Detection of virulence genes (magA and rmpA) and resistance gene (CTX-M) in Klebsiella pneumoniae isolated from neonates with septicemia

Abstract

Background: Neonatal sepsis (NS) due to K. pneumoniae is a major cause of morbidity and mortality in neonates. This study aimed to study the risk factors of NS caused by K.pneumoniae in NICU in Menoufia University Hospitals and to detect rmpA and magA virulence genes and CTX-M antibiotic resistance gene. Correlation between compliance of infection control measures and occurrence of NS and its outcome were also evaluated. Methods: Klebsiella pneumoniae were isolated from blood of neonates with sepsis and studied for hypermucovicosity by string test and detection of rmpA and magA genes. ESβL production was studied by cephalosporin/clavulanate combination disks and expression of CTX-M gene groups. Hand hygiene and other infection control measures compliance were evaluated by observational and practical methods. Results: Klebsiella pneumoniae was the most frequently isolated organism (31.6%) among neonates with confirmed sepsis. Hypermucoviscous phenotype was detected by string test in 39.6% of isolates while rmpA and magA genes were found in 47.9% and 8.3% respectively. ESβL production was confirmed in 75% (by cephalosporin/clavulanate combination disk). The CTX-M gene was found among 77.8% of ESβL-producing K. pneumoniae isolates. There was a negative correlation between hand hygiene and other infection control measures compliance and occurrence of NS. Conclusion: Virulence and antimicrobial resistance genes are common among K. pneumoniae isolated from neonates with sepsis in our locality. Implementation of infection control measures and proper antimicrobial stewardship programs may be helpful to overcome this problem..

Efficacy of Amikacin and Cefotaxime Synergy Against CTX-M-15-Resistant Klebsiella pneumoniae in Neonatal Sepsis

“…The results indicated a significantly higher level of blaCTX-M-15 gene expression in K. pneumoniae isolates (KR1-KR23) compared to susceptible isolates (p < 0.01). The findings were supported by Ghonaim et al (2021), who reported a significant difference in the presence of the CTX-M gene between ESβL-producing and non-ESβL-producing K. pneumoniae isolates. Calibration curves for each gene were produced using serially diluted cDNA prepared from in vitro-obtained RNA standards.…”

Detection of rmpA and magA genes in Hypervirulent Klebsiella pneumoniae Isolates from Tertiary Care Hospitals

“…In our study, strains of hvKp showed more resistance to antibiotics than cKP although this difference was not significant. Different results were stated by Ghonaim et al 24 they reported that the resistance rate in hvKp was lower than cKp as hvKps do not take up DNA from other resistant bacteria due to an increase expression of capsule-related genes large capsule size 25 .…”

“…For the genotypic characterization of hmvKp, 25 isolates out of 30 (83.3%) were rmpA gene positive. Similarly, Guo et al 29 , Ghonaim et al 24 showed that 12 out of 14 (85.7%), 17 out of 19 (89.5%) hmvKp strains carried rmpA gene respectively. Moreover, Lin et al 30 showed that 100 out of 124 (80.65%) of strains of hvKp harbored rmpA gene.…”