{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:28:08Z","timestamp":1790681288724,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100012155","name":"National Institute for Medical Research Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as an important global threat in recent years. The objective of the present study was to characterize the molecular characteristics, antibiotic resistance pattern and the distribution of virulence factors in CRKP isolated from different clinical specimens. A total of 60 clinical CRKP isolates were collected from clinical samples. Based on Clinical Laboratory Standards Institute guidelines, antimicrobial susceptibility testing was assessed by the disk diffusion method. Carbapenem and aminoglycoside resistance determinants in addition to virulence genes were inspected by PCR. Molecular characteristics of CRKP isolates were analyzed by random amplified polymorphic DNA (RAPD) PCR and enterobacterial repetitive intergenic consensus (ERIC) PCR. All isolates were resistant to imipenem, meropenem, cefoxitin, levofloxacin, cefotaxime, ceftazidime and ciprofloxacin. Resistance to tetracycline, gentamicin and kanamycin were detected in 53%, 75% and 72% of isolates, respectively. The most common carbapenem resistance genes were OXA-48 (28.5%) and NDM (22%). The most common aminoglycosides resistance genes were aac6\u00b4Ib (57%) and aac(3)-IVa (28%). The most prevalent virulence genes were mrkD (82%), entB (62%) and ybts (58%). ERIC and RAPD analyses revealed 55 and 53 different patterns of CRKP isolates, respectively. We conclude that CRKP infections have been associated with different genotypes and that the carbapenemase type (OXA-48) and AME gene (aac6\u00b4-Ib) were widely distributed in CRKP isolates in our hospital. Continued compliance with existing phenotypes and genotypes, and strict enforcement of infection control guidelines, are recommended approaches for the prevention and dissemination of these strains.<\/jats:p>","DOI":"10.1093\/femsle\/fnac100","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T16:01:57Z","timestamp":1666368117000},"source":"Crossref","is-referenced-by-count":7,"title":["Antimicrobial resistance pattern, virulence determinants and molecular analysis of carbapenem-resistant <i>Klebsiella pneumoniae<\/i> isolated from clinical samples in Iran"],"prefix":"10.1093","volume":"369","author":[{"given":"Mahsa","family":"Ghamari","sequence":"first","affiliation":[{"name":"Department of Microbiology, School of Medicine, Tehran University of Medical Sciences , 1417613151, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Beigverdi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Tehran University of Medical Sciences , 1417613151, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7205-8269","authenticated-orcid":false,"given":"Fereshteh","family":"Jabalameli","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Tehran University of Medical Sciences , 1417613151, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0208-7264","authenticated-orcid":false,"given":"Mohammad","family":"Emaneini","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, Tehran University of Medical Sciences , 1417613151, Tehran, Iran"},{"name":"Medical Mycology and Bacteriology Research Center, Kerman University of Medical Sciences , 7616914115, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,21]]},"reference":[{"key":"2022111513183635300_bib1","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1038\/s41598-018-36554-2","article-title":"Molecular characterization of carbapenem resistant Klebsiellapneumoniae and Klebsiellaquasipneumoniae isolated from Lebanon","volume":"9","author":"Arabaghian","year":"2019","journal-title":"Sci Rep"},{"key":"2022111513183635300_bib2","article-title":"Performance standards for antimicrobial susceptibility testing","volume-title":"CLSI supplement M100","author":"Clinical, and Institute L.S.","year":"2020","edition":"30th ed."},{"key":"2022111513183635300_bib3","doi-asserted-by":"crossref","first-page":"4377","DOI":"10.1128\/JCM.02316-14","article-title":"Multiplex PCR for detection of seven virulence factors and K1\/K2 capsular serotypes of Klebsiellapneumoniae","volume":"52","author":"Compain","year":"2014","journal-title":"J Clin Microbiol"},{"key":"2022111513183635300_bib4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1089\/mdr.2017.0102","article-title":"Prevalence of aminoglycoside-modifying enzymes in Escherichiacoli and Klebsiellapneumoniae producing extended spectrum \u03b2-lactamases collected in two multicenter studies in Spain","volume":"24","author":"Fern\u00e1ndez-Mart\u00ednez","year":"2018","journal-title":"Microb Drug Resist"},{"key":"2022111513183635300_bib5","doi-asserted-by":"crossref","first-page":"3198","DOI":"10.3389\/fmicb.2018.03198","article-title":"High prevalence of multidrug-resistant Klebsiellapneumoniae harboring several virulence and \u03b2-lactamase encoding genes in a Brazilian intensive care unit","volume":"9","author":"Ferreira","year":"2019","journal-title":"Front Microbiol"},{"key":"2022111513183635300_bib6","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1742-5573-2-10","article-title":"Choosing an appropriate bacterial typing technique for epidemiologic studies","volume":"2","author":"Foxman","year":"2005","journal-title":"Epidemiol Perspect Innov"},{"key":"2022111513183635300_bib7","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1089\/mdr.2016.0224","article-title":"Dissemination of genes encoding aminoglycoside-modifying enzymes and armA among enterobacteriaceae isolates in Northwest Iran","volume":"23","author":"Ghotaslou","year":"2017","journal-title":"Microb Drug Resist"},{"key":"2022111513183635300_bib8","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1186\/s12879-016-1942-z","article-title":"Clinical and molecular characteristics of Klebsiellapneumoniae ventilator-associated pneumonia in mainland China","volume":"16","author":"Guo","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2022111513183635300_bib9","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1556\/030.64.2017.026","article-title":"Emergence of NDM-1 among carbapenem-resistant Klebsiellapneumoniae in Iraqi hospitals","volume":"65","author":"Hussein","year":"2018","journal-title":"Acta Microbiol Immunol Hung"},{"key":"2022111513183635300_bib10","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1089\/mdr.2017.0404","article-title":"Molecular epidemiology and drug resistance pattern of carbapenem-resistant Klebsiellapneumoniae isolates from Iran","volume":"25","author":"Jafari","year":"2019","journal-title":"Microb Drug Resist"},{"key":"2022111513183635300_bib30_1667340186576","doi-asserted-by":"crossref","first-page":"17291","DOI":"10.1038\/s41598-017-17681-8","article-title":"Serotype and virulence genes of Klebsiella pneumoniae isolated from mink and its pathogenesis in mice and mink","volume":"7","author":"Jian-li","year":"2017","journal-title":"Sci Rep"},{"key":"2022111513183635300_bib11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.2147\/IDR.S186994","article-title":"Endemic dissemination of different sequence types of carbapenem-resistant Klebsiellapneumoniae strains harboring bla (NDM) and 16S rRNA methylase genes in Kerman hospitals, Iran, from 2015 to 2017","volume":"12","author":"Kiaei","year":"2019","journal-title":"Infect Drug Resist"},{"key":"2022111513183635300_bib12","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1179\/1973947813Y.0000000073","article-title":"Genetic basis of aminoglycoside resistance following changes in aminoglycoside prescription patterns","volume":"25","author":"Kosmidis","year":"2013","journal-title":"J Chemother"},{"key":"2022111513183635300_bib13","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1741-7007-12-41","article-title":"Comparative analysis of Klebsiellapneumoniae genomes identifies a phospholipase d family protein as a novel virulence factor","volume":"12","author":"Lery","year":"2014","journal-title":"BMC Biol"},{"key":"2022111513183635300_bib14","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.3389\/fmicb.2018.01595","article-title":"Characterization of CRISPR-Cas systems in clinical Klebsiellapneumoniae isolates uncovers its potential association with antibiotic susceptibility","volume":"9","author":"Li","year":"2018","journal-title":"Frontiers in Microbiology"},{"key":"2022111513183635300_bib15","volume-title":"Textbook of diagnostic microbiology-E-Book","author":"Mahon","year":"2018"},{"key":"2022111513183635300_bib16","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.meegid.2018.06.030","article-title":"Molecular epidemiology of aminoglycoside resistance in clinical isolates of Klebsiellapneumoniae collected from Qazvin and Tehran provinces, Iran","volume":"64","author":"Nasiri","year":"2018","journal-title":"Infect Genet Evol"},{"key":"2022111513183635300_bib17","doi-asserted-by":"crossref","first-page":"603","DOI":"10.2147\/IDR.S199639","article-title":"Molecular characterization, serotypes and phenotypic and genotypic evaluation of antibiotic resistance of the Klebsiellapneumoniae strains isolated from different types of hospital-acquired infections","volume":"12","author":"Ranjbar","year":"2019","journal-title":"Infect Drug Resist"},{"key":"2022111513183635300_bib18","doi-asserted-by":"crossref","DOI":"10.3947\/ic.2019.0027","article-title":"Virulence factors, capsular serotypes and antimicrobial resistance of hypervirulent Klebsiellapneumoniae and classical Klebsiellapneumoniae in Southeast Iran","volume":"51","author":"Rastegar","year":"2019","journal-title":"Infect Chemother"},{"key":"2022111513183635300_bib19","doi-asserted-by":"crossref","first-page":"e961","DOI":"10.1016\/j.ijid.2013.04.007","article-title":"Trends in antibiotic susceptibility and incidence of late-onset Klebsiellapneumoniae neonatal sepsis over a six-year period in a neonatal intensive care unit in Karachi, Pakistan","volume":"17","author":"Saleem","year":"2013","journal-title":"Int J Infect Dis"},{"key":"2022111513183635300_bib20","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1007\/s10096-017-3035-3","article-title":"Molecular characterization of intestinal carriage of carbapenem-resistant enterobacteriaceae among inpatients at two Iranian university hospitals: first report of co-production of blaNDM-7 and blaOXA-48","volume":"36","author":"Solgi","year":"2017","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2022111513183635300_bib21","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1093\/jac\/dky081","article-title":"Molecular epidemiology of NDM-1- and OXA-48-producing Klebsiellapneumoniae in an Iranian hospital: clonal dissemination of ST11 and ST893","volume":"73","author":"Solgi","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"2022111513183635300_bib22","doi-asserted-by":"crossref","first-page":"38929","DOI":"10.1038\/srep38929","article-title":"Molecular typing and virulence analysis of multidrug resistant Klebsiellapneumoniae clinical isolates recovered from Egyptian hospitals","volume":"6","author":"Wasfi","year":"2016","journal-title":"Sci Rep"},{"key":"2022111513183635300_bib24","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.mib.2018.04.004","article-title":"Klebsiella pneumoniae as a key trafficker of drug resistance genes from environmental to clinically important bacteria","volume":"45","author":"Wyres","year":"2018","journal-title":"Curr Opin Microbiol"},{"key":"2022111513183635300_bib25","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.cmi.2015.09.015","article-title":"National epidemiology of carbapenem-resistant and extensively drug-resistant Gram-negative bacteria isolated from blood samples in China in 2013","volume":"22","author":"Xu","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"2022111513183635300_bib26","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1128\/JCM.01150-06","article-title":"Capsular serotype K1 or K2, rather than magA and rmpA, is a major virulence determinant for Klebsiellapneumoniae liver abscess in Singapore and Taiwan","volume":"45","author":"Yeh","year":"2007","journal-title":"J Clin Microbiol"},{"key":"2022111513183635300_bib29_1667339622641","doi-asserted-by":"crossref","first-page":"289","DOI":"10.3389\/fmicb.2018.00289","article-title":"Phenotypic and Genotypic Characterization of Klebsiella pneumoniae Isolated From Retail Foods in China","volume":"9","author":"Zhang","year":"2018","journal-title":"Front Microbiol"},{"key":"2022111513183635300_bib27","doi-asserted-by":"crossref","first-page":"931","DOI":"10.2147\/IDR.S243032","article-title":"Dynamic epidemiology and virulence characteristics of carbapenem-resistant Klebsiellapneumoniae in Wenzhou, China from 2003 to 2016","volume":"13","author":"Zhao","year":"2020","journal-title":"Infect Drug Resist"},{"key":"2022111513183635300_bib28","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.3389\/fmicb.2017.01061","article-title":"Molecular epidemiology and risk factors of carbapenem-resistant Klebsiellapneumoniae infections in Eastern China","volume":"8","author":"Zheng","year":"2017","journal-title":"Front Microbiol"},{"key":"2022111513183635300_bib29","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s13756-020-00757-y","article-title":"Successful control of the first carbapenem-resistant Klebsiella pneumoniae outbreak in a Chinese hospital 2017-2019","volume":"9","author":"Zhu","year":"2020","journal-title":"Antimicrob Resist Infect Control"}],"container-title":["FEMS Microbiology Letters"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/femsle\/advance-article-pdf\/doi\/10.1093\/femsle\/fnac100\/46595053\/fnac100.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/femsle\/article-pdf\/369\/1\/fnac100\/47044683\/fnac100.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/femsle\/article-pdf\/369\/1\/fnac100\/47044683\/fnac100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T13:19:14Z","timestamp":1668518354000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/femsle\/article\/doi\/10.1093\/femsle\/fnac100\/6767588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,11,9]]}},"URL":"https:\/\/doi.org\/10.1093\/femsle\/fnac100","relation":{},"ISSN":["1574-6968"],"issn-type":[{"value":"1574-6968","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022]]},"published":{"date-parts":[[2022]]},"article-number":"fnac100"}}