title: Successful international clones of blaCTX-M-15-producing Klebsiella pneumoniae with coexpression of plasmid-mediated quinolone resistance (PMQR) determinants in Tehran hospitals.
abstract: The dissemination of plasmid-mediated multidrug resistance in Enterobacteriaceae is a major public health concern. We investigated the prevalence of plasmid-mediated quinolone resistance (PMQR), 16S rRNA methylases, CTX-M, and acquired AmpC enzymes in ESBL-producing Klebsiella pneumoniae (n=40) from Tehran hospitals. Plasmid replicon typing, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) were carried out for typing. CTX-M group 1 (confirmed as bla(CTX-M-15) in selected isolates) was found in 35/40 isolates. Thirty-two isolates hosted PMQR genes. Twenty isolates featured aac(6')-Ib-CR only; 9 isolates had aac(6')-Ib-CR and qnrB; 2 isolates had aac(6')-Ib-CR and qnrS; and 1 isolate had aac(6')-Ib-CR, qnrS, and qepA. The 16S rRNA methylase RmtB was found in 1 isolate; and acquired AmpC enzymes, in 6 isolates. PFGE detected 7 pulsotypes, the largest corresponded to sequence type 16. The successful clone ST101 was also found. The emergence of successful clones of K. pneumoniae in Tehran hospitals is concerning.
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Shoeib
authors.initials: S
authors.lastname: Nematzadeh
authors.affiliation: Department of Microbiology, Pasteur Institute of Iran, Tehran, Iran.
authors.forename: Fereshteh
authors.initials: F
authors.lastname: Shahcheraghi
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Solna, Stockholm, Sweden.
authors.forename: Aina
authors.initials: A
authors.lastname: Iversen
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, Solna, Stockholm, Sweden. Electronic address: christian.giske@karolinska.se.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Giske
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005838:Genotype; D006761:Hospitals; D006801:Humans; D007492:Iran / Q000453:epidemiology; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D017720:Molecular Epidemiology; D058889:Molecular Typing; D010957:Plasmids / Q000032:analysis*; D015363:Quinolones / Q000494:pharmacology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones; D047090:beta-Lactams; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases
keywords: Clonal complex; ESBL; MLST; PMQR