blood. Biochemical tests were performed for identification of isolates. Antibiotic susceptibility test was performed using disc diffusion method according to recommendations of Clinical and Laboratory Standards Institute using 13 antibiotic disks. K. pneumoniae isolates were screened by multiplex PCR amplification of qnrA, qnrB and qnrS using specific primers and sequence analysis of amplified regions of the isolates was also performed. Chi-square test was used to analysis and P value of < 0.05 was considered statistically significant. All clinical isolates were confirmed as K. pneumoniae by complete biochemical identification (gram staining, oxidase negative, indole positive, Simon's citrate positive and urease positive). Forty-three (40.2%) out of 107 isolates were multidrug-resistant (MDR). Ciprofloxacin (quinolone) susceptibility testing showed that 34 isolates (31.8%) were resistant, 7 isolates (6.5%) were intermediately resistant and 66 isolates (61.7%) were sensitive. Eighteen (16.8%) out of 107 K. pneumoniae clinical isolates were positive for qnr genes. Among all the qnr-positive isolates, 16 isolates (88.9%) carried qnrB, 1 isolate (5.55%) carried qnrS and the rest (5.55%) carried both qnrB and qnrS genes while no qnrA was detected in these clinical isolates. Qnr determinants were detected in 8 (23.5%) of the ciprofloxacinresistant isolates as well as 1 (14.3%) and 9 (13.6%) intermediate and sensitive isolates, respectively. No significant association was observed between ciprofloxacin resistance and presence of qnr genes (P>0.05). Findings of the present study indicated high frequency of qnr-positive K. pneumoniae in Lorestan province, Iran. However, there is no association between quinolone resistance and presence of qnr genes in isolates of K. pneumoniae.
ABSTRACT
The aim of this study was to evaluate the susceptibility of Klebsiella pneumoniae clinical isolates to antibiotics and to a quaternary ammonium compound (QAC) disinfectant as the concentrations used clinically and to determine the presence of the qacEΔ1 and cepA genes for the first time in Iran. In total, 85 K. pneumoniae isolates were randomly collected from hospitalized patients at the general hospitals in Lorestan, Iran. Antibiotic and antiseptic susceptibility testing was performed according to Clinical and Laboratory Standards Institute recommendations. K. pneumonia isolates were screened by PCR amplification of qacEΔ1 and cepA genes using specific primers and sequence analysis of the amplified regions were also performed. From 85 isolates of K. pneumoniae, 34 (40%) isolates were multidrug resistance (MDR). The evaluation of the susceptibility to the QAC disinfectant revealed that 51 (60%) isolates had reduced susceptibility to QAC disinfectant. The qacEΔ1 gene was detected in 26 isolates (30.6%). While cepA gene was found in 19 isolates (22.3%) of K. pneumonia. Seventy-three percent (19/26) qacEΔ1-positive isolates were detected in the biocide-resistant isolates. Whereas, 63.1% (12/19) cepA-positive isolates were found in the biocide-resistant isolates. Out of qacEΔ1 and cepA-positive isolates, 65.4% (17/26) and 42.1% (8/19) were among MDR isolates, respectively. No significant association of biocide resistance with the presence of qacEΔ1 and cepA genes was observed (P>0.05). The results of present study shows that there was a close link between qacEΔ1 gene and antibiotic resistance, but no significant association of biocide resistance with the presence of qacEΔ1 and cepA genes was observed in K. pneumoniae in Iran.
