First Report of Extended-Spectrum β-Lactamases Among Clinical Isolates of Klebsiella pneumoniae in Gaza Strip, Palestine.
Sixteen broad-spectrum cephalosporin-resistant Klebsiella pneumoniae isolates were recovered between April and June 2013 from Palestinian hospitals, Gaza Strip. Genes encoding extended-spectrum beta-lactamases (ESBLs) and other resistance genes were characterized by polymerase chain reaction and sequencing. The following β-lactamase genes were detected: blaCTX-M-15+ blaSHV1+ blaTEM-1(six isolates), blaCTX-M-15+ blaSHV5+ blaOXA-1(two isolates), blaCTX-M-14a(two isolates), blaCTX-M-15+ blaSHV33(one isolate), blaCTX-M-15+ blaTEM-1(one isolate), blaCTX-M-15+ blaSHV12+ blaOXA-1(one isolate), blaCTX-M-15+ blaSHV5(one isolate), blaCTX-M-15+ blaSHV1(one isolate), and blaCTX-M-3(one isolate). The ISEcp1 (in four cases truncated by IS26), orf477, or IS903 sequences were found upstream or downstream of blaCTX-Mgenes. The aac(6')-Ib-cr gene was found in seven isolates. The qnrS1 and qnrB1 genes were detected in five isolates and two isolates, respectively. Seven isolates contained class 1 integrons with four gene cassette arrangements: dfrA5 (three isolates), dfrA12-orf-aadA2 (two isolates), dfrA17-aadA5 (one isolate), and aadA1 (one isolate). A high clonal diversity was also observed among studied isolates by pulsed-field gel electrophoresis (12 unrelated profiles). This study demonstrates for the first time the emergence and polyclonal spread of multidrug-resistant ESBL-producing K. pneumoniae isolates among patients in a hospital setting in Gaza Strip, Palestine.
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.
Ghassan
G
Tayh
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.
Rym
R
Ben Sallem
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.
Houssem
H
Ben Yahia
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.|2 Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El-Manar , Tunis, Tunisie.
Haythem
H
Gharsa
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.
Naouel
N
Klibi
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.
Abdellatif
A
Boudabous
1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté des Sciences de Tunis, Université de Tunis-El Manar , Tunis, Tunisie.|2 Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El-Manar , Tunis, Tunisie.
Karim
K
Ben Slama
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002511:Cephalosporins / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D019004:Galanin / Q000031:analogs & derivatives / Q000235:genetics; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D008877:Middle East; D013373:Substance P / Q000031:analogs & derivatives / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; C074975:galantide; D013373:Substance P; D019004:Galanin; D001618:beta-Lactamases
ESBL; Klebsiella pneumoniae; antibiotic resistance; class 1 integron