Abstract
Klebsiella pneumonia infection rates have increased dramatically. Molecular typing and virulence analysis are powerful tools that can shed light on Klebsiella pneumonia infections. Whereas 77.7% (28/36) of clinical isolates indicated multidrug resistant (MDR) patterns, 50% (18/36) indicated carpabenem resistance. Gene prevalence for the AcrAB efflux pump (82.14%) was more than that of the mdtK efflux pump (32.14%) in the MDR isolates. FimH-1 and mrkD genes were prevalent in wound and blood isolates. FimH-1 gene was prevalent in sputum while mrkD gene was prevalent in urine. Serum resistance associated with outer membrane protein coding gene (traT) was found in all blood isolates. IucC, entB, and Irp-1 were detected in 32.14%, 78.5% and 10.7% of MDR isolates, respectively. We used two Polymerase Chain Reaction (PCR) analyses: Enterobacterial Repetitive Intergenic Consensus (ERIC) and Random Amplified Polymorphic DNA (RAPD). ERIC-PCR revealed 21 and RAPD-PCR revealed 18 distinct patterns of isolates with similarity ≥80%. ERIC genotyping significantly correlated with resistance patterns and virulence determinants. RAPD genotyping significantly correlated with resistance patterns but not with virulence determinants. Both RAPD and ERIC genotyping methods had no correlation with the capsule types. These findings can help up better predict MDR Klebsiella pneumoniae outbreaks associated with specific genotyping patterns.
Highlights
K. pneumonia belongs to family Enterobacteriaceaea and is related to other genera, such as Enterobacter, Escherichia, and Salmonella[1]
Thirty six of K. pneumoniae clinical isolates were collected as described under materials and methods
The extensive use of antimicrobials led to high incidence of resistance in K. pneumoniae[24]
Summary
K. pneumonia belongs to family Enterobacteriaceaea and is related to other genera, such as Enterobacter, Escherichia, and Salmonella[1]. K. pneumoniae is considered one of the most common Gram negative bacteria[2] It is an important pathogen in nosocomial infections in Egypt[3,4]. The AcrAB-TolC pump is composed of an outer-membrane channel (TolC), a secondary transporter located in the inner membrane (AcrB), and a periplasmic component (AcrA)[13] This pump is responsible for resistance to quinolones, tetracyclines, and chloramphenicol in various MDR isolates[14]. The MATE pumps, such as the mdtK system, transport some of those antimicrobial agents[15] Porins such as OmpK35 and OmpK36 are crucial for the penetration of antibiotics into the cells and for susceptibility to cephalosporins and carbapenems[16]. Molecular typing and virulence analysis of clinical isolates are powerful tools that can shed light on multidrug resistant (MDR) Klebsiella pneumonia infections. We used two Polymerase Chain Reaction (PCR) genotyping analyses: Enterobacterial Repetitive Intergenic Consensus (ERIC) and Random Amplified Polymorphic DNA (RAPD) to assess correlations of each with resistance patterns, virulence determinants, or capsule types of K. pneumoniae isolates
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