First Detection of 16S rRNA Methylase and blaCTX-M-15 Genes among Klebsiella pneumoniae Strains Isolated from Hospitalized Patients in Iran

Background: The increasing pattern of Multi-Drug Resistant (MDR) bacteria has limited number of therapeutic options especially for nosocomial isolates of Klebsiella pneumoniae. Therefore, in this study we aimed at molecular detecting of 16S rRNA methylase and blaCTX-M-15 among K. pneumoniae strains isolated from hospitalized patients in Mofid, Imam Hossein and Taleghani hospitals Materials and Methods: This study was done on 110 K.pneumoniae isolates from hospitals in Tehran, Iran. Antibiotic susceptibility tests were carried out by Kirby-Bauer disc diffusion and broth microdilution methods according to CLSI guidelines. ESBL, AmpC and KPC enzymes were detected by Combined Disk Diffusion Test (CDDT) and Modified Hodge Test (MHT) methods. The armA, rmtB, rmtC, rmtD and blaCTX-M-15 genes were detected by PCR and sequencing techniques. Typing of antibiotic resistance isolates was carried out by PFGE technique. Results: In this study, Fosfomycin, colistin and tigecycline were found to be more active than other antibiotics. Among the 110 K. pneumoniae strains, 60(54.5%), 33(30%) and 5(4.5%) were ESBL, Amp-C and KPC positive, respectively. The existence of blaCTX-M-15, armA and rmtC was detected in 40(36.3%), 15 (13.6%) and 2 (1.8%), respectively. Of 15 representative armA-producing K. pneumoniae isolates analyzed by PFGE, 9 different pulsotypes (PF1–9) were identified by Dice coefficients of ≥90% similarity. Conclusion: High-level aminoglycoside resistance in human pathogens result of due to16S rRNA methylases is one of the serious concerns in Iran.

[1]  G. Peirano,et al.  The Role of Epidemic Resistance Plasmids and International High-Risk Clones in the Spread of Multidrug-Resistant Enterobacteriaceae , 2015, Clinical Microbiology Reviews.

[2]  Yu-yang,et al.  Characterization of Extended-Spectrum Beta-Lactamase, Carbapenemase, and Plasmid Quinolone Determinants in Klebsiella pneumoniae Isolates Carrying Distinct Types of 16S rRNA Methylase Genes, and Their Association with Mobile Genetic Elements , 2015 .

[3]  Xiaoyan Yang,et al.  Molecular epidemiology of aminoglycosides resistance on Klebsiella pneumonia in a hospital in China. , 2015, International journal of clinical and experimental medicine.

[4]  Yang Liu,et al.  Characterization of extended-spectrum beta-lactamase, carbapenemase, and plasmid quinolone determinants in Klebsiella pneumoniae isolates carrying distinct types of 16S rRNA methylase genes, and their association with mobile genetic elements. , 2015, Microbial drug resistance.

[5]  H. Goudarzi,et al.  Evaluation of Genetic Pattern and Determination of oqxA Gene Expression Levels among Clinical Isolates of Klebsiella Pneumoniae Strains , 2014 .

[6]  H. Goudarzi,et al.  Detection of FOX, MOX, and ACT Genes in ESBL-producing Klebsiella pneumoniae Strains , 2014 .

[7]  H. Goudarzi,et al.  Detection of β-Lactamases and Outer Membrane Porins among Klebsiella pneumoniae Strains Isolated in Iran , 2014, Scientifica.

[8]  NobariSaman,et al.  Molecular characterization of carbapenem-resistant strains of Klebsiella pneumoniae isolated from Iranian patients: first identification of blaKPC gene in Iran. , 2014 .

[9]  F. Shahcheraghi,et al.  Molecular characterization of carbapenem-resistant strains of Klebsiella pneumoniae isolated from Iranian patients: first identification of blaKPC gene in Iran. , 2014, Microbial drug resistance.

[10]  Guiqing Wang,et al.  CTX-M β-Lactamase–producing Klebsiella pneumoniae in Suburban New York City, New York, USA , 2013, Emerging infectious diseases.

[11]  M. Jafari,et al.  The First Report of CMY, aac (6′)-Ib and 16S rRNA Methylase Genes Among Pseudomonas aeruginosa Isolates From Iran , 2013 .

[12]  A. Taherpour,et al.  Detection of OqxAB efflux pumps, OmpK35 and OmpK36 porins in extended-spectrum-β-lactamase-producing Klebsiella pneumoniae isolates from Iran. , 2013, Hippokratia.

[13]  Y. Doi,et al.  Coproduction of 16S rRNA Methyltransferase RmtD or RmtG with KPC-2 and CTX-M Group Extended-Spectrum β-Lactamases in Klebsiella pneumoniae , 2013, Antimicrobial Agents and Chemotherapy.

[14]  I. Balakrishnan,et al.  An evaluation of the Mast D69C AmpC Detection Disc Set for the detection of inducible and derepressed AmpC β-lactamases. , 2012, The Journal of antimicrobial chemotherapy.

[15]  S. Bi,et al.  blaKPC and rmtB on a single plasmid in Enterobacter amnigenus and Klebsiella pneumoniae isolates from the same patient , 2012, European Journal of Clinical Microbiology & Infectious Diseases.

[16]  Weiwei Wang,et al.  Diverse prevalence of 16S rRNA methylase genes armA and rmtB amongst clinical multidrug-resistant Escherichia coli and Klebsiella pneumoniae isolates. , 2011, International journal of antimicrobial agents.

[17]  Tzou-Yien Lin,et al.  Emergence and spread of multi-drug resistant organisms: think globally and act locally. , 2011, Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi.

[18]  D. Lye,et al.  World health day 2011: antimicrobial resistance and practical solutions. , 2011, Annals of the Academy of Medicine, Singapore.

[19]  P. Hsueh,et al.  High burden of antimicrobial resistance in Asia. , 2011, International journal of antimicrobial agents.

[20]  D. Mathai,et al.  Correlation of TEM, SHV and CTX-M extended-spectrum beta lactamases among Enterobacteriaceae with their in vitro antimicrobial susceptibility. , 2011, Indian journal of medical microbiology.

[21]  G. Bou,et al.  Emergence in Spain of a Multidrug-Resistant Enterobacter cloacae Clinical Isolate Producing SFO-1 Extended-Spectrum β-Lactamase , 2011, Journal of Clinical Microbiology.

[22]  S. Mobashery,et al.  The future of the β-lactams. , 2010, Current opinion in microbiology.

[23]  Kenneth S. Thomson,et al.  Extended-Spectrum-β-Lactamase, AmpC, and Carbapenemase Issues , 2010, Journal of Clinical Microbiology.

[24]  Y. Ni,et al.  Plasmid-Mediated 16S rRNA Methylases in Aminoglycoside-Resistant Enterobacteriaceae Isolates in Shanghai, China , 2008, Antimicrobial Agents and Chemotherapy.

[25]  Y. Lai,et al.  Widespread Dissemination of Aminoglycoside Resistance Genes armA and rmtB in Klebsiella pneumoniae Isolates in Taiwan Producing CTX-M-Type Extended-Spectrum β-Lactamases , 2008, Antimicrobial Agents and Chemotherapy.

[26]  B. Berçot,et al.  Plasmid-Mediated 16S rRNA Methylases among Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Isolates , 2008, Antimicrobial Agents and Chemotherapy.

[27]  Y. Ike,et al.  Novel Plasmid-Mediated 16S rRNA m1A1408 Methyltransferase, NpmA, Found in a Clinically Isolated Escherichia coli Strain Resistant to Structurally Diverse Aminoglycosides , 2007, Antimicrobial Agents and Chemotherapy.

[28]  Yohei Doi,et al.  16S ribosomal RNA methylation: emerging resistance mechanism against aminoglycosides. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[29]  Y. Ozawa,et al.  16S rRNA Methylase–producing, Gram-Negative Pathogens, Japan , 2007, Emerging infectious diseases.

[30]  D. Yong,et al.  Dissemination of 16S rRNA methylase-mediated highly amikacin-resistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii in Korea. , 2006, Diagnostic microbiology and infectious disease.

[31]  이경원,et al.  Dissemination of 16S rRNA methylase-mediated highly amikacin-resistant isolates of Klebsiella pneumoniae and Acinetobacter baumannii in Korea , 2006 .

[32]  J. Wu,et al.  Plasmid-mediated 16S rRNA methylases conferring high-level aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae isolates from two Taiwanese hospitals. , 2004, The Journal of antimicrobial chemotherapy.

[33]  P. Courvalin,et al.  Plasmid-Mediated High-Level Resistance to Aminoglycosides in Enterobacteriaceae Due to 16S rRNA Methylation , 2003, Antimicrobial Agents and Chemotherapy.

[34]  M. Ferraro Performance standards for antimicrobial susceptibility testing , 2001 .

[35]  A. N. Shibaeva [World Health Day]. , 1983, Fel'dsher i akusherka.