Cargando…

Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)

Hypervirulent Klebsiella pneumoniae (hvKp) is a new emerging variant of K. pneumoniae that is increasingly reported worldwide. The variant hvKp is known to cause severe invasive community-acquired infections such as metastatic meningitis, pyogenic liver abscesses (PLA) and endophthalmitis, but its r...

Descripción completa

Detalles Bibliográficos
Autores principales: Alharbi, Mohanned Talal, Almuhayawi, Mohammed S., Nagshabandi, Mohammed K., Tarabulsi, Muyassar K., Alruhaili, Mohammed H., Gattan, Hattan S., Al Jaouni, Soad K., Selim, Samy, Alanazi, Awadh, Alruwaili, Yasir, Zaied, Shaimaa Mohamed, Faried, Osama Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052956/
https://www.ncbi.nlm.nih.gov/pubmed/36985234
http://dx.doi.org/10.3390/microorganisms11030661
_version_ 1785015285437169664
author Alharbi, Mohanned Talal
Almuhayawi, Mohammed S.
Nagshabandi, Mohammed K.
Tarabulsi, Muyassar K.
Alruhaili, Mohammed H.
Gattan, Hattan S.
Al Jaouni, Soad K.
Selim, Samy
Alanazi, Awadh
Alruwaili, Yasir
Zaied, Shaimaa Mohamed
Faried, Osama Ahmed
author_facet Alharbi, Mohanned Talal
Almuhayawi, Mohammed S.
Nagshabandi, Mohammed K.
Tarabulsi, Muyassar K.
Alruhaili, Mohammed H.
Gattan, Hattan S.
Al Jaouni, Soad K.
Selim, Samy
Alanazi, Awadh
Alruwaili, Yasir
Zaied, Shaimaa Mohamed
Faried, Osama Ahmed
author_sort Alharbi, Mohanned Talal
collection PubMed
description Hypervirulent Klebsiella pneumoniae (hvKp) is a new emerging variant of K. pneumoniae that is increasingly reported worldwide. The variant hvKp is known to cause severe invasive community-acquired infections such as metastatic meningitis, pyogenic liver abscesses (PLA) and endophthalmitis, but its role in hospital-acquired infections (HAIs) is little known. The aim of this study was to evaluate the prevalence of hvKp among hospital-acquired (HA) K. pneumoniae infections in the intensive care unit (ICU) and to compare between hvKp and classical K. pneumoniae (cKP) regarding antimicrobial resistance pattern, virulence and molecular characteristics. The study was cross-sectional and included 120 ICU patients suffering from HA K. pneumoniae infections between January and September 2022. K. pneumoniae isolates were subjected to antimicrobial susceptibility testing and detection of extended-spectrum-β-lactamase (ESBL) production by the Phoenix 100 automated microbiology system, string test, biofilm formation, serum resistance assay, and detection of virulence-associated genes (rmpA, rmpA2, magA, iucA) and capsular serotype-specific genes (K1, K2, K5, K20, K57) by polymerase chain reaction (PCR). Of 120 K. pneumoniae isolates, 19 (15.8%) were hvKp. The hypermucoviscous phenotype was more significantly detected in the hvKp group than in the cKP group (100% vs. 7.9%, p ≤ 0.001). The rate of resistance to different antimicrobial agents was significantly higher in the cKP group than that in the hvKp group. Fifty-three strains were identified as ESBL-producing strains, which was more frequent in the cKP group than in the hvKp group (48/101 [47.5%] vs. 5/19 [26.3%], respectively, p ≤ 0.001). The hvKP isolates were highly associated with moderate and strong biofilm formation than cKP isolates (p = 0.018 and p = 0.043 respectively). Moreover, the hvKP isolates were highly associated with intermediate sensitivity and re sistance to serum in the serum resistance assay (p = 0.043 and p = 0.016 respectively). K1, K2, rmpA, rmpA2, magA and iucA genes were significantly associated with hvKp (p ≤ 0.001, 0.004, <0.001, <0.001, 0.037 and <0.001, respectively). However, K5, K20 and K57 were not associated with hvKp. The hvKp strains have emerged as a new threat to ICU patients because of their ability to cause more severe and life-threatening infections than cKP. The string test alone as a laboratory test for screening of hvKp has become insufficient. Recently, hvKp was defined as hypermucoviscous- and aerobactin-positive. It is important to improve the awareness towards the diagnosis and management of hvKp infections.
format Online
Article
Text
id pubmed-10052956
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100529562023-03-30 Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU) Alharbi, Mohanned Talal Almuhayawi, Mohammed S. Nagshabandi, Mohammed K. Tarabulsi, Muyassar K. Alruhaili, Mohammed H. Gattan, Hattan S. Al Jaouni, Soad K. Selim, Samy Alanazi, Awadh Alruwaili, Yasir Zaied, Shaimaa Mohamed Faried, Osama Ahmed Microorganisms Article Hypervirulent Klebsiella pneumoniae (hvKp) is a new emerging variant of K. pneumoniae that is increasingly reported worldwide. The variant hvKp is known to cause severe invasive community-acquired infections such as metastatic meningitis, pyogenic liver abscesses (PLA) and endophthalmitis, but its role in hospital-acquired infections (HAIs) is little known. The aim of this study was to evaluate the prevalence of hvKp among hospital-acquired (HA) K. pneumoniae infections in the intensive care unit (ICU) and to compare between hvKp and classical K. pneumoniae (cKP) regarding antimicrobial resistance pattern, virulence and molecular characteristics. The study was cross-sectional and included 120 ICU patients suffering from HA K. pneumoniae infections between January and September 2022. K. pneumoniae isolates were subjected to antimicrobial susceptibility testing and detection of extended-spectrum-β-lactamase (ESBL) production by the Phoenix 100 automated microbiology system, string test, biofilm formation, serum resistance assay, and detection of virulence-associated genes (rmpA, rmpA2, magA, iucA) and capsular serotype-specific genes (K1, K2, K5, K20, K57) by polymerase chain reaction (PCR). Of 120 K. pneumoniae isolates, 19 (15.8%) were hvKp. The hypermucoviscous phenotype was more significantly detected in the hvKp group than in the cKP group (100% vs. 7.9%, p ≤ 0.001). The rate of resistance to different antimicrobial agents was significantly higher in the cKP group than that in the hvKp group. Fifty-three strains were identified as ESBL-producing strains, which was more frequent in the cKP group than in the hvKp group (48/101 [47.5%] vs. 5/19 [26.3%], respectively, p ≤ 0.001). The hvKP isolates were highly associated with moderate and strong biofilm formation than cKP isolates (p = 0.018 and p = 0.043 respectively). Moreover, the hvKP isolates were highly associated with intermediate sensitivity and re sistance to serum in the serum resistance assay (p = 0.043 and p = 0.016 respectively). K1, K2, rmpA, rmpA2, magA and iucA genes were significantly associated with hvKp (p ≤ 0.001, 0.004, <0.001, <0.001, 0.037 and <0.001, respectively). However, K5, K20 and K57 were not associated with hvKp. The hvKp strains have emerged as a new threat to ICU patients because of their ability to cause more severe and life-threatening infections than cKP. The string test alone as a laboratory test for screening of hvKp has become insufficient. Recently, hvKp was defined as hypermucoviscous- and aerobactin-positive. It is important to improve the awareness towards the diagnosis and management of hvKp infections. MDPI 2023-03-06 /pmc/articles/PMC10052956/ /pubmed/36985234 http://dx.doi.org/10.3390/microorganisms11030661 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alharbi, Mohanned Talal
Almuhayawi, Mohammed S.
Nagshabandi, Mohammed K.
Tarabulsi, Muyassar K.
Alruhaili, Mohammed H.
Gattan, Hattan S.
Al Jaouni, Soad K.
Selim, Samy
Alanazi, Awadh
Alruwaili, Yasir
Zaied, Shaimaa Mohamed
Faried, Osama Ahmed
Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)
title Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)
title_full Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)
title_fullStr Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)
title_full_unstemmed Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)
title_short Antimicrobial Resistance Pattern, Pathogenicity and Molecular Properties of Hypervirulent Klebsiella pneumonia (hvKp) among Hospital-Acquired Infections in the Intensive Care Unit (ICU)
title_sort antimicrobial resistance pattern, pathogenicity and molecular properties of hypervirulent klebsiella pneumonia (hvkp) among hospital-acquired infections in the intensive care unit (icu)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10052956/
https://www.ncbi.nlm.nih.gov/pubmed/36985234
http://dx.doi.org/10.3390/microorganisms11030661
work_keys_str_mv AT alharbimohannedtalal antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT almuhayawimohammeds antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT nagshabandimohammedk antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT tarabulsimuyassark antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT alruhailimohammedh antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT gattanhattans antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT aljaounisoadk antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT selimsamy antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT alanaziawadh antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT alruwailiyasir antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT zaiedshaimaamohamed antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu
AT fariedosamaahmed antimicrobialresistancepatternpathogenicityandmolecularpropertiesofhypervirulentklebsiellapneumoniahvkpamonghospitalacquiredinfectionsintheintensivecareuniticu