title: Detection of blaKPC and blaGES Carbapenemase Genes in Klebsiella pneumoniae Isolated from Hospitalized Patients in Kashan, Iran.
abstract: BACKGROUND
  Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are among the highly antimicrobial resistant gram negative bacteria and infections due to them are an increasingly major health problem worldwide.
  
  
  METHODS
  In this study we have detected the blaKPC and blaGES carbapenemase genes in Klebsiella pneumoniae isolated from hospitalized patients in Kashan, Iran. In a cross-sectional study, a total of 181 K. pneumoniae isolates were recovered from clinical specimens during November 2013 to October 2014.
  
  
  RESULTS
  Antimicrobial susceptibility profiles were determined using disk diffusion method according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and CLSI guidelines. Carbapenem-resistant K. pneumoniae isolates were identified. PCR method and sequencing were used for detection of blaKPC and blaGES carbapenemase genes. Of the 181 K. pneumoniae isolates, 35 (19.3%) were found to be resistant to imipenem and 150 (82.9%) were identified as MDR strains. Among carbapenems, the most resistant rate 39 (21.5%) was seen against ertapenem using disk diffusion method. Of K. pneumoniae isolates 21 (11.6%) and 42 (23.2%) carried blaKPC and blaGES genes, respectively and 19(10.5%) carried both genes simultaneously.
  
  
  CONCLUSIONS
  The data of current study revealed that the frequency of resistance to carbapenems and production of carbapenemase enzymes especially GES type was high among clinical isolates of K pneumoniae in Kashan, Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Firoozeh
authors.forename: Mehdi
authors.initials: M
authors.lastname: Aghaseyed-Hosseini
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zibaei
authors.affiliation: Department of Microbiology and Immunology, Kashan, 87159-88141, I.R. Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Piroozmand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000502:physiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics* / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: Antimicrobial resistance; GES; KPC; Klebsiella pneumonia; carbapenem; carbapenemases