Email updates

Keep up to date with the latest news and content from BMC Proceedings and BioMed Central.

This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

First report of QNRA isolated from extended spectrum B-lactamase producing hospital-acquired Klebsiella pheumoniae in Kuwait

L Vali*, AA Dashti, MM Jadaon, S El-Shazly and BT Jose

  • * Corresponding author: L Vali

Author Affiliations

Kuwait University, Kuwait, Kuwait

For all author emails, please log on.

BMC Proceedings 2011, 5(Suppl 6):P139  doi:10.1186/1753-6561-5-S6-P139


The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1753-6561/5/S6/P139


Published:29 June 2011

© 2011 Vali et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

Extended Spectrum beta-lactamase (ESBL)-mediated resistant Klebsiella pneumoniae are important opportunistic pathogens. In this study we investigated the prevalence of plasmid-mediated fluoroquinolone resistance in ESBL-producing K. pneumoniae in nosocomial infections in Kuwait.

Methods

From a total of 72 non-duplicate quinolone and cephalosporin resistant Enterobacteriacae obtained from October-December 2010 from Ahmadi hospital in Kuwait, 16 were K. pneumoniae. Antimicrobial susceptibility was determined by Vitek, Microscan, double disc diffusion, agar dilution and E-test against a panel of 26 antimicrobial agents. The presence of blaSHV, blaTEM, blaCTX-M, gyrA, parC, qnrA, qnrB, qnrS and class 1 integrons were determined by PCR and sequencing. Pulsed-field gel electrophoresis (PFGE) was used for typing the strains and the results were analysed according to Tenover criteria.

Results

All 16 isolates were resistant to all antibiotics tested including ciproflaxoacin (MIC>4), tazobactam (MIC>16), cefotaxime (MIC>16) and ceftazidime (MIC>16); except for carbapenems, amikacin, and tigecycline. blaTEM, blaSHV& & blaCTX-M-15 were present in 81.25% (13), 81.25% (13) and 68.75% (11) respectively. Nine (56.25%) isolates contained all three bla genes of which one harboured qnrA (A2 allele) and a class 1 integron. No mutations were found in gyrA and parC. PFGE revealed that K. pneumoniae isolates harbouring ESBL genes consisted of two distinct clones.

Conclusion

Contrary to a previous study, we hereby report the emergence of plasmid-mediated qnrA gene among ESBL producing nosocomial K. pneumoniae for the first time in Kuwait. Identification of these strains are crucial for administering the correct antibiotic and preventing their spread among hospitalised patients.

Disclosure of interest

None declared.