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Emergence of co-existence of blaNDM with rmtC and qnrB genes in clinical carbapenem-resistant Klebsiella pneumoniae isolates in burning center from southeast of Iran

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Abstract

Dissemination of carbapenemase-producing Klebsiella pneumoniae along with 16S rRNA methyltransferase (16S-RMTase) has been caused as a great concern for healthcare settings. The aim of this study was to investigate the prevalence of resistance genes among K. pneumoniae isolates. During October 2015 to February 2016, 30 non-duplicative K. pneumoniae strains were isolated from clinical specimens in a burn center in Kerman, Iran. Antibiotic susceptibility tests of isolates, carbapenemase, extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamase-producing isolates were determined by phenotypic methods. The beta-lactamase, oqxA/B efflux pumps, qnr A, B, S, 16S-RMTase (rmt A, B, and C), and mcr-1 resistance genes were determined by PCR. Enterobacterial repetitive intergenic consensus (ERIC)-PCR was used for molecular typing. According to our findings, tigecycline has been shown the most active agent against K. pneumoniae isolates. Antibiotic resistance genes, blaTEM-1, blaSHV-12, blaCTX-M-15, blaCTX-M-2, blaNDM-1, blaFOX, blaMOX, blaEBC, blaACC, blaCIT, rmtC, qnrB, qnrS, oqxA, and oqxB, were detected in 11 (36.7%), 13 (43.3%), 11 (36.6%), 5 (16.6%), 9 (30%), 1 (3.3%), 1 (3.3%), 1 (3.3%), 1 (3.3%), 2 (6.7%), 1 (3.3%), 9 (30%), 2 (6.7%), 18 (60%), and 13 (43.3%) of isolates, respectively. The blaNDM-1 with rmtC was simultaneously observed in one isolate. ERIC-PCR results revealed 25 distinct patterns in eight clusters (A–H) and five singletons. This study highlights the high prevalence of blaNDM and emergence of rmtC among carbapenem-resistant K. pneumoniae. The resistance genes are often co-located on the conjugative plasmids, so it might be the reason of the rapid spread of them. The prevalence of multidrug-resistant K. pneumoniae isolates limits the available treatment options and presents tremendous challenges to public health.

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Funding

This research was supported by the Kerman University of Medical Sciences and health services (grant no. 95000056).

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Authors and Affiliations

  1. Department of Microbiology and Virology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

    Somayeh Kiaei, Mohammad Moradi, Hossein Hosseini Nave & Davood Kalantar-Neyestanaki

  2. Student Research Committee, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran

    Somayeh Kiaei, Zahra Hashemizadeh & Majid Taati-Moghadam

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  1. Somayeh Kiaei
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  2. Mohammad Moradi
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  3. Hossein Hosseini Nave
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  4. Zahra Hashemizadeh
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  5. Majid Taati-Moghadam
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  6. Davood Kalantar-Neyestanaki
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Correspondence to Davood Kalantar-Neyestanaki.

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Ethic approval code

This study was approved by ethical committee of Kerman University of Medical Sciences. The ethic approval code is IR.KMU.REC.1395.436.

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Kiaei, S., Moradi, M., Hosseini Nave, H. et al. Emergence of co-existence of blaNDM with rmtC and qnrB genes in clinical carbapenem-resistant Klebsiella pneumoniae isolates in burning center from southeast of Iran. Folia Microbiol 64, 55–62 (2019). https://doi.org/10.1007/s12223-018-0630-3

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