Hospital Practices and Research

Abstract Background: Klebsiella pneumoniae (K. pneumoniae) is a major cause of hospital-acquired infections, where treatment options are restricted due to drug-resistant strains, including those producing extended-spectrum beta-lactamases (ESBLs) and carbapenemases.
Objectives: This study focuses on the molecular identification of beta-lactamase and carbapenemase genes in K. pneumoniae strains from Valiasr Hospital, Zanjan, to enhance infection control and antimicrobial strategies.
Methods: In this cross-sectional study, 50 K. pneumoniae clinical isolates were obtained from blood, urine, and wound samples of ICU patients in 2024. Phenotypic identification and antimicrobial susceptibility testing were performed using the Kirby-Bauer disk diffusion method. Genomic DNA extraction was performed using the phenol-chloroform method, followed by polymerase chain reaction (PCR) to identify resistance genes (blaCTX-M, blaTEM, blaSHV, blaIMP, blaVIM). The PCR products were analyzed via agarose gel electrophoresis, with data processed using SPSS version 26.
Results: The mean age of the patients was 58.90 years, and the isolates exhibited high resistance rates to ampicillin (90%), piperacillin (78%), and cefotaxime (72%). Genotypic testing indicated ESBL gene frequencies: blaTEM (46%), blaSHV (44%), and blaCTX-M (40%), along with carbapenemase genes blaVIM and blaIMP in 26% and 22% of isolates, respectively. A significant link was found between the blaTEM gene and urinary isolates (P = 0.037). Furthermore, the presence of the blaTEM, blaSHV, and blaCTX-M genes was associated with MDR, XDR, and PDR phenotypes (P < 0.05), with 100% of MDR isolates containing all three genes.
Conclusion: The study found a high prevalence of ESBL genes linked to multidrug resistance patterns among K. pneumoniae isolates in ICUs. The presence of carbapenemase genes (blaIMP and blaVIM) indicates a shift toward carbapenem resistance, underscoring the urgent need for better antibiotic surveillance and infection control in these settings.

Abstract Background: One third of the world’s population is infected with TB, and the disease is known as the second deadly global infection, even more severe than measles. The disease kills about 2 million people a year. Approximately 8 million people in the world are affected by advanced tuberculosis (TB).
Objective: The current study aimed to determine the frequency of resistance to the antibiotics isoniazid and rifampin in positive culture pulmonary TB patients in Zahedan city during 2013-2016.
Methods: This descriptive cross-sectional study studied 100 samples from patients who referred to Boo-Ali hospital of Zahedan city from 2014 to 2016. First, the isoniazid solution was prepared, and then the rifampin solution was prepared. After that, 200 μL of mycobacterium suspension was added to the antibiotic and antibiotic-free control.
Results: Of 100 patients participating in the study, 50 (50%) were male and 50 (50%) were female. Participants had an average age of 51.69 ± 20.41 years (95-12 years), 79 (79%) were Iranians and 21 (21%) were Afghans. Of the 100 samples, 55 (55%) were from the year 2013, 21 (21%) were from 2014, 10 (10%) were from 2015, and 14 (14%) were from year 2016. The samples examined showed that 4 (4%) were resistant and 96% were sensitive.
Conclusion: The results of the current study showed that out of 100 samples, 4 cases (4%) had resistance and 96% were sensitive; 2% were resistant to isoniazid, and 2% were resistant to isoniazid and rifampin.