Genotypic characterization of hypervirulent Klebsiella pneumoniae (hvKp) in a tertiary care Indian hospital

• Published in: International microbiology 2024-10, Vol.27 (5), p.1373-1382
• Main Authors: Behera, Birasen, Swain, Pragyan Paramita, Rout, Bidyutprava, Panigrahy, Rajashree, Sahoo, Rajesh Kumar
• Format: Article
• Language: English
• Subjects: Amides; Anti-Bacterial Agents - pharmacology; Antibiotic resistance; Antibiotics; Applied Microbiology; Bacterial Proteins - genetics; beta-Lactamases - genetics; Biofilms; Biomedical and Life Sciences; Carbapenemase; Colistin; Drug resistance; Drug Resistance, Multiple, Bacterial - genetics; Endophthalmitis; Eukaryotic Microbiology; Gene amplification; Genes; Genotype; Hospitals; Humans; Immunodeficiency; India - epidemiology; Klebsiella; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella pneumoniae; Klebsiella pneumoniae - classification; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Klebsiella pneumoniae - pathogenicity; Life Sciences; Medical Microbiology; Meningitis; Microbial Ecology; Microbial Sensitivity Tests; Microbiology; Multidrug resistance; Osteomyelitis; Pathogens; Robust control; Serogroup; Serotypes; Soft tissues; Tertiary Care Centers - statistics & numerical data; Virulence - genetics; Virulence Factors - genetics; β Lactamase; β-Lactam antibiotics
• ISSN: 1618-1905; 1139-6709; 1618-1905
• DOI: 10.1007/s10123-024-00480-3

Hypervirulent  Klebsiella pneumoniae  (hvKp) is an emerging pathogen and causes endophthalmitis, liver abscess, osteomyelitis, meningitis, and necrotizing soft tissue infections in both immunodeficient and healthy people. The acquisition of the antibiotic resistance genes of hvKp has become an emerging concern throughout the globe. In this study, a total of 74  K . pneumoniae  isolates were collected and identified by VITEK2 and  bla SHV  gene amplification. Out of these, 18.91% (14/74) isolates were identified as hvKp by both phenotypic string test and genotypic  iucA  PCR amplification. The antibiotic susceptibility revealed that 57.14% (8/14) isolates were multidrug-resistant (MDR) and 35.71% (5/14) isolates were extremely drug-resistant (XDR). All the isolates were resistant to β-lactam, β-lactamase + inhibitor groups of antibiotics, and the least resistance to colistin. Of 14 hvKp isolates, all isolates are positive for iroB  (100%) ,  followed by  iutA  (92.85%),  peg344  (85.71%) , rmpA (57.14%), and magA  (21.42%) genes. Among serotypes, K1 was the most prevalent serotype 21.4% (3/14), followed by K5 14.3% (2/14). The most common carbapenemase gene was bla OXA-48 (78.57%) followed by bla NDM (14.28%) and bla KPC (14.28%) which co-carried multiple resistance genes such as bla SHV (100%), bla CTX-M (92.85%), and bla TEM (78.57%). About 92.85% (13/14) of hvKp isolates were strong biofilm producers, while one isolate (hvKp 10) was the only moderate biofilm producer. The (GTG)5-PCR molecular typing method revealed high diversity among the hvKp isolates in the tertiary care hospital. Our findings suggest that MDR-hvKp is an emerging pathogen and a challenge for clinical practice. In order to avoid hvKp strain outbreaks in hospital settings, robust infection control and effective surveillance should be implemented.