Carbapenem resistance in Escherichia coli and Klebsiella pneumonia is a main clinical problem. The Class D OXA-48 carbapenemase are emerging as an important menace mostly in the Mediterranean area. This investigation focused on the prevalence of Carbapenem resistant Escherichia coli and Klebsiella pneumonia using disk diffusion method and modified Hodge test (confirmatory test), as well as PCR for detection of OXA-48 gene. Between December 2012 and June 2013, a total of 138 wound’s swab samples was collected from burn units in Sina Hospital, Tabriz, Iran. All isolates were Cultured and diagnosed by standard microbiological and biochemical tests. Subsequently, the isolates were screened by disk diffusion method and confirmatory test (modified Hodge test)for Carbapenemase production. Resistant isolates were evaluated by PCR for molecular assessing. 22 among of 63, Klebsiella pneumoniae and 7 among of 38, E. coli isolates showed resistance to ertapenem. The results of the modified Hodge test with ertapenem disk showed that carbapenemase was produced by 20 Klebsiella pneumoniae and 3 E. coli isolates.We report the first isolation of Escherichia coli and Klebsiella pneumonia strains harboring blaOXA-48 gene in burn units in Sina Hospital, Tabriz, Iran. Our data show that OXA-48 enzymes are the predominant carbapenemase in Tabriz, Iran. The OXA-48 producers were significantly shown more susceptible to colistin and ciprofloxacin. The transmission of OXA-48 producers have occurred among patients as medical tourism. Because patients have travelled from Turkey and Azerbaijan to Tabriz for treatment likely transferred OXA-48 isolates to Tabriz. OXA-48 producer also probably could be colonized by the patient hospital staff and should be screened for these isolates on admission to hospital. The infection control measures should be considered after emerging OXA-48 producer, in order to including more attention for hand hygiene, wearing gloves and gowns for the period of patient care activities, and isolation of patients in private rooms and restrict the use of carbapenems as an antimicrobial stewardship program seem to prevent spread of these isolates in Iranian hospitals.
OXA-48, carbapenemase, Klebsiella pneumoniae, Escherichia coli, Burn patients
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