Beta-lactamase determinants and molecular typing of carbapenem-resistant classic and hypervirulent Klebsiella pneumoniae clinical isolates from southwest of Iran

Morteza Saki; Mansour Amin; Mohammad Savari; Mohammad Hashemzadeh; Seyed Saeid Seyedian

doi:10.3389/fmicb.2022.1029686

Beta-lactamase determinants and molecular typing of carbapenem-resistant classic and hypervirulent Klebsiella pneumoniae clinical isolates from southwest of Iran

Front Microbiol. 2022 Nov 3:13:1029686. doi: 10.3389/fmicb.2022.1029686. eCollection 2022.

Authors

Morteza Saki^{1

2}, Mansour Amin^{1

2}, Mohammad Savari^{1

2}, Mohammad Hashemzadeh^{1

2}, Seyed Saeid Seyedian³

Affiliations

¹ Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
² Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
³ Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

This study investigated the molecular epidemiology of carbapenem-resistant classic Klebsiella pneumoniae (CR-cKp) and carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp) isolates in southwestern Iran. From 2019 to 2021, 136 (88.9%) cKp and 17 (11.1%) hvKp isolates were identified using biochemical tests and polymerase chain reaction (PCR). Antibiotic resistance, beta-lactamases, and clonal relatedness of carbapenem-resistant isolates were investigated using disk diffusion, PCR, and enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR), respectively. The different markers of hvKp isolates were as follows: string test (35.3%, n = 6/17), magA (11.8%, n = 2/17), rmpA (11.8%, n = 2/17), rmpA2 (52.9%, n = 9/17), iucA (52.9%, n = 9/17), and peg344 (35.3%, n = 6/17). Also, 55.1% (n = 75/136) of cKp and 47.1% (n = 8/17) of hvKp isolates were CR-cKp and CR-hvKp, respectively. All CR-hvKp (100.0%, n = 8) isolates were MDR. Colistin, tetracycline, and tigecycline were the most effective antibiotics. The occurrence of beta-lactamase genes in 75 CR-cKp and 8 CR-hvKp isolates was as follows: bla _NDM (41.3, 25.0%), bla _IMP (4.0, 0.0%), bla _VIM (8.0, 0.0%), bla _GES (14.7, 25.0%), bla _OXA-48-like (20.0, 0.0%), bla _CTX-M (26.7, 12.5%), bla _SHV (24.0, 12.5%), bla _TEM (10.7, 0.0%), bla _FOX (6.7, 0.0%), bla _DHA (6.7, 0.0%), bla _CMY (5.3, 0.0%), bla _LAT (12.0, 0.0%), and bla _ACT (8.0, 0.0%). ERIC-PCR showed a high diversity among isolates. In this study, the occurrence of MDR CR-hvKp isolates harboring bla _NDM and bla _GES was detected for the first time in southwestern Iran. To prevent the spread of CR-hvKp and reduce selection pressure, long-term surveillance and more effective treatment strategies should be implemented.

Keywords: ESBLs; Iran; beta-lactamase; carbapenem-resistant; hypervirulent Klebsiella pneumoniae.

Grants and funding

This work was supported by the Vice Chancellor for Research Affairs, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, and Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (grant no: OG-9821).