year 16, Issue 6 (November - December 2022)
Iran J Med Microbiol 2022, 16(6): 490-505 |
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Mosayeb Rostamian1 
, Sepide Kadivarian2 , Sara Kooti2 , Shirin Dashtbin3 , Ramin Abiri4 , Amirhooshang Alvandi 5
, Sepide Kadivarian2 , Sara Kooti2 , Shirin Dashtbin3 , Ramin Abiri4 , Amirhooshang Alvandi 5
1- Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
2- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
3- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4- Fertility and Infertility Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Medical Technology Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran , ah_alvandi@kums.ac.ir
2- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
3- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4- Fertility and Infertility Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Medical Technology Research Center, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran , ah_alvandi@kums.ac.ir
Abstract: (2577 Views)
Background and Aim: Nosocomial infections caused by gram-negative bacteria are among the most important health-threatening challenges of the current century, particularly following the emergence and spreading of antibiotic-resistance strains. Extended-spectrum beta-lactamase (ESBL), one of the most important antibiotic resistance mechanisms, is spreading worldwide. Surveillance and gathering data on the prevalence of antibiotic resistance and their associated encoding genes could assist in selecting treatment strategies and policies. This systematic review and meta-analysis was designed to assess the prevalence of ESBL-positive bacteria and their resistance genes in medical centers of Kermanshah city, west of Iran.
Materials and Methods: All studies published as original articles were retrieved by searching in EMBASE, Scopus, PubMed/Medline, Google Scholar, and Persian databases of SID and Magiran, using appropriate keywords All published studies in the field were included without time restriction until 30-Mar-2022. Comprehensive Meta-Analysis software was used to analyze the data.
Results: The prevalence of ESBL-positive and multidrug resistance (MDR) bacteria in Kermanshah medical centers were 34.8% and 56.1%, respectively. The highest and lowest prevalence of ESBL-positive bacteria was observed for Enterobacter cloacae (59.14%) and Pseudomonas aeruginosa (4.55%), respectively. The highest and lowest prevalence of the resistance genes were observed for blaOXA-51 (99.3%) and blaKPC (0.6%), respectively. The highest resistance was estimated to mezlocillin antibiotic (92.2%).
Conclusion: This study showed that the prevalence of ESBL-positive and MDR bacteria is high in Kermanshah medical centers, and it provides significant information to health policymakers to implement appropriate strategies to reduce the prevalence of resistant bacteria.
Keywords: Extended-spectrum-beta-lactamase, Gram-negative bacteria, Antibiotic resistance, Prevalence, Meta-analysis
Type of Study: Meta-analysis Article |
Subject:
Medical Bacteriology
Received: 2022/03/6 | Accepted: 2022/06/28 | ePublished: 2022/09/9
Received: 2022/03/6 | Accepted: 2022/06/28 | ePublished: 2022/09/9
References
1. Breijyeh Z, Jubeh B, Karaman R. Resistance of gram-negative bacteria to current antibacterial agents and approaches to resolve it. Molecules. 2020;25(6):1340. [DOI:10.3390/molecules25061340] [PMID] [PMCID]
2. Mehrad B, Clark NM, Zhanel GG, Lynch III JP. Antimicrobial resistance in hospital-acquired gram-negative bacterial infections. Chest. 2015;147(5):1413-21. [DOI:10.1378/chest.14-2171] [PMID] [PMCID]
3. Peymani A, Naserpour-Farivar T, Zare E, Azarhoosh K. Distribution of blaTEM, blaSHV, and blaCTX-M genes among ESBL-producing P. aeruginosa isolated from Qazvin and Tehran hospitals, Iran. J Prev Med Hyg. 2017;58(2):E155.
4. Pishtiwan AH, Khadija KM. Prevalence of blaTEM, blaSHV, and blaCTX-M genes among ESBL-producing Klebsiella pneumoniae and Escherichia coli isolated from thalassemia patients in Erbil, Iraq. Mediterr J Hematol Infect Dis. 2019;11(1). [DOI:10.4084/mjhid.2019.041] [PMID] [PMCID]
5. Pana ZD, Zaoutis T. Treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLs) infections: what have we learned until now? F1000Research. 2018;7. [DOI:10.12688/f1000research.14822.1] [PMID] [PMCID]
6. Pormohammad A, Nasiri MJ, Azimi T. Prevalence of antibiotic resistance in Escherichia coli strains simultaneously isolated from humans, animals, food, and the environment: a systematic review and meta-analysis. Infect Drug Resist. 2019;12:1181. [DOI:10.2147/IDR.S201324] [PMID] [PMCID]
7. Barzegar S, Arzanlou M, Teimourpour A, Esmaelizad M, Yousefipour M, MohammadShahi J, et al. Prevalence of the Integrons and ESBL Genes in Multidrug-Resistant Strains of Escherichia coli Isolated from Urinary Tract Infections, Ardabil, Iran. Int J Med Microbiol. 2022;16(1):56-65. [DOI:10.30699/ijmm.16.1.56]
8. McInnes MD, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. Jama. 2018;319(4):388-96. [DOI:10.1001/jama.2017.19163] [PMID]
9. Flokas ME, Karanika S, Alevizakos M, Mylonakis E. Prevalence of ESBL-producing Enterobacteriaceae in pediatric bloodstream infections: a systematic review and meta-analysis. PloS one. 2017;12(1):e0171216. [DOI:10.1371/journal.pone.0171216] [PMID] [PMCID]
10. Storberg V. ESBL-producing Enterobacteriaceae in Africa-a non-systematic literature review of research published 2008-2012. Infect Ecol Epidemiology. 2014;4(1):20342. [DOI:10.3402/iee.v4.20342] [PMID] [PMCID]
11. Flokas ME, Alevizakos M, Shehadeh F, Andreatos N, Mylonakis E. ESBL-producing Enterobacteriaceae Colonization in Long-Term Care Facilities (LTCFs): A Systematic Review and Metaâ analysis. Int J Antimicrob Agents. 2017. [DOI:10.1016/j.ijantimicag.2017.08.003] [PMID]
12. Irek EO, Amupitan AA, Aboderin AO, Obadare TO. A systematic review of healthcare-associated infections in Africa: An antimicrobial resistance perspective. Afr J Lab Med. 2018;7(2):1-9. [DOI:10.4102/ajlm.v7i2.796] [PMID] [PMCID]
13. Mansouri F, Sheibani H, Javedani Masroor M, Afsharian M. Extended‐spectrum beta‐lactamase (ESBL)‐producing Enterobacteriaceae and urinary tract infections in pregnant/postpartum women: A systematic review and meta‐analysis. Int J Clin Pract. 2019;73(12):e13422. [DOI:10.1111/ijcp.13422] [PMID]
14. Zhang J, Zheng B, Zhao L, Wei Z, Ji J, Li L, et al. Nationwide high prevalence of CTX-M and an increase of CTX-M-55 in Escherichia coli isolated from patients with community-onset infections in Chinese county hospitals. BMC Infect Dis. 2014;14(1):1-10. [DOI:10.1186/s12879-014-0659-0] [PMID] [PMCID]
15. Tanko N, Bolaji RO, Olayinka AT, Olayinka BO. A systematic review on the prevalence of extended-spectrum beta lactamase-producing Gram-negative bacteria in Nigeria. J Glob Antimicrob Resist. 2020;22:488-96. [DOI:10.1016/j.jgar.2020.04.010] [PMID]
16. Tufa TB, Fuchs A, Tufa TB, Stötter L, Kaasch AJ, Feldt T, et al. High rate of extended-spectrum beta-lactamase-producing gram-negative infections and associated mortality in Ethiopia: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2020;9(1):1-10. [DOI:10.1186/s13756-020-00782-x] [PMID] [PMCID]
17. Abrar S, Hussain S, Khan RA, Ul Ain N, Haider H, Riaz S. Prevalence of extended-spectrum-β-lactamase-producing Enterobacteriaceae: first systematic meta-analysis report from Pakistan. Antimicrob Resist Infect Control. 2018;7(1):1-11. [DOI:10.1186/s13756-018-0309-1] [PMID] [PMCID]
18. Tariq TM. Bacteriologic profile and antibiogram of blood culture isolates from a children's hospital in Kabul. J Coll Physicians Surg Pak. 2014;24(6):396-9.
19. Kiros T, Workineh L, Tiruneh T, Eyayu T, Damtie S, Belete D. Prevalence of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Ethiopia: A Systematic Review and Meta-Analysis. Int J Microbiol. 2021;2021. [DOI:10.1155/2021/6669778] [PMID] [PMCID]
20. Livermore DM, Canton R, Gniadkowski M, Nordmann P, Rossolini GM, Arlet G, et al. CTX-M: changing the face of ESBLs in Europe. J Antimicrob Chemother. 2007;59(2):165-74. [DOI:10.1093/jac/dkl483] [PMID]
21. Ben Sallem R, Ben Slama K, Estepa V, Jouini A, Gharsa H, Klibi N, et al. Prevalence and characterisation of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates in healthy volunteers in Tunisia. Eur J Clin Microbiol Infect Dis. 2012;31(7):1511-6. [DOI:10.1007/s10096-011-1471-z] [PMID]
22. Abbassi MS, Torres C, Achour W, Vinué L, Sáenz Y, Costa D, et al. Genetic characterisation of CTX-M-15-producing Klebsiella pneumoniae and Escherichia coli strains isolated from stem cell transplant patients in Tunisia. Int J Antimicrob Agents. 2008;32(4):308-14. [DOI:10.1016/j.ijantimicag.2008.04.009] [PMID]
23. Dahmen S, Bettaieb D, Mansour W, Boujaafar N, Bouallegue O, Arlet G. Characterization and molecular epidemiology of extended-spectrum β-lactamases in clinical isolates of Enterobacteriaceae in a Tunisian University hospital. Microb Drug Resist. 2010;16(2):163-70. [DOI:10.1089/mdr.2009.0108] [PMID]
24. Elhani D, Bakir L, Aouni M, Passet V, Arlet G, Brisse S, et al. Molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae strains in a university hospital in Tunis, Tunisia, 1999-2005. Clin Microbiol Infect. 2010;16(2):157-64. [DOI:10.1111/j.1469-0691.2009.03057.x] [PMID]
25. Datta S, Wattal C, Goel N, Oberoi JK, Raveendran R, Prasad K. A ten year analysis of multidrug resistant blood stream infections caused by Escherichia coli & Klebsiella pneumoniae in a tertiary care hospital. Indian J Med Res. 2012;135(6):907.
26. Amin H, Zafar A, Ejaz H, Jameel N-u-A. Phenotypic characterization of ESBL producing Enterobacter cloacae among children. Pak J Med Sci. 2013;29(1):144. [DOI:10.12669/pjms.291.2385] [PMID] [PMCID]
27. Ali A, Rafi S, Qureshi A. Frequency of extended spectrum beta lactamase producing gram negative bacilli among clinical isolates at clinical laboratories of Army Medical College, Rawalpindi. Rawalpindi PRO. 2004;2:25-9.
28. Jabeen K, Zafar A, Hasan R. Frequency and sensitivity pattern of extended spectrum beta lactamase producing isolates in a tertiary care hospital laboratory of Pakistan. J Pak Med Assoc. 2005;55(10):436.
29. Leylabadlo HE, Pourlak T, Aghazadeh M, Asgharzadeh M, Kafil HS. Extended-spectrum beta-lactamase producing gram negative bacteria In Iran: A review. Afr J Infect Dis. 2017;11(2):39-53. [DOI:10.21010/ajid.v11i2.6] [PMID] [PMCID]
30. Ghaderi RS, Yaghoubi A, Amirfakhrian R, Hashemy SI, Ghazvini K. The prevalence of genes encoding ESBL among clinical isolates of Escherichia coli in Iran: A systematic review and meta-analysis. Gene Reports. 2020;18:100562. [DOI:10.1016/j.genrep.2019.100562]
31. Beigverdi R, Jabalameli L, Jabalameli F, Emaneini M. Prevalence of extended-spectrum β-lactamase-producing Klebsiella pneumoniae: First systematic review and meta-analysis from Iran. J Glob Antimicrob Resist. 2019;18:12-21. [DOI:10.1016/j.jgar.2019.01.020] [PMID]
32. Mohd Asri NA, Ahmad S, Mohamud R, Mohd Hanafi N, Mohd Zaidi NF, Irekeola AA, et al. Global prevalence of nosocomial multidrug-resistant Klebsiella pneumoniae: a systematic review and meta-analysis. Antibiotics. 2021;10(12):1508. [DOI:10.3390/antibiotics10121508] [PMID] [PMCID]
33. Al-Agamy MH, Shibl AM, Tawfik AF. Prevalence and molecular characterization of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Riyadh, Saudi Arabia. Ann Saudi Med. 2009;29(4):253-7. [DOI:10.4103/0256-4947.55306] [PMID] [PMCID]
34. Alfaresi MS, Elkoush AA, Alshehhi HM, Abdulsalam AI. Molecular characterization and epidemiology of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in the United Arab Emirates. Med Princ Pract. 2011;20(2):177-80. [DOI:10.1159/000319912] [PMID]
35. Dziri O, Dziri R, Maraoub A, Chouchani C. First report of SHV-148-Type ESBL and CMY-42-type AmpC β-lactamase in klebsiella pneumoniae clinical isolates in Tunisia. Microb Drug Resist. 2018;24(10):1483-8. [DOI:10.1089/mdr.2018.0073] [PMID]
36. Vaez H, Salehi-Abargouei A, Ghalehnoo ZR, Khademi F. Multidrug resistant Pseudomonas aeruginosa in Iran: A systematic review and metaanalysis. J Glob Infect Dis. 2018;10(4):212. [DOI:10.4103/jgid.jgid_113_17] [PMID] [PMCID]
37. Heuer O, Gunell M, Economopoulou A, Blomquist A, Brown D, Walton C, et al. European Centre for Disease Prevention and Control. Antimicrobial resistance surveillance in Europe 2010. Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) OH ed pp 30-31 Stockholm 2011 European Centre for Disease Prevention. 2010:30-1.
38. Moges F, Endris M, Belyhun Y, Worku W. Isolation and characterization of multiple drug resistance bacterial pathogens from waste water in hospital and non-hospital environments, Northwest Ethiopia. BMC Res Notes. 2014;7(1):1-6. [DOI:10.1186/1756-0500-7-215] [PMID] [PMCID]
39. Alp E, Leblebicioglu H, Doganay M, Voss A. Infection control practice in countries with limited resources. Ann Clin Microbiol Antimicrob. 2011;10(1):1-4. [DOI:10.1186/1476-0711-10-36] [PMID] [PMCID]
40. Ayari K, Bourouis A, Chihi H, Mahrouki S, Naas T, Belhadj O. Dissemination and genetic support of broad-spectrum beta-lactam-resistant Escherichia coli strain isolated from two Tunisian hospitals during 2004-2012. Afr Health Sci. 2017;17(2):346-55. [DOI:10.4314/ahs.v17i2.8] [PMID] [PMCID]
41. Alp E, Damani N. Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries. J Infect Dev Ctries. 2015;9(10). [DOI:10.3855/jidc.6832] [PMID]
42. Karanika S, Karantanos T, Arvanitis M, Grigoras C, Mylonakis E. Fecal colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae and risk factors among healthy individuals: a systematic review and metaanalysis. Rev infect dis. 2016;63(3):310-8. [DOI:10.1093/cid/ciw283] [PMID]
43. Arsalane L, Zerouali K, Katfy K, Zouhair S. Molecular characterization of extended spectrum β-lactamase-producing Escherichia coli in a university hospital in Morocco, North Africa. Afr J Urol. 2015;21(3):161-6. [DOI:10.1016/j.afju.2015.02.005]
44. To KK, Lo W-U, Chan JF, Tse H, Cheng VC, Ho P-L. Clinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity. Int J Infect Dis. 2013;17(2):e120-e4. [DOI:10.1016/j.ijid.2012.09.008] [PMID]
45. Ouedraogo A-S, Sanou M, Kissou A, Sanou S, Solaré H, Kaboré F, et al. High prevalence of extended-spectrum ß-lactamase producing enterobacteriaceae among clinical isolates in Burkina Faso. BMC Infect Dis. 2016;16(1):1-9. [DOI:10.1186/s12879-016-1655-3] [PMID] [PMCID]
46. Lukac PJ, Bonomo RA, Logan LK. Extended-spectrum β-lactamase-producing Enterobacteriaceae in children: old foe, emerging threat. Clin Infect Dis. 2015;60(9):1389-97. [DOI:10.1093/cid/civ020] [PMID] [PMCID]
47. Yang J, Ye L, Guo L, Zhao Q, Chen R, Luo Y, et al. A nosocomial outbreak of KPC-2-producing Klebsiella pneumoniae in a Chinese hospital: dissemination of ST11 and emergence of ST37, ST392 and ST395. Clin Microbiol Infect. 2013;19(11):E509-E15. [DOI:10.1111/1469-0691.12275] [PMID]
48. Diriba K, Awulachew E, Gemede A, Anja A. The magnitude of extended-spectrum beta-lactamase-producing Enterobacteriaceae from clinical samples in Ethiopia: a systematic review and meta-analysis. Access Microbiology. 2021;3(3). [DOI:10.1099/acmi.0.000195] [PMID] [PMCID]
49. Ozer B, Duran N, Onlen Y, Savas L. Efflux pump genes and antimicrobial resistance of Pseudomonas aeruginosa strains isolated from lower respiratory tract infections acquired in an intensive care unit. J Antibiot. 2012;65(1):9-13. [DOI:10.1038/ja.2011.102] [PMID]
50. Fozouni L, Yaghoobpour M, Ahani Azari A. Probiotics in goat milk: a promising solution for management of drug-resistant Acinetobacter baumannii. J Biomed J. 2019;7(2):31-8.
51. Pourshafie MR, Mousavi SF, Parzadeh M. Ribotipagem e perfil de resistência a antibióticos de Pseudomonas aeruginosa isolada no Irã. Braz J Microbiol. 2007;38:435-9. [DOI:10.1590/S1517-83822007000300010]
52. Akya A, Ahmadi M, Khodamoradi S, Rezaei MR, Karani N, Elahi A, et al. Prevalence of bla CTX-M, bla CTX-M-2, bla CTX-M-8, bla CTX-M-25 and bla CTX-M-3 Genes in Escherichia coli Isolated from Urinary Tract Infection in Kermanshah City, Iran. J Clin Diagnostic Res. 2019;13(8).
53. Akya A, Elahi A, Chegenelorestani R, Rezaee M. Dissemination of multidrug-resistant, class I and II integrons and molecular typing of CTX-M-producing Klebsiella pneumoniae. Int j appl basic med res. 2018;8(2):100. [DOI:10.4103/ijabmr.IJABMR_333_16] [PMID] [PMCID]
54. Akya A, Jafari S, Ahmadi K, Elahi A. Frequency of blaCTX-M, blaTEM and blaSHV genes in Citrobacters isolated from Imam Reza Hospital in Kermanshah. J Maz Univ Med Sci. 2015;25(127):65-73.
55. Rezaei M. Phenotypic and Genotypic Assessment of ESBL Production in Klebsiella pneumoniae Isolates from Kermanshah Medical Centers (Iran). Qom Univ Med Sc J. 2017;11(9):61-9.
56. Azizi M, Mortazavi SH, Etemadimajed M, Gheini S, Vaziri S, Alvandi A, et al. Prevalence of extended-spectrum β-Lactamases and antibiotic resistance patterns in Acinetobacter baumannii isolated from clinical samples in Kermanshah, Iran. Jundishapur J Microbiol. 2017;10(12):1-7. [DOI:10.5812/jjm.61522]
57. Davodian E, Sadeghifard N, Ghasemian A, Noorbakhsh S. Molecular detection of blaveb-1 beta-lactamase encoding gene among extended spectrum b-lactamase positive wound isolates of Pseudomonas aeruginosa. Arch Pediatr Infect Dis. 2015;3(4). [DOI:10.5812/pedinfect.26362]
58. Davodian E, Sadeghifard N, Ghasemian A, Noorbakhsh S. Presence of blaPER-1 and blaVEB-1 beta-lactamase genes among isolates of Pseudomonas aeruginosa from South West of Iran. J Epidemiol Glob Health. 2016;6(3):211-3. [DOI:10.1016/j.jegh.2016.02.002] [PMID] [PMCID]
59. Erfan H, Alisha A. The frequency of broad-spectrum beta-lactamase CTX-M genotypes in Pseudomonas aeruginosa isolated from Kermanshah hospitals (2013-14). J Kermanshah Univ Medical Sci. 2015;19(4):207-14.
60. Hemmati M, Vaziri S, Afsharian M, Mansouri F, Zamanian MH, Fereshteh S, et al. Molecular Investigation of Extended-Spectrum β-Lactamase and Patterns of Antibiotic Resistance in Enterobacter cloacae Isolates from Teaching Hospitals in Kermanshah, Iran. J Clin Diagnostic Res. 2019;13(9). [DOI:10.7860/JCDR/2019/41823.13116]
61. Khodadoost M, Akya A, Ale Taha SM, Adabagher S. The frequency of antibiotic resistance and ctx-m gene in Escherichia coli isolated. Studies in Medical Sciences. 2013;24(5):318-28.
62. Mohajeri P, Rostami Z, Farahani A, Norozi B. Distribution of ESBL producing Uropathogenic Escherichia coli and carriage of selected [beta]-lactamase genes in Hospital and community isolates in west of Iran. Ann Trop Med Public Health. 2014;7(5):219. [DOI:10.4103/1755-6783.154823]
63. Mohajeri P, Kavosi S, Esmailzadeh T, Farahani A, Dastranj M. Molecular characteristics of extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae isolates in the West of Iran. Advances in Human Biology. 2018;8(3):175. [DOI:10.4103/AIHB.AIHB_20_18]
64. Ranjbar R, Farahani A. Study of genetic diversity, biofilm formation, and detection of Carbapenemase, MBL, ESBL, and tetracycline resistance genes in multidrug-resistant Acinetobacter baumannii isolated from burn wound infections in Iran. Antimicrob Resist Infect Control. 2019;8(1):1-11. [DOI:10.1186/s13756-019-0612-5] [PMID] [PMCID]
65. Sarshar MHF, Akya A. The frequency of extended spectrum β-lactamase genes of SHV-2a, SHV-5 and SHV-12 in clinical isolates of klebsiella pneumoniae isolated from Kermanshah medical centers in 2014. Arak Med Univ J. 2016;19(2):59-67.
66. Sarvazad H, Darbouy M. Correlation of Antibiotic Resistance with SHV, CTX-M and TEM Extended-Spectrum Beta Lactamases Genes among Klebsiella pneumoniae Isolates from Patients in Kermanshah Hospitals. J Ardabil Univ Medical Sci. 2017;17(3):353-62.
67. Vaziri S, Mansouri F, Abiri R, Alvandi A, Mortazavi SH, Ahmadi K, et al. Prevalence study of extended spectrum beta-lactamase in klebsiella pneumonia isolated from patients with ventilator-associated pneumonia in Kermanshah City, Iran. J Isfahan Med Sch. 2017;35(444):1113-9.
68. Yousefi-Fatmesari G, Hemmati M, Mortazavi S, Mansouri F, Azizi M, Etemadimajed M, et al. Frequency of blaCTX-M, blaTEM, and blaSHV genes in Escherichia coli isolated from urine samples of children in Kermanshah city, Iran. J Isfahan Med Sch. 2017;35(430):551-7.
69. Mohajeri P, Farahani A, Feizabadi MM, Ketabi H, Abiri R, Najafi F. Antimicrobial susceptibility profiling and genomic diversity of Acinetobacter baumannii isolates: A study in western Iran. Iran J Microbiol. 2013;5(3):195.
70. Akya A, Jafari S, Ahmadi K, Elahi A. The Frequency of Carbapenemase Genes in Citrobacter Frundii and Citrobacter Koseri Isolated from Clinical Specimens in Imam Reza Hospital, Kermanshah, Iran. J Kerman Univ Medical Sci. 2015;22(6):629-38.
71. Zare A, Akya A, Nejat P. The frequency of blaVIM, blaIMP, blaKPC and blaNDM Carbapenemase genes in clinical isolates of Klebsiella Pneumoniae in Kermanshah medical centers. 2015.
72. Norozi B, Farahani A, Mohajeri P, Davoodabadi A. Molecular epidemiology of hospital acquired OXA-carbapenemase-producing Acinetobacter baumannii in Western Iran. Asian Pacific J Trop Dis. 2014;4:S803-S7. [DOI:10.1016/S2222-1808(14)60731-3]
73. Mohajeri P, Farahani A, Feizabadi M, Norozi B. Clonal evolution multidrug resistant Acinetobacter baumannii by pulsed-field gel electrophoresis. Indian J Med Microbiol. 2015;33(1):87-91. [DOI:10.4103/0255-0857.148390] [PMID]
74. Mohajeri P, Farahani A, Mehrabzadeh RS. Molecular characterization of multidrug resistant strains of Acinetobacter baumannii isolated from intensive care units in west of Iran. J Clin Diagnostic Res. 2017;11(2):DC20. [DOI:10.7860/JCDR/2017/21156.9397] [PMID] [PMCID]
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