detection of is903, is26 and isecp1 elements in ctx-m-producing klebsiella pneumoniae and escherichia coli isolates from patients with leukemia in iran

Background: the ability of extended spectrum beta-lactamases (esbls) production is one of the main mechanisms for the emergence of antibiotic resistance in escherichia coli and klebsiella pneumoniae. objectives: the aim of this study was to evaluate the occurrence of is903, is26, and isecp1 insertion elements among the ctx-mproducing k. pneumoniae and e. coli isolates from patients with leukemia in tehran. methods: eighty e. coli and k. pneumoniae isolates were recovered from patients admitted to hospitals of tehran. antibiotic susceptibility tests were performed by kirby-bauer disc diffusion and broth microdilution methods. detection of esbl producers was evaluated by phenotypic confirmatory test. the presence of is903, is26, and isecp1 insertion elements in ctx-m-positive e. coli and k. pneumoniae isolates was investigated by pcr-sequencing methods. results: the rate of resistance of 80 e. coli and k. pneumoniae isolates against the nine antibiotics was as follows: 100% to ampicillin, 15% to amikacin, 51% to ciprofloxacin, 30% to gentamicin, 58% to ceftriaxone, 10% to imipenem, 63% to cefotaxime, 51% to levofloxacin, and 55% to ceftazidime. using phenotypic confirmatory test revealed that 51 (63.75%) isolates were esbl producers. the prevalence of ctx-m-1, ctx-m-2, ctx-m-9, ctx-m-8, and ctx-m-25 genes was 87.5%, 13.75%, 23.75%, 10%, and 0%, respectively. is903, is26, and isecp1 elements were detected in 93.75%, 71.25%, and 100% of the isolates, respectively. conclusions: this study indicates that the high prevalence of antibiotic resistance, is and ctx-m-producing e. coli, and k. pneumoniae isolates could be a major concern and highlights the need for infection control measures.