Antibiotic resistance, virulence and genetic diversity of Klebsiella pneumoniae in community- and hospital-acquired urinary tract infections in Iran

Abstract

Klebsiella pneumoniae is among the most important causes of urinary tract infection (UTI). The aim of this study was to investigate the prevalence and correlation of antibiotic resistance with virulence characteristics and genetic diversity in K. pneumoniae isolated from UTIs in Iran. Phenotypic tests and antibiotic susceptibility were carried out on the isolates. Detection of the virulence and extendedspectrum β-lactamase (ESBL) genes was performed by polymerase chain reaction. Pulsed-field gel electrophoresis (PFGE) was used for exploring the genomic relatedness. Hemolysin, biofilm, and hypermucoviscosity formation were observed in 87.1%, 86.4%, and 12.1% of isolates, respectively. The antibiotic resistance rate of K. pneumoniae isolates ranged from 12.1% for meropenem to 100% for amoxicillin. The prevalence of virulence genes ranged from 1.4% for cnf-1 to 100% for mrkD, fimH, kpn, and entB genes. In this study, 91.7%, 33.3%, and 4.2% of phenotypically ESBL-producers were positive for bla CTX-M , bla TEM , and bla SHV genes, respectively. An association was observed between the presence of traT, fyuA, or cnf-1 genes with antibiotic resistance. Two clone types were obtained by PFGE that indicate different K. pneumoniae clones in community-and hospital-acquired UTIs. The findings of this study are valuable in development of treatment strategies against UTIs in Iran.

Global Prevalence of Nosocomial Multidrug-Resistant Klebsiella pneumoniae: A Systematic Review and Meta-Analysis

“…Most of the ESBL-KP and CRKP have contributed to the emergence of multidrug-resistance strains, diminishing treatment options for patients [ 6 , 11 ]. Furthermore, both resistance ( bla TEM , bla SHV , bla KPC , bla OXA , qnrB1 , oqxA , dfrA12 , sul2 , fosA, and mgrB ) [ 12 ], and virulence genes (iro , kpn , fimH, mrkD , entB , traT , rmpA , fyuA , magA, and hlyA ) [ 13 ] encoded in the bacterium genome played significant factors in the emergence of MDR K . pneumoniae.…”

Association between biofilm-production and antibiotic resistance in Escherichia coli isolates: A laboratory-based case study and a literature review

“…Irrespective of the disease-presentation, the first key step in the pathogenesis of E. coli infections is the adherence to mucosal surfaces; subsequently, aggregation of bacteria inside the biofilm protects them from sheer forces and the onslaught of immune cells [52,69,70]. The relevant virulence-determinants of E. coli include adhesins (representative genes e.g., afa, CSH, fimH, fimP, pap, sfa, traT), toxins (cytotoxic necrotizing factor: Cnf1, haemolysin: hlyA, others: saT, vaT), suppressors of the immune system (shiA, sisA, sisB, sivH) and siderophores (aerobactin: aer, salmochelin: iro, enterobactin: ent, yersiniabactin: irp, others: iuD, iutA, yfcv), which all contribute to their survival and invasiveness in the infected host [71][72][73][74]. Surface factors, such as various adhesins have a pivotal role in mediating the adhesion of E. coli to biotic and abiotic surfaces, and the subsequent production of EPS.…”

Bacterial Antibiotic Resistance: The Most Critical Pathogens

“…pneumoniae is a member of the family Enterobacterales, non-fastidious, commonly encapsulated gram-negative bacillus [8]. K. pneumoniae can cause different types of nosocomial and community acquired infections, including urinary tract infections, pneumonia, liver abscess, surgical site infections and bloodstream infections especially in immunocompromised patients [88,89]. Since the bacteria doesn't spread through the air, to get a Klebsiella infection person-to-person contact is required [90].…”