Hospital Practices and Research

Abstract Background: Klebsiella pneumoniae is a gram-negative, short, facultative anaerobic bacillus that commonly grows in laboratory culture environments, including blood agar, EMB, Mueller-Hinton agar, and nutrient agar. As an opportunistic pathogen, it poses significant treatment challenges due to increasing antibiotic resistance. Objectives: The purpose of this study is to determine the relationship between antibiotic resistance and the frequency of qnrS and qnrA genes in clinical isolates of Klebsiella pneumonia. Methods: In this study, 100 patients referred to Sina Hospital in Tabriz due to urinary tract infections (UTIs) were examined. Common biochemical tests confirmed the presence of Klebsiella in 20 samples. The antibiotic sensitivity pattern of the isolates was determined using the disc diffusion method, and the results of the antibiogram test were analyzed. The resistance of the samples to five different types of antibiotics was assessed. Results: In this study, the highest antibiotic resistance was observed against nalidixic acid. The presence of the qnrS gene was confirmed in five isolates of Klebsiella pneumoniae, while the qnrA gene was absent in all isolates. The sensitivity of the Klebsiella pneumoniae strain to iron oxide nanoparticles was evaluated using the well method at a concentration of 0.08 g in 100 ml of water. One sample in a volume of 100 ml and two samples in a volume of 200 ml formed halos with diameters of 11 mm, 14 mm, and 12 mm, respectively. Conclusion: The findings of the present study showed that the frequency of qnrS genes was high in fluoroquinolone-resistant samples of Klebsiella pneumoniae, and this factor could lead to progressive antimicrobial resistance in different hospital departments.

Abstract Background: Urinary tract infections are among the most prevalent human infections, primarily caused by Enterobacteriaceae. Currently, a significant number of Enterobacteriaceae produce extended-spectrum beta-lactamases (ESBLs), rendering them resistant to beta-lactam antibiotics and resulting in treatment failures.
Objectives: The aim of this study was to determine the frequency of blaSHV and blaTEM genes in Enterobacter isolates from clinical samples at Amir al-Momenin Hospital in Maragheh city in 2023, as well as to assess their antibiotic and probiotic resistance patterns.
Methods: One hundred urine samples from patients with urinary tract infections hospitalized at Amir Al-Momenin Hospital were included in the study. ESBL-producing bacteria were identified using the agar disk diffusion method according to CLSI criteria, employing 30 µg ceftazidime and cefotaxime antibiotic disks, both with and without clavulanic acid. PCR was utilized to amplify the genes for examining the frequency of blaTEM and blaSHV genes. Electrophoresis of the samples was conducted on a 1% agarose gel.
Results: Of the 21 samples, the ESBL index was negative in 7 samples, resulting in a frequency of 33.33%, while it was positive in 14 samples, with a frequency of 66.67%. The frequency of the blaTEM gene in positive bacterial samples was 95.23%, and the frequency of the blaSHV gene was 92.52%.
Conclusion: The disk diffusion test on antibiotic-sensitive samples found that the highest average growth inhibition zone was associated with the CTC antibiotic, while the lowest average growth inhibition zone was related to the NA antibiotic.