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.