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Objectives:   Drug resistance among gram-negative bacteria is a worldwide challenge. Due to the importance of drug-resistant  Klebsiella pneumoniae  and  Escherichia coli  strains in hospital-acquired infections, we aimed to determine the phenotypic and genotypic characteristics of ESBL-, AmpC-, and carbapenemase-producing isolates obtained from hospitalized patients in Tehran and Ilam (Iran).   Materials and Methods:   In total, 90  K. pneumoniae  isolates and 65  E. coli  isolates were collected from various infections. Phenotypic identification of bacterial isolates was performed using standard methods. Phenotypic screening of ESBL, AmpC, and carbapenemase enzymes was carried out. Detection of ESBL, AmpC, and carbapenemase genes was also performed by the PCR method.   Results:   Phenotypic detection tests showed that 36 (40%)  K. pneumoniae  and 23 (35.4%)  E. coli  isolates were ESBL producers. Moreover, 18 (20%) and 6 (9.2%)  K. pneumoniae  and  E. coli  isolates were AmpC producers, respectively. Modified Hodge test results indicated that 39 (43.3%)  K. pneumoniae  and 18 (27.7%)  E. coli  isolates produced carbapenemase. Molecular tests showed that 40% of  K. pneumoniae  and 36.9% of  E. coli  isolates were ESBL positive. AmpC was detected in 24.4 and 13.8% of  K. pneumoniae  and  E. coli  isolates. Carbapenemase was detected in 34 (37.8%)  K. pneumoniae  and 13 (20%)  E. coli  isolates. ­  Conclusion:   In this study, 3  K. pneumoniae  isolates simultaneously carried ESBL, AmpC, and carbapenemase genes. Up-to-date strategies such as combination therapy or utilization of new antimicrobial agents might help to combat such drug-resistant organisms.

Phenotypic and Genotypic Characterization of ESBL-, AmpC-, and Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli Isolates