Prevalence and Molecular Characterization of Extensively Drug Resistant Hypervirulent (Hypermucoviscous) K. pneumoniae Isolates from Al-Najaf province
Background: Extensively drug-resistant (XDR) is resistant to all but one or two categories of antibiotics were sensitive, Klebsiella pneumoniae mainly has two path types that pose a danger to our health: classical (cKp) and hypervirulent (hvKp). hvKp is known to cause life-threatening and community-acquired pyogenic infections such as pyogenic liver abscesses, osteomyelitis, endophthalmitis, and metastatic meningitis in healthy individuals. The current study aimed to investigate the prevalence of XDR-hvKp and the genes responsible for resistance in hvKp isolates obtained from Najaf province clinical samples. Methods: about 121 K. pneumoniae clinical isolates were collection from Private Laboratories and Public Health Laboratory in Najaf province during the period of study, determine the antibiotic susceptibility of K. pneumoniae isolates by using Kirby-Bauer disk diffusion method to 25 antimicrobial agents according to the CLSI (2022). Hypervirulent isolates were diagnosed using the test called string test. Molecular detection for main ESBL, AmpC, carbapenemases, AMEs, 16S-RMTase, PMQR, capsular serotypes, and class I integrons genes by PCR. Results: from 121 K. pneumoniae clinical isolates XDR isolates had represented in 23 (19%). Out of 23 XDR isolates, 5 (21.7%) had a positive string test and were identified as hypervirulent K. pneumoniae. The isolates showed significantly higher resistance to most antibiotics and the PCR analyses demonstrated that four of these isolates harbored multiple antibiotic-resistant genes. In addition, molecular characterization revealed that 78.3% of all the XDR isolates carried wzy-K2 serotype gene. Notably, 4 (80%) hypervirulent and 14 (77.8%) classical isolates were found in this study, which contained wzy-K2 gene. Conclusion: The study highlighted the emergence of five XDR hypervirulent isolates, the occurrence of hypervirulent isolates is particularly worrisome due to the confluence of both hypervirulence and XDR.
Resistant Hypervirulent; Al-Najaf province; Extensively Drug