Presence of qacEΔ1 and cepA genes and susceptibility to a hospital biocide in clinical isolates of Klebsiella pneumoniae in Iran.

The aim of this study was to evaluate the susceptibility of Klebsiella pneumoniae clinical isolates to antibiotics and to a quaternary ammonium compound (QAC) disinfectant as the concentrations used clinically and to determine the presence of the qacEΔ1 and cepA genes for the first time in Iran. In total, 85 K. pneumoniae isolates were randomly collected from hospitalized patients at the general hospitals in Lorestan, Iran. Antibiotic and antiseptic susceptibility testing was performed according to Clinical and Laboratory Standards Institute recommendations. K. pneumonia isolates were screened by PCR amplification of qacEΔ1 and cepA genes using specific primers and sequence analysis of the amplified regions were also performed. From 85 isolates of K. pneumoniae, 34 (40%) isolates were multidrug resistance (MDR). The evaluation of the susceptibility to the QAC disinfectant revealed that 51 (60%) isolates had reduced susceptibility to QAC disinfectant. The qacEΔ1 gene was detected in 26 isolates (30.6%). While cepA gene was found in 19 isolates (22.3%) of K. pneumonia. Seventy-three percent (19/26) qacEΔ1-positive isolates were detected in the biocide-resistant isolates. Whereas, 63.1% (12/19) cepA-positive isolates were found in the biocide-resistant isolates. Out of qacEΔ1 and cepA-positive isolates, 65.4% (17/26) and 42.1% (8/19) were among MDR isolates, respectively. No significant association of biocide resistance with the presence of qacEΔ1 and cepA genes was observed (P>0.05). The results of present study shows that there was a close link between qacEΔ1 gene and antibiotic resistance, but no significant association of biocide resistance with the presence of qacEΔ1 and cepA genes was observed in K. pneumoniae in Iran.