Abstract Background Infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are a serious threat to public health, and the spread of these strains is a critical concern. The aim of this study was to evaluate the prevalence of clinical CRKP isolates and their carbapenem-resistance genes, and to examine the clonal and genetic diversity of the isolates. Methods Different clinical specimens from hospitalized patients were investigated for K. pneumoniae . Susceptibility to carbapenems was evaluated by the disk diffusion method. The carbapenem inactivation method (CIM) and combined disk test (CDT) were used to investigate the activity of carbapenemase and metallo-beta-lactamase (MBL), respectively. Molecular detection of carbapenem resistance genes was done by polymerase chain reaction (PCR). Genotyping of isolates was performed using multilocus sequence typing (MLST). Results Of 200 clinical K. pneumoniae isolates, 84 (42%) were identified as CRKP, of which 54 (64.29%) and 30 (35.71%) were MBL-producer and MBL-non-producer, respectively. The bla SIM, bla VIM , bla NDM-1 , and bla IMP genes were found in 28 (51.85%), 54 (100%), 25 (46.29%), and 3 (5.55%) MBL-producing isolates. The bla KPC gene was detected in all (100%) MBL-non-producers, while no bla GES gene was found. MLST typing of 30 selected isolates showed five sequence types (STs), of which ST1671 was the most prevalent ( n = 14, 46.66%), with the majority of isolates ( n = 11, 78.57%) recovered from the neurology ICU. Conclusion The increase in carbapenemase and MBL resistance among clinical isolates of K. pneumoniae should be of concern to hospital infection control authorities. The spread of the same ST (ST1671) among several isolates with different resistances suggests the need for further investigation in this area.
Nouraei et al. (Wed,) studied this question.
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