The spread of aminoglycoside resistant genes in clinical isolates of Klebsiella pneumoniae from Kermanshah medical centers

Introduction: Resistance of Klebsiella pneumoniae to aminoglycosides is a serious therapeutic problem, especially in hospitals. The aim of this study was to determine resistance to aminoglycosides and frequency of aac (3)-IIa, aac (6')- Ib, aac (3)-IV, aph (3')- Ia and ant (2")- Ia K. pneumoniae isolated from Kermanshah Medical Centers.

Methods: A total of 165 samples from different clinical samples were investigated and among them 100 isolates of K. pneumoniae by Keith API-20E was confirmed. The antibiotic sensitivity test to aminoglycosides by disk diffusion method was performed. After extraction the bacterial genome, the genes of aac (3)- Ia, aac (3)-IV, aph (3')-Ia, aac (6')- Ib and ant (2")- Ia were tested using PCR. Data are statistically analyzed.

Results: Of 100 isolates, 49 isolates (49%) were resistant to tobramycin and / or gentamycin. Frequency of aac (6')-Ib, aph (3')-Ia and ant (2")-Ia among isolates were 87.7%, 42.8% and 24.4%, respectively. But aac (3)-IV and aac (3)- IIa genes were not found in any of the isolates.

Conclusion: K.pneumoniae isolates phenotypically showed lower resistance aminoglyocosides tested in compared to the most previous studies. However, the aac (6 ') - Ib, aph (3') - Ia and ant (2 ") - Ia resistant genes had a high prevalence rate. The high prevalence of resistance genes in Kermanshah can be consequences of extensive and inappropriate prescribing of aminoglycosides and the lack of effective measures for infection control in hospitals.