Molecular Characterization of Superbugs Harboring Extended-spectrum β-lactamase (ESBL) and Carbapenemase Resistance Genes Among Hospitalized Patients in Southwestern Iran, Western Asia

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Sep 12

PMID 39263100

Authors

Farhad Moradi

Maryam Akbari

Roghayyeh Vakili-Ghartavol

Mohsen Ostovari

Nahal Hadi

Affiliations

Soon will be listed here.

Abstract

Background: Detection of superbugs carrying Extended-spectrum β-lactamase (ESBL) and Carbapenemase resistance genes among hospitalized patients is crucial for infection control and prevention. The aim of this molecular study was to investigate the spread of ESBL and Carbapenemase-producing in two hospitals located in Southwest Iran.

Methods: One hundred clinical isolates of were randomly collected from two hospitals over a period of five months, from November 2023. The isolates were confirmed using biochemical and genotypic tests. According to the CLSI 2022 guidelines isolates that exhibited resistance to at least one of the three indicator cephalosporins or carbapenems were selected for evaluation of ESBL and carbapenemase production. This was done using a combination disk confirmatory test and the modified carbapenem inactivation method (mCIM). Finally, the presence of ESBLs and carbapenemase resistance encoding genes was assessed using PCR and specific primers.

Results: Out of the 100 isolates, the percentage of antibiotic resistance was cefoxitin (29 %), cefixime (28 %), ceftazidime (26 %), cefotaxime (24 %), cefepime (22 %), ceftriaxone (21 %), imipenem (20 %), and meropenem (17 %). Additionally, thirty isolated strains were found to be multidrug-resistant. Out of these, twenty-seven strains demonstrated a potential for ESBLs, twenty strains for Carbapenemase, and seventeen strains for both ESBLs and Carbapenemase production. Moreover, the occurrence of ESBLs and carbapenemase genes was as follows: (25 %), (23 %), (20 %), (17 %), and (13 %). It is important to mention that we did not detect the and resistant genes among clinical isolates.

Conclusion: Based on the results, the existence of this type of resistance in hospital centers needs to be reevaluated in terms of empirical antibiotic prescribing. Additionally, it is recommended that infection control measures should be taken for public health. Also, it's suggested that hospital-acquired infections caused by superbug resistant strains should be addressed.

Citing Articles

Aeromonas characteristics in Iran, Southwest Asia; a systematic review and meta-analysis on epidemiology, reservoirs and antibiotic resistance profile from aquatic environments to human society during 2000-2023.

Moradi F, Hadi N, Bazargani A, Abdi F, Ghorbanian N BMC Vet Res. 2025; 21(1):107.

PMID: 40001054 PMC: 11863832. DOI: 10.1186/s12917-024-04431-y.

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