Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran
Azadeh Taraghian, Bahram Nasr Esfahani, Sharareh Moghim, Hossein Fazeli Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Hossein Fazeli Email h_fazeli@med.mui.ac.irIntroduction: This study was conducted to identify the hypermucovisc...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-09-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/characterization-of-hypervirulent-extended-spectrum-beta-lactamase-pro-peer-reviewed-article-IDR |
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| author | Taraghian A Nasr Esfahani B Moghim S Fazeli H |
| author_facet | Taraghian A Nasr Esfahani B Moghim S Fazeli H |
| author_sort | Taraghian A |
| collection | DOAJ |
| description | Azadeh Taraghian, Bahram Nasr Esfahani, Sharareh Moghim, Hossein Fazeli Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Hossein Fazeli Email h_fazeli@med.mui.ac.irIntroduction: 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 blaSHV 63.8%, followed by blaTEM 59.0%, and blaCTX-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 blaSHV 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.Keywords: hypervirulent Klebsiella pneumoniae, urinary tract infections, capsular group, ESBL, qnr |
| first_indexed | 2024-12-12T09:54:26Z |
| format | Article |
| id | doaj.art-ee79044069da4c39aca91066a072a555 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-12-12T09:54:26Z |
| publishDate | 2020-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-ee79044069da4c39aca91066a072a5552022-12-22T00:28:11ZengDove Medical PressInfection and Drug Resistance1178-69732020-09-01Volume 133103311156874Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from IranTaraghian ANasr Esfahani BMoghim SFazeli HAzadeh Taraghian, Bahram Nasr Esfahani, Sharareh Moghim, Hossein Fazeli Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranCorrespondence: Hossein Fazeli Email h_fazeli@med.mui.ac.irIntroduction: 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 blaSHV 63.8%, followed by blaTEM 59.0%, and blaCTX-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 blaSHV 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.Keywords: hypervirulent Klebsiella pneumoniae, urinary tract infections, capsular group, ESBL, qnrhttps://www.dovepress.com/characterization-of-hypervirulent-extended-spectrum-beta-lactamase-pro-peer-reviewed-article-IDRhypervirulent klebsiella. pneumoniaeurinary tract infectionscapsular groupesblqnr |
| spellingShingle | Taraghian A Nasr Esfahani B Moghim S Fazeli H Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran Infection and Drug Resistance hypervirulent klebsiella. pneumoniae urinary tract infections capsular group esbl qnr |
| title | Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran |
| title_full | Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran |
| title_fullStr | Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran |
| title_full_unstemmed | Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran |
| title_short | Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Among Urinary Tract Infections: The First Report from Iran |
| title_sort | characterization of hypervirulent extended spectrum beta lactamase producing klebsiella pneumoniae among urinary tract infections the first report from iran |
| topic | hypervirulent klebsiella. pneumoniae urinary tract infections capsular group esbl qnr |
| url | https://www.dovepress.com/characterization-of-hypervirulent-extended-spectrum-beta-lactamase-pro-peer-reviewed-article-IDR |
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