Abstract
This study aimed for isolation and identification of Klebsiella pneumoniae was an opportunistic pathogen responsible for a wide range of clinical syndromes such as pneumonia in both hospital and community settings. Assessment some immune parameter this study was carried out in Al-Diwaniya Teaching Hospital in Al-Diwaniya Province during the period from December 2018 to February 2019. A total of 272 individuals in both sex: 139 males and 133 females, including 210 sputum and blood specimens were collected from patients with pneumonia and 62 blood specimens were collected from healthy persons as a control group. The result of Microbiological tests of sputum was found 120(57.2%) specimens as Gram negative bacteria. From these specimens found 62(51.7%) have been appeared as positive result for K. pneumoniae and represented a major cause for pneumonia in this study, 37(59.7%) of them were males and 25(40.3%) female. 59(95.16%) of K. pneumoniae isolates have capsule when stained negatively with Indian ink. While, 60 (96.77%) isolates were appeared hypermucoviscosity (HVM) phenotype. The level of interferon gamma (IFN-γ) and toll like receptor (TLR4) concentration was measured by using enzyme-linked immunosorbent assay (ELIZA) and was found that IFN-γ is significantly (p ˂0.05) raised in all age groups of patients in comparison to the healthy control groups. The level of IFN-γ in age group (1-10) years recorded high percentage (293.123) compared with other age groups.. On the other hand, the level of TLR4 concentration was found that is significantly (p˂0.05) raised in all age groups of patients in comparison to the healthy control group. The level of TLR4 in age group (51-60) years recorded high percentage (12.993) compared to other age groups.
Highlights
Pneumonia can be transmitted by airborne germs from an infected individual are inhaled by someone else
Mucoid isolates of K. pneumoniae were identified by inoculating bacteria on MCA and incubated at 37 oC for 24 hours, after incubation the colony touched by a loop and lifted vertically away from surface of MCA, colonies formed a string ≥ 5 mm in length show Hypermucoviscosity Test (HMV) isolates (Macfaddin, 2000)
The most general results in this study evidenced that the majority of patients with pneumonia showed the presence of Gram-negative bacteria more than Gram positive bacteria
Summary
Pneumonia can be transmitted by airborne germs from an infected individual are inhaled by someone else. Klebsiella pneumoniae considered as one of the most important pathogens but the mechanism by which this bacterium causes diseases is still not fully understood and approximately most studies have limited facts about this mechanism because of not wide ranges of virulence factors investigated, and few studies exist at the present time to study the relationship between virulence factors and resistance of K. pneumoniae to antibiotics (Paczosa & Mecsas, 2016). Successful defense against infections requires a coordinated action of multiple immune cell subsets In this context, it is widely appreciated that interferon γ (IFNγ) and toll like receptors 4 TLR4 decisively coordinate immune responses by modulating cell-autonomous immunity and inflammatory responses, and by dictating immune cell-to-cell communications. While type I IFNγ are the major effector cytokines of the host defense response against bacterial infections. TLR4 the most important TLR for the recognition of K. pneumoniae by virtue of its capacity to sense lipopolysaccharide (LPS) present in the outer membrane of this Gram-negative pathogen (Sender & Stamme, 2014)
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