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Antibiotic Susceptibility, Biofilm-Forming Ability, and Prevalence of Extended-Spectrum Beta-Lactamase (ESBL)- and Biofilm-Associated Genes Among Klebsiella pneumoniae Isolates from Hospitalized Patients in Northwest of Iran

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Abstract

Klebsiella pneumoniae is an opportunistic bacterium, which is globally recognized for its high prevalence and antimicrobial resistance (AMR). Biofilm-forming capability, susceptibility testing, and phenotypic confirmatory test for extended-spectrum beta-lactamase (ESBL)-producing isolate recognition of 104 K. pneumoniae isolates were performed according to the Clinical Laboratory Standard Institute (CLSI) guidelines. The prevalence of ESBL-associated genes bla-VIM, bla-NDM, and bla-OXA-48, as well as biofilm-associated genes luxS, fimH1, wza, and mrkD, was determined by multiplex PCR. The highest resistance rate was against ampicillin (100.0%). Among the 104 K. pneumoniae isolates, 52 (50.0%) and 31 (29.8%) isolates were determined as multi- and extensively drug resistant (MDR, XDR), respectively. Moreover, 21 (40.4%) isolates were determined as ESBL producing. Among 50 biofilm-producing K. pneumoniae isolates, 7 (14.0%), 15 (30.0%), and 28 (56.0%) isolates exhibited high, moderate, and weak levels of biofilm formation, respectively. A number of 41 (78.8%) isolates were susceptible to colistin, and 10 (19.2%) were resistant. AMR was significantly higher (P < 0.05) in the biofilm-forming isolates compared with non-biofilm formers.

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Data Availability

All the results of this study were classified and maintained by the dissertation in the Zanjan University of Medical Sciences. We indeed provided all raw data on which our study is based.

Code Availability

(IR.ZUMS.REC.1400.031)

Abbreviations

VIM:

Verona integron-encoded metallo-β-lactamase

NDM:

New Delhi metallo-β-lactamase

AMR:

Antimicrobial resistance

CLSI:

Clinical and Laboratory Standards Institute

CRKP:

Carbapenem-resistant K. pneumoniae

EPS:

Extracellular Polymeric Substances

ESBL:

Extended-spectrum beta-lactamase

ICU:

Intensive Care Unit

KPC:

K. pneumoniae Carbapenemase

LB:

Luria–Bertani

MDR:

Multidrug Resistant

MIC:

Minimal Inhibitory Concentrations

MR:

Methyl Red

NCCLS:

National Committee for Clinical Laboratory Standards

PBS:

Phosphate Buffer Saline

SIM:

Sulfide Indole Motility

TSB:

Tryptic Soy Broth

TSI:

Triple Sugar Iron

UTI:

Urinary Tract Infection

VP:

Voges–Proskauer

XDR:

Extensively Drug resistant

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Acknowledgements

The authors are grateful for the support of their colleagues in Medical Microbiology Department of Zanjan University of Medical Sciences.

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Authors and Affiliations

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

    Bahman Mirzaei, Aida Ebrahimi, Shima Keshavarzi & Siamak Hydarzadeh

  2. Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran

    Farzad Badmasti

  3. Education and Extension Organization, Razi Vaccine and Serum Research Institute, Agricultural Research, Karaj, Iran

    Maryam Dadar

  4. Department of Life Technologies, University of Turku, Turku, Finland

    Narges Moradi

Authors
  1. Bahman Mirzaei
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  2. Aida Ebrahimi
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Contributions

All authors read and approved the manuscript. Contributions of the authors in this study were as follows: BM: was involved in conceptualization, supervision, methodology, final editing, and review; AE: was involved in laboratory tests; SK: was involved in writing and data curation; FB: was involved in preparation of standard isolates and standardization of molecular tests; NM: was involved in analyzing SPSS and writing; and MD: was involved in the final review.

Corresponding author

Correspondence to Bahman Mirzaei.

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The authors declare that they have no competing interests.

Ethical Approval

This study complied with ethical principles and the standards for conducting clinical research and was approved by the Ethics Committee of Zanjan University of Medical Sciences (IR.ZUMS.REC.1400.031).

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Informed consent was obtained from all individual participants or their parent or legal guardian in the case of children under 16 included in the study.

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Mirzaei, B., Ebrahimi, A., Keshavarzi, S. et al. Antibiotic Susceptibility, Biofilm-Forming Ability, and Prevalence of Extended-Spectrum Beta-Lactamase (ESBL)- and Biofilm-Associated Genes Among Klebsiella pneumoniae Isolates from Hospitalized Patients in Northwest of Iran. Curr Microbiol 80, 175 (2023). https://doi.org/10.1007/s00284-023-03247-7

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