• Zahra Hosseinzadeh, Hadi Sedigh Ebrahim-Saraie, Jamal Sarvari, Jalal Mardaneh, Behzad Dehghani, Seyed Mohammad Hossein Rokni-Hosseini, and Mohammad Motamedifar.
• Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
• J Chin Med Assoc. 2018 Jun 1; 81 (6): 536-540.

BackgroundOne of the most important emerging carbapenem-resistant bacteria is Klebsiella pneumoniae (K. pneumoniae). The present study aimed to investigate the antibiotic susceptibility pattern of K. pneumoniae isolates and detection of carbapenemase producing K. pneumoniae obtained from Iranian hospitalized patients.MethodsThis cross-sectional study was performed on 211 K. pneumoniae isolates which were recovered from different clinical specimens from 2014 to 2015. Modified Hodge test (MHT) and double disk synergy test (DDST) were done for detection of carbapenemase and metallo-beta-lactamase (MBL) producing K. pneumoniae. The presence of antibiotic resistance determinants was investigated by polymerase chain reaction (PCR) method.ResultsThe results of antibiotic susceptibility showed that all isolates were resistant to ampicillin, and then mostly resistant to piperacillin and ceftazidime with 76.3% and 66.8%, respectively. On the other hand, the highest sensitivity was toward polymyxin B, followed by carbapenems. Of 29 carbapenem-resistant isolates, all were high-level imipenem-resistant isolates (Minimum inhibitory concentration ≥4), except 4 isolates. The results of MHT and DDST showed that 93.1% (27/29) of carbapenem-resistant isolates were carbapenemase and MBL producing isolates, respectively. The presence of blaNDM-1 and blaOXA-48-like genes was detected in 27 (10.9%) and 2 (0.9%) isolates, respectively.ConclusionThis is the first identification of blaNDM-1 and blaOXA-48-like in K. pneumoniae in Southwestern Iran and the highest reported prevalence of blaNDM in this bacterium from Iran. Since carbapenem-resistant isolates containing New Delhi metallo-beta-lactamase 1 (NDM-1) were almost resistant to all the tested antibiotics, the resistance due to this gene may be increased in the near future as a potential health threat.Copyright © 2017. Published by Elsevier Taiwan LLC.

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