Abstract

IntroductionNosocomial infections (NIs) are a major challenge worldwide. Identification of antibiotic resistance pattern extended spectrum beta-lactamases (ESBLs) and carbapenem-resistant Enterobacteriaceae (CRE) were the objectives of this study.MethodsIn this cross-sectional study, the antimicrobial susceptibility pattern of bacterial isolates collected from patients with NIs in ICU was determined. Overall, 42 Escherichia coli and Klebsiella pneumoniae isolates from different infection sites were used to determine phenotypic tests of ESBLs, Metallo-beta-lactamases (MBLs) and CRE. Detection of ESBLs, MBLs and CRE genes were performed by the polymerase chain reaction (PCR) method.ResultsFrom 71 patients with NIs, 103 different bacterial strains were isolated. The most frequently isolated bacteria were E. coli (n = 29; 28.16), Acinetobacter baumannii (n = 15; 14.56), and K. pneumoniae (n = 13; 12.26). Also, the rate of multidrug-resistant (MDR) isolates was 58.25 (60/103). Based on phenotypic confirmation tests, 32 (76.19) isolates of E. coli and K. pneumoniae produced ESBLs, and 6 (14.28) isolates were identified as CRE producers. PCR showed the high prevalence of the bla(CTX-M) (n = 29; 90.62) in ESBL genes. In addition, bla(NDM) was detected in 4 (66.66), bla(OXA-23) in 3 (50), and bla(OXA-48) gene in 1 (16.66) isolates. The bla(VIM), bla(KPC), and bla(IMP) genes were not detected in any of the isolates.ConclusionThe Gram-negative bacteria E. coli, A. baumannii, and K. pneumoniae with high resistance levels were the most common bacteria causing NIs in the ICU. This study for the first time identified bla(OXA-11), bla(OXA-23), and bla(NDM-1) genes in E. coli and K. pneumoniae in Ilam city of Iran.