Identification of the Extended Spectrum Beta- lactamase Producing Klebsiella pneumoniae Isolated from Different Clinical Specimens, from Besat Hospital, Hamedan, Iran

Background and Objectives: Enterobacteriaceaefamilycontains important bacteria involved in nosocomial infections like, K. pneumoniae. The gram- negative bacteria can cause avariety ofinfections such as urinary tract infection, blood infection and etc. antibiotic resistant in K. pneumoniaecan lead to prolongation of stay in hospital and also, increase ofmorbidity and mortality. ESBL producing K. pneumoniaecan become resistant to all beta- lactam antibiotics except carbapenem. Theaim of this study was detection of ESBL producing K. pneumoniaein clinical specimens by phenotypic and molecular methods in specimens collected from Besat hospital, Hamedan, Iran. Materials and methods:In this cross sectional study, 89K. pneumoniaewere collected from different clinical specimens inBesathospital, Hamedan. Resistance tocefotaxime and ceftazidime were examined by disc diffusion method, according to CLSI guide line. Combination disc by cefotaxime and cefotaxime- clavulanic acid and also ceftazidime and ceftazidime- clavulanic acid wereusedfor phenotypic identification of ESBL producing strains. DNA extraction of isolates were prepared by DNA extraction kit (Thermo). Detection of TEM, CTX-M and SHV were done by PCR as most common ESBL producer genes. Results:According to antibiotic susceptibly testing,34of89collected K. pneumoniaewere resistant to cefotaxime and/ or ceftazidime. The results of combination disc method showed 25(73.5%) ESBL positivestrains. SHV is the most detected ESBL producer genesand was identified in 22 (88%) of K. pneumoniaewith positive phenotypic ESBL detection test. 17 (68%) had TEM and none of them carried CTX-M gene. Conclusion: The results of study showeda high rate of ESBL producing K. pneumoniaein Hamedan and it can be considerable because K. pneumoniaeis one of the important causes of nosocomial infections. ESBL producing can make more antibiotic resistance in K. pneumoniaeand consequently increase morbidity and mortality. On the other hand, this high rate of presence of ESBL producing K. pneumoniaein border city can bean important issue because it comesto Iran from other countries. So, care of traffic at the borders of the country may be helpful for control of spread of suchantibiotic resistant bacteria in Iran.