Study the association between virulence genes and antibiotic resistance in hypervirulent Klebsiella pneumoniae isolates

Document Type : Original Article

Author

Medical Microbiology Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq.

Abstract

This study investigates differences between classical and hypervirulent Klebsiella pneumoniae strains by analyzing virulence genes (K1, K2, iutA, p-rmpA, c-rmpA, magA) and antibiotic resistance. A total of 132 isolates were collected from various sources in six Baghdad hospitals in a cross-sectional study. Hyper-mucoviscosity was determined using the string test, and Vitek2 was used for identification and susceptibility testing. PCR detected virulence genes. Most isolates (46.2%) came from urine, while 0.8% were from umbilical, abscess, and tissue biopsies. Resistance was highest to beta-lactamase and folic acid inhibitors; minocycline showed the lowest resistance. Drug resistance patterns included XDR (30.3%), MDR (22.7%), and PDR (12.1%). Hypervirulent strains accounted for 3.8% of isolates, with 20% showing a hyper-mucoviscous phenotype; 96.2% were classical strains, with 70.1% hyper-mucoviscous. Among hypervirulent strains, 80% showed XDR/MDR patterns versus 64.6% of classical strains. The study found a strong association between hypervirulent strains and resistance. Although only five strains were hypervirulent, 80% showed multiple resistance patterns. Identifying these strains and understanding their resistance profiles is vital for therapy and outbreak control. This study highlights the emerging threat of hypervirulent, extensively drug-resistant K. pneumoniae in Iraqi hospitals.

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History

  • Receive Date: 14 July 2024
  • Revise Date: 26 August 2024
  • Accept Date: 04 April 2025

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