The Spread of Carbapenemase Genes in Klebsiellapneumoniae in Iran: a Systematic Review

The emergence and global spread of carbapenemases produced by Klebsiella pneumoniae is a serious problem to health services worldwide. K. pneumoniae, belonging to the Enterobacteriaceae family, is commonly found in the human gastrointestinal tract and environment, especially in the hospital environment. Carbapenem is administered as the first treatment for severe infections created by multi-drug resistant K. pneumoniae. Despite the fact that the carbapenemase-producing K. pneumoniae has become more prevalent in Iran, few investigations have probed into the prevalence of different carbapenemase genes in Iran.

The aim of this study was to examine the prevalence of carbapenemase genes in K. pneumoniae from 2010 to 2018 in Iran. PubMed and Scopus databases were searched for the articles published between 2010 and 2018 in Iran.

A total of 25 papers published between 2012 and 2018 were selected. The highest frequency of blaNDM, blaIMP, blaVIM, blaKPC and, blaOXA48 genes were related to cities of Shiraz in 2017 [23 (26.14%)], Hamedan in 2017 [2 (50%)], Babol in 2015 [15 (41.66%)], Isfahan in 2013 [65 (44.83%)] and, and Isfahan in 2018 [90 (76.27%)], respectively. The results showed that the frequency of blaNDM, blaOXA48, and blaIMP genes increased in 2017 and 2018, and there was an increase in the frequency of the blaVIM gene in 2014 and 2015, and the blaKPC gene in 2013. The highest percentage of carbapenemases genes isolated in Iran were related to blaKPC [145 (37.08%)], blaOXA48 [118 (30.18%)], and blaNDM [88 (22.51%)], and the lowest percentages were reported in blaIMP [4 (1.02%)], and blaVIM [36 (9.21%)], respectively.

The results of our review showed that blaNDM and blaOXA48 carbapenemase genes have been increasing in Iran, and it seems that traveling is one of the most important factors in the transmission of carbapenemase genes.