The Prevalence of Carbapenemase Producing Klebsiella pneumoniae Strains Isolated from Clinical Urine Specimens in University Teaching Hospitals, Iran

Background and Aims: Klebsiella pneumoniae is a gram negative opportunistic pathogen of nosocomial infections that causes pneumonia, urinary tract infection (UTI), meningitis, septicemia and diarrhea. The emergence and spread of carbapenemase producing Klebsiella pneumoniae often cause failure in the treatment of infections. The aim of this study was to evaluate the prevalence of carbapenemase producing Klebsiella pneumoniae strains isolated from clinical urine specimens. Materials and Methods: In this descriptive-sectional study, from December 2013 to August 2014, 130 Klebsiella pneumoniae isolates were collected from hospitalized patients with urinary tract infections and identified by biochemical tests. Antimicrobial susceptibility test was evaluated by the standard disk diffusion method (Kirby-Bauer). E.test method was used for determining of meropenem minimum inhibitory concentration (MIC). Carbapenemase producing was investigated by the Modified Hodge Test (MHT). blaKPC was evaluated by conventional polymerase chain reaction (PCR) method using specific primer pair. Results: The results showed that 61 (46.9%) isolates were non-susceptible to at least one of the carbapenems. 35 (26.9%), 5 (3.8%) and 5 (3.8%) isolates were resistant to imipenem, meropenem and ertapenem, respectively. 45.9% (28 of 61) of isolates were carbapenemase producing and all of them were negative for the presence of blaKPC. Conclusions: With respect to the high prevalence of carbapenemase producing Klebsiella pneumoniae isolates, it is recommended that MHT is performed in routine laboratories for limiting and controlling the spread of the carbapenem resistant isolates.