Molecular and clinical characterization of hypervirulent Extended-spectrum beta-lactamases producer Klebsiella pneumoniae among urinary tract infections; the first report from Iran

Background and Aim : New hypervirulent variants of K. pneumoniae (hvKp) with antimicrobial susceptibility are emerging globally.This study was conducted to identify the hypermucoviscosity, iron acquisition, and capsule serotypes of K. pneumoniae strains isolated from UTI among community patients and assess the frequency of Plasmid-mediated quinolone resistance and Extended-spectrum beta-lactamases genes between classic and hypervirulent strainsMethods : ۱۰۵ UTI K. pneumoniae were isolated from community patients. Demographic data related to the underlying diseases and clinical manifestations were further collected. Antibiotic resistance pattern and molecular characterization were respectively compared among ESBL-positive, ESBL-negative, hvKp, and Classic isolates.Results : Among ۱۰۵ K. pneumoniae from UTI, ۱۱ (۱۰.۵%) were considered as hvKp. Diabetes mellitus was the most prevalent underlying disease. Cefotaxime, cefixim, trimethoprim–sulfamethoxazole, and ciprofloxacin were the most inactive antibiotics in hvKp with a resistance rate of ۵۴.۵%. Molecular characterization revealed that ۷.۶% of all isolates carried k۱ and ۶۶.۶% carried K۲ genes. The most common qnr gene was qnrB ۶۱ (۸۴.۷%), followed by qnrS ۴۷ (۶۵.۲%) and qnrA ۱۶ (۲۲.۲%). At least one ESBL genes were detected in all hvKps, and blaSHV was observed in ۹۰.۹% of hvKp group and ۶۰.۶% of CKp group (P value= .۰۴۸)Conclusion : This study showed a high frequency of antimicrobial and multi drug resistant among hvKp isolates. Therefore, hvKp isolates are turning to a growing comprehensive problem in community-UTIs Coexistence of PMQR and ESBL genes in hvkp indicates that urgent need is required to enhance the clinical knowledge and management of hvKp infections.

کلیدواژه ها:

hypervirulent Klebsiella. Pneumoniae ، urinary tract infections ، capsular group ، ESBL ، qnr