Iranian Journal of War and Public Health

eISSN (English): 2980-969X
eISSN (Persian): 2008-2630
pISSN (Persian): 2008-2622
Volume 15, Issue 1 (2023)                   Iran J War Public Health 2023, 15(1): 101-105 | Back to browse issues page

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Banoon S, Hussein Ali Z, Al-Kraety I, Aziz Z. Molecular Detection of blaTEM and blaCTX-M Encoding Genes from Klebsiella oxytoca Isolates from Tonsillitis. Iran J War Public Health 2023; 15 (1) :101-105
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1- Department of Biology, College of Science, University of Misan, Misan, Iraq
2- Alameen Center for Advanced Research and Biotechnology, Imam Ali Holy Shrine, Najaf, Iraq
3- Department of Medical Laboratory Techniques, Faculty of Health and Medical Techniques, University of Alkafeel, Najaf, Iraq
* Corresponding Author Address: Department of Biology, College of Science, University of Misan, Misan, Iraq. Postal Code: 62001 (
Abstract   (592 Views)
Aims: Tonsillitis is inflammation of the tonsils, a common clinical state caused by bacterial or viral infections. There are different types of tonsillitis; acute, sub-acute, chronic, and recurrent. The aim of this study was the isolation and identification of Klebsiella oxytoca isolated from tonsillitis based on conventional standard bacteriological methods and confirmed by VITEK-2 compact system.
Materials & Methods: A polymerase chain reaction was performed to detect blaCTX-M and blaTEM genes.
Findings: A total of 50 specimens were recovered from tonsillitis using swab sampling, which contained 35 bacterial growths. Onto the MacConkey agar, 15 isolates were confirmed as K. oxytoca using IMVIC test and VITEK-2 compact system. In the genotypic test, K. oxytoca isolates contained 11 (73.3%) blaCTX-M and 10 (66.6%) blaTEM genes.
Conclusion: The use of the VITEK-2 system is necessary to confirm the precise identification of K. oxytoca nosocomial pathogens from tonsillitis. The existence of blaTEM and blaCTX-M gene in half of K. oxytoca isolates is a concern that needs control strategies.

1. Alasmari NS, Bamashmous RO, Alshuwaykan RM, Alahmari MA, Alshahrani AA, Alqarni SA, et al. Causes and treatment of tonsillitis. Egyp J Hosp Med. 2017;69(8):2975-80. [Link] [DOI:10.12816/0042838]
2. Rossolini GM, D'andrea MM, Mugnaioli C. The spread of CTX‐M‐type extended‐spectrum β‐lactamases. Clin Microbiol Infect. 2008;14 Suppl 1:33-41. [Link] [DOI:10.1111/j.1469-0691.2007.01867.x]
3. Neog N, Phukan U, Puzari M, Sharma M, Chetia P. Klebsiella oxytoca and emerging nosocomial infections. Curr Microbiol. 2021;78(4):1115-23. [Link] [DOI:10.1007/s00284-021-02402-2]
4. Doud MS, Grimes-Zeppegno R, Molina E, Miller N, Balachandar D, Schneper L, et al. A k2A-positive Klebsiella pneumoniae causes liver and brain abscess in a Saint Kitt's man. Int J Med Sci . 2009;6(6):301-4. [Link] [DOI:10.7150/ijms.6.301]
5. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL. The function of wzy_K1 (magA), the serotype K1 polymerase gene in Klebsiella pneumoniae cps gene cluster. J Infect Dis. 2010;201(8):1268-9. [Link] [DOI:10.1086/652183]
6. Saha R, Farrance CE, Verghese B, Hong S, Donofrio RS. Klebsiella michiganensis sp. nov., a new bacterium isolated from a tooth brush holder. Curr Microbiol. 2013;66(1):72-8. [Link] [DOI:10.1007/s00284-012-0245-x]
7. Lin WP, Wang JT, Chang SC, Chang FY, Fung CP, Chuang YC, et al. The antimicrobial susceptibility of Klebsiella pneumoniae from community settings in Taiwan, a trend analysis. Sci Rep. 2016;6(1):36280. [Link] [DOI:10.1038/srep36280]
8. Lowe C, Willey B, O'Shaughnessy A, Lee W, Lum M, Pike K, et al. Outbreak of extended-spectrum β-lactamase-producing Klebsiella oxytoca infections associated with contaminated handwashing sinks. Emerg Infect Dis. 2012;18(8):1242-7. [Link] [DOI:10.3201/eid1808.111268]
9. Vergara-López S, Domínguez MC, Conejo MC, Pascual Á, Rodríguez-Baño J. Wastewater drainage system as an occult reservoir in a protracted clonal outbreak due to metallo-β-lactamase-producing Klebsiella oxytoca. Clin Microbiol Infect. 2013;19(11):E490-8. [Link] [DOI:10.1111/1469-0691.12288]
10. Moradigaravand D, Martin V, Peacock SJ, Parkhill J. Population structure of multidrug-resistant Klebsiella oxytoca within hospitals across the United Kingdom and Ireland identifies sharing of virulence and resistance genes with K. pneumoniae. Genome Biol Evol. 2017;9(3):574-87. [Link] [DOI:10.1093/gbe/evx019]
11. Nathisuwan S, Burgess DS, Lewis JS. Extended‐spectrum β‐lactamases: epidemiology, detection, and treatment. Pharmacotherapy. 2001;21(8):920-8. [Link] [DOI:10.1592/phco.21.11.920.34529]
12. Smet A, Van Nieuwerburgh F, Vandekerckhove TT, Martel A, Deforce D, Butaye P, e al. Complete nucleotide sequence of CTX-M-15-plasmids from clinical Escherichia coli isolates: insertional events of transposons and insertion sequences. Plos One. 2010;5(6):e11202. [Link] [DOI:10.1371/journal.pone.0011202]
13. Reinthaler FF, Feierl G, Galler H, Haas D, Leitner E, Mascher F, et al. ESBL-producing E. coli in Austrian sewage sludge. Water Res. 2010;44(6):1981-5. [Link] [DOI:10.1016/j.watres.2009.11.052]
14. Birbrair A, Frenette PS. Niche heterogeneity in the bone marrow. Ann N Y Acad Sci. 2016;1370(1):82-96. [Link] [DOI:10.1111/nyas.13016]
15. Ghafourian S, Sadeghifard N, Soheili S, Sekawi Z. Extended spectrum beta-lactamases: definition, classification and epidemiology. Curr Issues Mol Biol. 2015;17(1):11-21. [Link]
16. Shaikh S, Fatima J, Shakil S, Rizvi SM, Kamal MA. Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment. Saudi J Biol Sci. 2015;22(1):90-101. [Link] [DOI:10.1016/j.sjbs.2014.08.002]
17. Livermore DM. beta-Lactamases in laboratory and clinical resistance. Clin Microbiol Rev. 1995;8(4):557-84. [Link] [DOI:10.1128/CMR.8.4.557]
18. Steward CD, Wallace D, Hubert SK, Lawton R, Fridkin SK, Gaynes RP, et al. Ability of laboratories to detect emerging antimicrobial resistance in nosocomial pathogens: a survey of project ICARE laboratories. Diagn Microbiol Infect Dis. 2000;38(1):59-67. [Link] [DOI:10.1016/S0732-8893(00)00161-9]
19. Zhao WH, Hu ZQ. Epidemiology and genetics of CTX-M extended-spectrum β-lactamases in Gram-negative bacteria. Crit Rev Microbiol. 2013;39(1):79-101. [Link] [DOI:10.3109/1040841X.2012.691460]
20. Sharma J, Sharma M, Ray P. Detection of TEM & SHV genes in Escherichia coli & Klebsiella pneumoniae isolates in a tertiary care hospital from India. Indian J Med Res. 2010;132(3):332-6. [Link]
21. Aziz ZS, Shakir A, Addoos SA. Identification of ESBL CTX-M-15 genes from isolates of urinary tract infections. Al-Kufa Univ J Biol. 2015;7(1). [Link]
22. Coque TM, Baquero F, Cantón R. Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill. 2008;13(47):19044. [Link] [DOI:10.2807/ese.13.47.19044-en]
23. Shishegar M, Ashraf MJ. Posttonsillectomy bacteremia and comparison of tonsillar surface and deep culture. Adv Prev Med. 2014;2014:161878. [Link] [DOI:10.1155/2014/161878]
24. Almayali EJ, AL-Kraety IA. Molecular detection of aap gene in Staphylococcus aureus isolated from tonsillitis. Plant Arch. 2019;19:1400-2. [Link]
25. Hoffmann KM, Deutschmann A, Weitzer C, Joainig M, Zechner E, Högenauer C, et al. Antibiotic-associated hemorrhagic colitis caused by cytotoxin-producing Klebsiella oxytoca. Pediatrics. 2010;125(4):e960-3. [Link] [DOI:10.1542/peds.2009-1751]
26. Sambrook J. Molecular cloning: a laboratory manual. 3rd Edition. Cold Spring Harbor, New York: Cold Spring Harbor Laboratory Press; 2001. [Link]
27. Stephenson FH. Calculations for molecular biology and biotechnology. 3rd Edition. Academic Press; 2016. [Link]
28. Yang X, Lai Y, Li C, Yang J, Jia M, Sheng J. Molecular epidemiology of Pseudomonas aeruginosa isolated from lower respiratory tract of ICU patients. Braz J Biol. 2021;81(2):351-60. [Link] [DOI:10.1590/1519-6984.226309]
29. Weinroth MD, Scott HM, Norby B, Loneragan GH, Noyes NR, Rovira P, et al. Effects of ceftiofur and chlortetracycline on the resistomes of feedlot cattle. Appl Environ Microbiol. 2018;84(13):e00610-18. [Link] [DOI:10.1128/AEM.00610-18]
30. Colle JG. Mackie & Mccartney practical medical microbiology. 14th Edition. Churchill Living Stone New York: Elsevier; 1996. [Link]
31. MacFaddin JF. Biochemical tests for identification of medical bacteria. 3rd Edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2000. [Link]
32. Brisse S, Grimont F, Grimont PA. The genus klebsiella. Prokaryotes. 2006:159-96. [Link] [DOI:10.1007/0-387-30746-X_8]
33. Rawy DK, El-Mokhtar MA, Hemida SK, Askora A, Yousef N. Isolation, characterization and identification of Klebsiella pneumoniae from assiut university hospital and sewage water in assiut governorate, Egypt. Assiut Univ J Botany Microbiol. 2020;49(2):60-76. [Link] [DOI:10.21608/aunj.2020.221181]
34. Yang J, Long H, Hu Y, Feng Y, McNally A, Zong Z. Klebsiella oxytoca complex: update on taxonomy, antimicrobial resistance, and virulence. Clin Microbiol Rev. 2022;35(1):e0000621. [Link] [DOI:10.1128/CMR.00006-21]
35. Phetburom N, Boueroy P, Chopjitt P, Hatrongjit R, Nuanualsuwan S, Kerdsin A. Phenotypic and molecular characterization of β-lactamase and plasmid-mediated quinolone resistance genes in Klebsiella oxytoca isolated from slaughtered pigs in Thailand. Vet World. 2022;15(2):309-15. [Link] [DOI:10.14202/vetworld.2022.309-315]
36. Humphries R, Bobenchik AM, Hindler JA, Schuetz AN. Overview of changes to the clinical and laboratory standards institute performance standards for antimicrobial susceptibility testing, M100. J Clin Microbiol. 2021;59(12):e0021321. [Link] [DOI:10.1128/JCM.00213-21]
37. Kpoda DS, Ajayi A, Somda M, Traore O, Guessennd N, Ouattara AS, et al. Distribution of resistance genes encoding ESBLs in Enterobacteriaceae isolated from biological samples in health centers in Ouagadougou, Burkina Faso. BMC Res Notes. 2018;11(1):471. [Link] [DOI:10.1186/s13104-018-3581-5]
38. Ibrahim ME, Algak TB, Abbas M, Elamin BK. Emergence of bla TEM, bla CTX M, bla SHV and bla OXA genes in multidrug resistant Enterobacteriaceae and Acinetobacter baumannii in Saudi Arabia. Exp Ther Med. 2021;22(6):1450. [Link] [DOI:10.3892/etm.2021.10885]
39. Alag RN, Aziz ZSD. Occurrence of plasmid encoded ESBLs blaCTX-M, blaTEM genes of E. coli isolated from Clinical cases in Maysan province. Int J Sci Technol Res. 2019;8(11):122-6. [Link]
40. Paterson DL, Hujer KM, Hujer AM, Yeiser B, Bonomo MD, Rice LB, et al. Extended-spectrum β-lactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and widespread prevalence of SHV-and CTX-M-type β-lactamases. Antimicrob Agents Chemother. 2003;47(11):3554-60. [Link] [DOI:10.1128/AAC.47.11.3554-3560.2003]
41. Tsuka T, Ozaki H, Saito D, Murase T, Okamoto Y, Azuma K, et al. Genetic characterization of CTX-M-2-producing Klebsiella pneumoniae and Klebsiella oxytoca associated with bovine mastitis in Japan. Front Vet Sci. 2021;8:659222. [Link] [DOI:10.3389/fvets.2021.659222]

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