شناسایی کلبسیلا پنومونیه تولید‌کننده بتالاکتامازهای وسیع‌الطیف KPC در نمونه‌های بالینی در ایران

Background :Nowadays beta lactamase-producing multiple-drug resistance Klebsiella pneumoniae is as an important factor in nosocomial infections which has produced therapeutic difficulties in worldwide. The purpose of this study was to identify KPC-producing K. pneumoniae (blakpc) in clinical samples in Iran. Materials and Methods: After identification of isolates in species level using cultural and biochemical methods, the susceptibility tests were carried out on 180 isolates of K. pneumoniae using disk diffusion method. Also MIC (Minimum inhibitory concentrations) was determined for meropenem and imipenem. Then all isolates of Klebsiella were considered for presence of blakpc gene by PCR. Results: In this study of 202 isolates of Klebsiella, 180 isolates (89.1%) of K. pneumoniae and 22 isolates (10.9%) of Klebsiella oxytoca were isolated from patients. More than 55% of isolates showed multiple-drug resistance and also above 40% resistance to imipeneme and meropeneme was recorded. The MIC of isolates which were resistant to carbapenemes was above 32µg/ml.The PCR results showed that 22 cases (11.9%) of isolates had blakpc gene which most of them had been isolated from urine and blood samples of patients who were hospitalized in the ICU and pediatrics. Conclusion: Regarding the existence of blakpc gene in K. pneumoniae and possibility of transformation of these genes to the other bacteria, reconsideration in antibiotics consumption patterns and more attention to nosocomial infections control criteria are inevitable.