Prevalence of qnrA, qnrB, and qnrS Genes in Klebsiella pneumoniae Isolates From Patients in Hospitals in Sabzevar, Iran: A Cross-sectional From February ۲۰۲۲ to October ۲۰۲۳

Introduction: Klebsiella pneumoniae has emerged as a significant opportunistic pathogen responsible for nosocomial infections, including hospital-acquired pneumonia (HAP) and various intra-abdominal infections. The aim of this study was to investigate the prevalence of qnrA, qnrB, and qnrS genes in K. pneumoniae isolates from patients in hospitals in Sabzevar, Iran.Materials & Methods: Of ۱۰۰ specimens of urine, respiratory secretions, blood, tracheal lavage, pleural fluid and trachea were collected from patients referred to hospitals in Sabzevar, northeastern Iran. Identification of bacteria was performed by gram stain, culture characteristics and biochemical methods. Bacterial susceptibility to quinolone antibiotics using the Kirby-Bauer disk diffusion method according to Clinical Laboratory Standards Institute (CLSI) guidelines (۲۰۲۳). The extracted DNA was subjected to polymerase chain reaction (PCR) assay targeting three genes of qnrA, qnrB and qnrS using specific primers. The data were analyzed using the chi-squared test and the Fisher’s exact test with the IBM SPSS Statistics version ۲۶ software. P<۰.۰۵ were also considered statistically significant.Results: ۱۰۰ non-duplicate K. pneumoniae isolates were collected from various clinical specimens, including urine (۶۲%), respiratory tract secretions (۶%), trachea (۱۸%), blood (۱۰%), tracheal lavage (۳%), and pleural fluid (۱%). The highest and lowest resistance were related to ampicillin (۹۲%) and nitrofurantoin (۲۲%), respectively. The qnrA, qnrB and qnrS genes were present in ۶۱%, ۵۶% and ۴۷% of the isolates, respectively. There is a statistically significant association between the presence of qnr genes and resistance to fluoroquinolones (P<۰.۰۰۲).Conclusion: Based on these results, qnrA-producing K. pneumoniae strains were isolated from patients. Thus, prescribing appropriate antibiotics and detection of qnr genes is required and it can be useful in tracking, treating and knowledge of K. pneumoniae infection prevalence rate.

کلیدواژه ها:

Klebsiella pneumoniae ، antimicrobial susceptibility ، qnr genes