Antibiotic resistance pattern of Klebsiella pneumoniae in obtained samples from Ziaee Hospital of Ardakan, Yazd, Iran during 2016 to 2017
Jamshid Ayatollahi, Mohammad Sharifyazdi, Razieh Fadakarfard, Seyed Hossein Shahcheraghi
Abstract
Background: In recent years, due to the inappropriate use of antibiotics, drug resistance has increased in gram negative bacilli, including Klebsiella pneumoniae. Drug resistance is associated with an increase in mortality and therapeutic costs. Therefore, determination of an antibiotic resistance pattern for choosing the appropriate treatment for infections caused by this bacterium seems necessary. This study was conducted to determine the antibiotic resistance pattern of Klebsiella pneumoniae species isolated from patients referring to Ziaee Hospital in Ardakan in 2016-2017.
Materials and Methods: For this descriptive-analytic study, all positive cultures of Klebsiella pneumoniae in patients referred to Ziaee Hospital in Ardakan during 2016 to 2017, were evaluated. Antibiotic resistance patterns of the samples were determined by the standard method of propagation of the disk from 12 different antibiotics and data analyzed by SPSS 21 software.
Results and discussions: The results of this study, which were performed on 75 samples, showed that 22 (29.3%) were male and 53 (70.7%) were female. Klebsiella's resistance to clarithromycin was 100%, but was 100% susceptible to amikacin. The percentage of Klebsiella's resistance to ampicillin was 78.3%, cefalotin 75%, cotrimoxazole 43.9%, ceftriaxone 32%, ciprofloxacin 30.9%, cefotaxime 24%, and ampicillin 20%. The highest sensitivity of Klebsiella pneumoniae for antibiotics was 100% for amikacin, 82.8% for meropenem and 82% for cefepime. Due to the high prevalence of resistance in Klebsiella samples, there is a need for strict measures in the administration of antibiotics. Antibiotic resistance can also be reduced by choosing the appropriate antibiotic for treatment and by taking antibiotic susceptibility tests.
Keywords
References
1. Lorenzoni VV, Rubert FdC, Rampelotto RF, Hörner R. Increased antimicrobial resistance in Klebsiella pneumoniae from a University Hospital in Rio Grande do Sul, Brazil. Rev Soc Bras Med Trop. 2018;51(5):676-9. doi: 10.1590/0037-8682-0362-2017.
2. Ruiz-Garbajosa P, Cantón R. Epidemiología de los bacilos gramnegativos multirresistentes. Rev Esp Quimioter. 2016;29(1):21-5.
3. Jo A, Ding T, Ahn J. Comparison of antibiotic resistance phenotypes in laboratory strains and clinical isolates of Staphylococcus aureus, Salmonella Typhimurium, and Klebsiella pneumoniae. Food Sci Biotechnol. 2017;26(6):1773-9. doi:10.1007/s10068-017-0191-2.
4. Khameneh B, Diab R, Ghazvini K, Bazzaz BSF. Breakthroughs in bacterial resistance mechanisms and the potential ways to combat them. Microb Pathog. 2016;95:32-42. doi: 10.1016/j.micpath.2016.02.009.
5. El-Sokkary RH, Ramadan RA, El-Shabrawy M, El-Korashi LA, Elhawary A, Embarak S, et al. Community acquired pneumonia among adult patients at an egyptian university hospital: bacterial etiology, susceptibility profile and evaluation of the response to initial empiric anti.biotic therapy. Infect Drug Resist. 2018;11:2141. doi: 10.2147/IDR.S182777.
6. El-Mahdy R, El-Kannishy G, Salama H. Hypervirulent Klebsiella pneumoniae as a hospital-acquired pathogen in the intensive care unit in Mansoura, Egypt. Germs. 2018;8(3):140. doi: 10.18683/germs.2018.1141.
7. Tenover FC, Reller LB, Weinstein MP. Rapid detection and identification of bacterial pathogens using novel molecular technologies: infection control and beyond. Clinical infectious diseases 2007, 44(3):418-23. doi: 10.1086/510684.
8. Fluit AC, Visser MR, Schmitz F-J. Molecular detection of antimicrobial resistance. Clin Microbiol Rev. 2001;14(4):836-71. doi: 10.1128/CMR.14.4.836-871.2001.
9. Satter S, Mahbub H, Shamsuzzaman S. Antibiotic Resistance Pattern and Prevalence of Aminoglycoside-Modifying Enzymes in Escherichia Coli and
Klebsiella species Isolated from a Tertiary Care Hospital in Bangladesh. Mymensingh Med J. 2018;27(3):561-6.
10. Alcántar-Curiel MD, Ledezma-Escalante CA, Jarillo-Quijada MD, Gayosso-Vázquez C, Morfín-Otero R, Rodríguez-Noriega E, et al. Association of Antibiotic Resistance, Cell Adherence, and Biofilm Production with the Endemicity of Nosocomial Klebsiella pneumoniae. BioMed Res Int. 2018;2018. doi: 10.1155/2018/7012958.
11. Veeraraghavan B, Jesudason MR, Prakasah JAJ, Anandan S, Sahni RD, Pragasam AK, et al. Antimicrobial susceptibility profiles of gram-negative bacteria causing infections collected across India during 2014–2016: Study for monitoring antimicrobial resistance trend report. Indian J Med Microbiol. 2018;36(1):32. doi: 10.4103/ijmm.IJMM_17_415.
12. Nepal R, Shrestha B, Joshi DM, Joshi RD, Shrestha S, Singh A. Antibiotic Susceptibility Pattern of Gram-negative Isolates of Lower Respiratory Tract Infection. J Nepal Health Res Counc. 2018;16(1):22-6.
13. Khan HA, Ahmad A, Mehboob R. Nosocomial infections and their control strategies. Asian Pac J Trop Biomed. 2015;5(7):509-14.
14. Alcantar-Curiel D, Tinoco JC, Gayosso C, Carlos A, Daza C, Perez-Prado MC, et al. Nosocomial bacteremia and urinary tract infections caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae with plasmids carrying both SHV-5 and TLA-1 genes. Clin Infect Dis. 2004;38(8):1067-74. doi: 10.1086/382354.
15. Kim J, Jo A, Chukeatirote E, Ahn J. Assessment of antibiotic resistance in Klebsiella pneumoniae exposed to sequential in vitro antibiotic treatments. Ann Clin Microbiol Antimicrob. 2016;15(1):60. doi: 10.1186/s12941-016-0173-x.
16. Mohammed MA, Alnour TM, Shakurfo OM, Aburass MM. Prevalence and antimicrobial resistance pattern of bacterial strains isolated from patients with urinary tract infection in Messalata Central Hospital, Libya. Asian Pac J Trop Med. 2016;9(8):771-6. doi: 10.1016/j.apjtm.2016.06.011.
17. Singh NP, Rani M, Gupta K, Sagar T, Kaur IR. Changing trends in antimicrobial susceptibility pattern of bacterial isolates in a burn unit. Burns 2017;43(5):1083-7. doi: 10.1016/j.burns.2017.01.016.
18. Ullah F, Malik SA, Ahmed J. Antimicrobial susceptibility pattern and ESBL prevalence in Klebsiella pneumoniae from urinary tract infections in the North-West of Pakistan. Afr J Microbiol Res. 2009;3(11):676-80.
19. Ahanjan M, Naderi F, Solimanii A. Prevalence of Beta-lactamases Genes and Antibiotic Resistance Pattern of Klebsiella pneumoniae Isolated from Teaching Hospitals, Sari, Iran, 2014. J Mazandaran Univ Med Sci. 2017;27(149):79-87.
20. Manjula N, 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):DC08. doi: 10.7860/JCDR/2014/9594.5048.
Submitted date:
02/04/2020
Reviewed date:
02/25/2020
Accepted date:
03/05/2020
Publication date:
03/05/2020