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Molecular Detection of CTX-M Genes in Klebsiella pneumoniae Isolated from Different Clinical Samples in Baghdad City

Author: Ahmed Salim Mohammed
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 152-160
Publisher: Babylon University جامعة بابل

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Abstract

CTX-M extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae have been reported to be an important nosocomial infections. A total of 50 K. pneumonia isolates were isolated from different clinical samples in some public hospitals in Baghdad city during the period from October to December 2013. Bacterial identification was done using conventional cultural & chemical methods &and VITEK 2 cards (GN) for identification, while the antimicrobial drug susceptibility of K. pneumoniae was performed by disk diffusion test and the minimum inhibitory concentration (MIC) testing was performed using VITEK 2 automated system (bioMérieux, France). ESBL production was phenotypically detected by double disk synergy test according to the Clinical and Laboratory Standards Institute(CLSI) guidelines. The presence of bla-gene encoded CTX-M was detected by conventional PCR technique.Out of 50 K. Pneumonia isolates,13 (26%) were ESBL producer by CDT, the minimum inhibatory concentration (MIC) of different antibiotics was performed on these 13(26%) isolates using VITEK2 AST-GN30 showed that 13 (100%) isolates were Ceftazidime,Ceftraiaxone and Cefepime resistant with MIC ≥16- ≥64 µg/ml,and 8(61.53%) of ESBL producing isolates were carbapenem sensitive 8 (61.53%) with MIC <=0.25 µg/ml. PCR assay revealed that 4 (30.76%) of the ESBL producing isolates harbored blaCTX-M gene.Extended spectrum beta lactamase mediated resistance in K. pneumonia is a cause for concern in the therapy of critically ill patients. The ESBL producing K. pneumoniae isolates were more resistant to various antimicrobial agents. This suggests that ESBL producing isolates in hospitals may cause serious infections that illustrated when these strains were responsible for a nosocomial outbreak.The findings strongly suggest that there is a need to track the detection of ESBL producers and that judicious use of carbapenems is necessary to prevent the further spread of these organisms. The prevalence of multi-drug resistant K. pneumoniae isolates especially ESBL producing bacteria was increased in Baghdad city .Phenotypic and molecular characterization of ESBL provide information about the prevalence of ESBL producing K. pneumoniae in Baghdad. The blaCTX-M was one of the predominant ESBL genes in K. pneumoniae in this study.

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