Antibiotic resistance pattern of Klebsiella pneumoniae isolated from nosocomial infections in Aleshtar hospital, Lorestan province

Document Type : Original Article

Authors

1 MSc of Microbiology, Department of Biology, Islamic Azad University, Ashkezar Branch, Ashkezar, Iran

2 Assistant Professor, Infectious Diseases Specialist, Lorestan University of Medical Sciences, Khorramabad, Iran

3 MSc of Microbiology, Department of Biology, Islamic Azad University, Borujerd Branch, Borujerd, Iran

Abstract

Introduction: Klebsiella pneumoniae is one of Klebsiella species. K. pneumoniae is one of the most important bacteria causing nosocomial infections. This bacterium threatens public health and leads to increased hospital costs and mortality rate. The purpose of this study was to determine the pattern of antibiotic resistance in K. pneumoniae in nosocomial infections.
Methods: This study was performed on 51 samples of Klebsiella isolates from 500 patients in three units of Aleshtar hospital in 9 months. The antibiotic resistance of K. pneumoniae to 18 antibiotics was performed by Kirby Bauer disk diffusion method.
Results: The frequency of K. pneumonia among 500 samples was determined 51 cases (10.2%). The largest number of K. pneumoniae was isolated from the infectious unit (49.02%). The frequency of K. pneumoniae based on the source of infection for urine was 22 cases (43.14%), sputum 17 (33.33%), stool 6 (11.77%), wound 4 (7.84%), blood 2 (3.92%), and cerebrospinal fluid 0 (0%), respectively. K. pneumoniae resistance to antibiotics included: ceftriaxone (94.12%), ciprofloxacin (90.20%), ofloxacin (86.27%), cefotaxime (78.43%), nalidixic acid (58.82%), nitrofurantoin (56.86%), aztreonam (54.90%), ampicillin/sulbactam (50.98% ), ticarcillin (45.09%), cefepime (43.14%), colistin (43.14%), gentamicin (41.18%), azithromycin (41.18%), polymyxin B (39.22%), piperacillin/tazobactam (19.61%), amikacin ( 15.69%), imipenem (5.88%), and meropenem (3.92%).
Conclusion: Meropenem and imipenem with the lowest resistance were the most effective antibiotics against K .pneumoniae. Ceftriaxone, and ciprofloxacin antibiotic had the lowest effect on the treatment of K. pneumoniae.

Keywords


1. Jain A, Singh K. Recent advances in the management of nosocomial infection. Journal of Medical Education and Research (JK Sciences) 2007; 9(1): 3-8.
2. Shaikh JM, Devrajani BR, Shah SZ, Akhund T, Bibi I. Frequency, pattern and etiology of nosocomial infection in intensive care unit: an experience at a tertiary care hospital. J Ayub Med Coll Abbottabad 2008; 20(4): 37-40.
3. Bereket W, Hemalatha K, Getenet B, Wondwossen T, Solomon A, Zeynudin A, et al. Update on bacterial nosocomial infections. Eur Rev Med Pharmacol Sci 2012; 16(8): 1039-44.
4. Peleg AY, Hooper DC. Hospital-Acquired infection due to gram-negative bacteria. N Engl J Med 2010; 362(19): 1804-13.
5. Arivett BA, Ream DC, Fiester SE, Mende K, Murray CK, Thompson MG, et al. Draft genome sequences of Klebsiella pneumoniae clinical type strain ATCC 13883 and three multidrug-resistant clinical isolates. Genome Announcements 2015; 3(1): e01385-14.
6. Brooks GF. Enteric gram-negative rods (Enterobacteriaceae). In: Brooks GF, Butel GS, Morse SA, editors. Jawetz, Melnick, & Adelberg’s Medical Microbiology. 23rd ed. USA: McGraw-Hill; 2004. p. 248-61.
7. Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and Pathogenicity Factors. Clin Microbiol Rev 1998; 11(4): 589-603.
8. Donnenberg MS. Enterobacteriaceae. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pennsylvania: Churchill Livingstone Elsevier; 2010. p. 218.
9. Sikarwar AS, Batra HV. Prevalence of antimicrobial drug resistance of Klebsiella pneumoniae in India. Int J Biosci Biochem Bioinforma 2010; 1(3): 211-5.
10. Davies J, Davies D. Origins and Evolution of Antibiotic Resistance. Microbiol Mol Biol Rev 2010; 74(3): 417-33.
11. Khadri H, Surekha S, Lakshmi S, Narasimha G. Multi drug resistance and β-lactamase production by Klebsiella pneumoniae. Afr J Biotechnol 2007; 6(15): 1791-3.
12. Comandatore F, Sassera D, Ambretti S, Landini MP, Daffonchio D, Marone P, et al. Draft genome sequences of two multidrug resistant Klebsiella pneumoniae ST258 isolates resistant to colistin. Genome Announc 2013; 1(1): 1-2.
13. Saeidynia F, Keihanian F, Saeidynia A. Antibiotic resistance in blood culture samples from patients referred to Razi laboratory of Rasht, 2006-2011. Advances in Infectious Diseases 2014; 4(3): 165-72.
14. Bina M, Pournajaf A, Mirkalantari S, Talebi M, Irajian G. Detection of the Klebsiella pneumoniae carbapenemase (KPC) in K.pneumoniae isolated from the clinical samples by the phenotypic and genotypic methods. Iran J Pathol 2015; 10(3): 199-205.
15. Barakzahi M, Hormozi B, Rashki A, Rashki Ghalehnoo Z. Prevalence of extended spectrum β-Lactamase in Klebsiella pneumonia isolates in a teaching hospital of Zahedan City, Iran. Avicenna J Clin Microb Infec 2014; 1(3): e22934.
16. Feizabadi MM, Etemadi G, Rahmati M, Mohammadi-Yeganeh S, Shabanpoor S, Asadi S. Antibiotic resistance patterns and genetic analysis of klebsiella pneumoniae isolates from the respiratory tract. National Research Institute of Tuberculosis and Lung Disease 2007; 6(3): 20-5.
17. Manjula NG, Math GC, Nagshetty K, Patil SA, Gaddad SM, Shivannavar CT. Antibiotic susceptibility pattern of ESβL producing Klebsiella pneumoniae isolated from urine samples of pregnant women in Karnataka. J Clin Diagn Res 2014; 8(10): 8-11.
18. Kumar AR. Antimicrobial sensitivity pattern of Klebsiella pneumonia isolated from pus from tertiary care hospital and issues related to the rational selection of antimicrobials. J Chem Pharm Res 2013; 5(11): 326-31.
19. Kalaskar A, Venkataramana K. Determination of antimicrobial resistance pattern and production of Extended-Spectrum Β-Lactamases amongst Escherichia coli and Klebsiella pneumoniae from clinical isolates. J Med Bacteriol 2012: 1(3): 17-24.
20. Romanus II, Egwu OA. Analysis of antibiotic susceptibility of Klebsiella pneumoniae isolated from different clinical specimen in Enugu State. Canadian Journal of Pure and Applied Sciences 2011; 5(3): 1609-14.