prevalence of extended-spectrum β-lactamase and integron gene carriage in multidrug-resistant klebsiella species isolated from outpatients in yazd, iran

Background: community-acquired infections by multidrug- resistant (mdr), extended-spectrum β-lactamase (esbl) producing klebsiella species (klebsiella spp.) is of major concern worldwide. antibiotic resistance, production of extended- spectrum β-lactamases (esbls), and carbapenemases, as well as the presence of classes 1, 2, and 3 integrons in outpatient isolates of klebsiella collected from yazd central laboratory, yazd, iran.methods: we collected 250 klebsiella isolates from yazd central laboratory between august 2015 and october 2017. antibiotic susceptibility was determined against 18 antibiotics by disc diffusion, and multidrug-resistant isolates were tested for esbl production by the phenotypic confirmatory test according to clsi 2017 protocols. the amplification of β-lactamase genesblashv, blatem, blactx-m, blaoxa-48, blakpc, and blandm, classes 1, 2, and 3 integrase genes, was carried out using specific primers and polymerase chain reaction (pcr).results: of the 250 klebsiella outpatient isolates, 3.6% were k. oxytoca and the rest were k. pneumoniae. disc diffusion showed that 21 (8.4%) isolates were mdr, 19 (90.4%) of which were esbl producers including one k. oxytoca. the most prevalentβ-lactamase gene was blashv followed by blatem and blactx-m, but blaoxa-48, blakpc, and blandm were not detected. class 1 integron was detected in 18 out of 21 mdr isolates (85.7%), butclasses 2 and 3 were not observed. two isolates were resistant to carbapenems and harbored blashv, blatem, and blactx-m, as well as class 1 integron.conclusion: esbl production and the presence of multiple β-lactamase genes in mdr community isolates of klebsiella spp. can have significant implications in terms of the spread ofthese opportunistic pathogens.