Characterization of Hypervirulent Extended-Spectrum beta-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran

(2020) Characterization of Hypervirulent Extended-Spectrum beta-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran. Infection and Drug Resistance. pp. 3103-3111. ISSN 1178-6973

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Abstract

Introduction: This study was conducted to identify the hypermucoviscosity, iron acquisition, and capsule serotypes of K. pneumoniae strains isolated from urinary tract infections among community-acquired patients (CA) and assess the frequency of plasmid-mediated quinolone resistance (PMQR) and extended-spectrum beta-lactamases (ESBL) genes between classic and hypervirulent strains. Materials and Methods: A total of 105 K. pneumoniae were isolated from CA-UTI. Demographic data related to the underlying diseases and clinical manifestations were further collected. Antibiotic resistance pattern and molecular characterization were compared among ESBL-positive, ESBL-negative, hypervirulent, and classic isolates. Results: The results revealed that 52.4 of the isolates were confirmed as ESBL producers and 11 (10.5) were considered as hypervirulent K. pneumoniae (hvKp). Ciprofloxacin and nalidixic acid were the most inactive antibiotics with resistance rates of 68.6 and 64.8, respectively. Molecular characterization revealed that 7.6 of all the isolates carried k1 and 66.6 carried K2 genes. The most frequent ESBL gene was bla(SHV) 63.8, followed by bla(TEM) 59.0, and bla(CTX-M) 58.1. ESBL genes were significantly more in hvKp than in cKp. Moreover, 61 (84.7), 47 (65.2), and 16 (22.2) of isolates harbored qnrB, qnrS, and qnrA. ESBL genes were detected in all hvKps, and bla(SHV) was observed in 90.9 of hvKp (P value = 0.048, 95). Discussion: This study reported the high frequency of antimicrobial and multidrug resistance among hvKp isolates. Coexistence of PMQR and ESBL genes in hvkp indicates the necessity to enhance the clinical knowledge and management of hvKp infections.

Item Type: Article
Keywords: hypervirulent Klebsiella pneumoniae urinary tract infections capsular group ESBL qnr MEDIATED QUINOLONE RESISTANCE ESCHERICHIA-COLI HIGH PREVALENCE ENTEROBACTERIACEAE EMERGENCE STRAINS GENES
Subjects: QW Microbiology and Immunology > QW 1-300 Microbiology
Divisions: Faculty of Medicine > Department of Basic Science > Department of Microbiology
Page Range: pp. 3103-3111
Journal or Publication Title: Infection and Drug Resistance
Journal Index: ISI
Volume: 13
Identification Number: https://doi.org/10.2147/IDR.S264440
ISSN: 1178-6973
Depositing User: Zahra Otroj
URI: http://eprints.mui.ac.ir/id/eprint/13797

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