A Molecular detection of some capsular Serotypes Genes in multidrug resistance Klebsiella pneumonia classical and hyper virulent in Iraqi patients capsular Serotypes Genes in multidrug resistance Klebsiella pneumonia classical and hyper virulent in Iraqi patients
Article Sidebar
Main Article Content
Abstract
Klebsiella pneumoniae is an opportunistic pathogenic bacterium and a major cause of nosocomial infections. This study aimed to detect selected capsular serotype genes in multidrug-resistant hypervirulent (hvKp) and classical (cKp) K. pneumoniae isolates from urinary tract infection (UTI) cases using conventional polymerase chain reaction (PCR). This cross-sectional study included 250 urine samples collected from male and female patients aged 18–65 years presenting with UTI symptoms. The study was conducted at Medical City Hospital, Baghdad, Iraq, from October 2023 to February 2024. Samples were cultured on MacConkey agar, nutrient agar, blood agar, and UTI medium for bacterial isolation. Identification was performed using standard biochemical tests and confirmed by the VITEK 2 compact system for antibiotic susceptibility profiling. The string test was used to differentiate hvKp from cKp strains. Capsular serotype genes K1 and K2 were detected in selected multidrug-resistant K. pneumoniae isolates using conventional PCR. Of the 250 urine samples, 201 (84.6%) showed positive bacterial growth. The mean patient age was 54 ± 12 years, with a higher prevalence of UTIs in females. Escherichia coli and K. pneumoniae were the most frequently isolated pathogens. Among the 62 K. pneumoniae isolates, 21 (33.9%) were identified as hvKp and 41 (66.1%) as cKp. Antibiotic susceptibility testing showed that 34% of cKp isolates were multidrug-resistant (MDR), while 90.4% of hvKp isolates exhibited MDR profiles. Molecular analysis of 42 selected MDR K. pneumoniae isolates (21 cKp and 21 hvKp) revealed that 19 of the cKp isolates harbored capsular genes—K1 in 11 isolates (57.9%) and K2 in 8 (42.1%). Among hvKp isolates, 18 carried capsular genes, with K1 in 7 isolates (39%) and K2 in 9 (50%). Conclusion: Hypervirulent K. pneumoniae isolates showed a higher frequency of multidrug resistance and extended-spectrum β-lactamase (ESBL) production compared to classical strains. The K1 and K2 capsular serotypes were predominant among hvKp isolates, while both were also present in cKp strains but at varying proportions.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The Journal of Medical and Oral Biosciences uses a Creative Commons Attribution (CC Attribution-ShareAlike 4.0) and its license of (CC BY-SA 4.0). This license allows the authors to hold ownership of the copyright of their articles.
Attribution-Share Alike 4.0 International License (CC BY-SA 4.0). 
Under the CC BY-SA 4.0 the authors are free to:
Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
No use, distribution or reproduction is permitted which does not comply with these terms.
https://creativecommons.org/licenses/by-sa/4.0/
References
, Weiss DS. Hypervirulent Klebsiella pneumoniae – clinical and molecular perspectives. J Intern Med. 2020 Mar 21;287(3):283–300.
2. Russo TA, Marr CM. Hypervirulent Klebsiella pneumoniae. Clin Microbiol Rev. 2019 Jun 19;32(3).
3. Marr CM, Russo TA. Hypervirulent Klebsiella pneumoniae : a new public health threat. Expert Rev Anti Infect Ther. 2019 Feb 5;17(2):71–3.
4. Kochan TJ, Nozick SH, Medernach RL, Cheung BH, Gatesy SWM, Lebrun-Corbin M, et al. Genomic surveillance for multidrug-resistant or hypervirulent Klebsiella pneumoniae among United States bloodstream isolates. BMC Infect Dis. 2022 Dec 7;22(1):603.
5. Boyle DP, Zembower TR. Epidemiology and Management of Emerging Drug-Resistant Gram-Negative Bacteria. Urologic Clinics of North America. 2015 Nov;42(4):493–505.
6. Paczosa MK, Mecsas J. Klebsiella pneumoniae: Going on the Offense with a Strong Defense. Microbiology and Molecular Biology Reviews. 2016 Sep;80(3):629–61.
7. Gonzalez-Ferrer S, Peñaloza HF, Budnick JA, Bain WG, Nordstrom HR, Lee JS, et al. Finding Order in the Chaos: Outstanding Questions in Klebsiella pneumoniae Pathogenesis. Infect Immun. 2021 Mar 17;89(4).
8. Husna A, Rahman MdM, Badruzzaman ATM, Sikder MH, Islam MR, Rahman MdT, et al. Extended-Spectrum β-Lactamases (ESBL): Challenges and Opportunities. Biomedicines. 2023 Oct 30;11(11):2937.
9. Lan Y, Zhou M, Jian Z, Yan Q, Wang S, Liu W. Prevalence of pks gene cluster and characteristics of Klebsiella pneumoniae ‐induced bloodstream infections. J Clin Lab Anal. 2019 May 8;33(4).
10. EUCAST. Clinical breakpoints-breakpoints and guidance, 2018. https://www.eucast.org/clinical_breakpoints/ Accessed December 10, 2019 . 2019;
11. Miftode IL, Nastase E, Miftode R Ștefan, Miftode E, Iancu L, Luncă C, et al. Insights into multidrug resistant K. pneumoniae urinary tract infections: From susceptibility to mortality. Exp Ther Med. 2021 Jul 30;22(4):1086.
12. Al Ismail D, Campos-Madueno EI, Donà V, Endimiani A. Hypervirulent Klebsiella pneumoniae (hvKp): Overview, Epidemiology, and Laboratory Detection. Pathog Immun. 2025 Jan 24;10(1):80–119.
13. Abbas SM, Dhahi MAR. Evaluation of some Virulence Factors and Drug Resistance of Bacteria Isolated from the Urine of Patients with TCC-Bladder Cancer. Baghdad Science Journal. 2022 Jun 1;19(3):0469.
14. Zamani A, Yousefi Mashouf R, Ebrahimzadeh Namvar AM, Alikhani MY. Detection of magA Gene in Klebsiella spp. Isolated from Clinical SamplesDetection of magA. Iran J Basic Med Sci. 2013 Feb;16(2):173–6.
15. Ali Mohammed Hussein Al-Kamoosi, Ibtisam Habeeb AL-Azawi. Detection of Capsular Polysaccharide Virulence Genes rmpA and magA of Klebsiella Pneumonia Isolate from Diabetic Foot Ulcer Patient in Najaf Governorate in Iraq. Indian Journal of Forensic Medicine & Toxicology. 2021 Mar 24;15(2):3061–7.
16. Zhou S, Ren G, Liu Y, Liu X, Zhang L, Xu S, et al. Challenge of evolving Klebsiella pneumoniae infection in patients on hemodialysis: from the classic strain to the carbapenem-resistant hypervirulent one. Int J Med Sci. 2022;19(3):416–24.
17. Wen Z, Chen Y, Liu T, Han J, Jiang Y, Zhang K. Predicting Antibiotic Tolerance in hvKP and cKP Respiratory Infections Through Biofilm Formation Analysis and Its Resistance Implications. Infect Drug Resist. 2024 Apr;Volume 17:1529–37.
18. EL-Mahdy R, El-Kannishy G, Salama H. Hypervirulent Klebsiella pneumoniae as a hospital-acquired pathogen in the intensive care unit in Mansoura, Egypt. Germs. 2018 Sep 3;8(3):140–6.
19. Wang Y, Hua M, Wang J, Xing W, Chen J, Liu J, et al. Clonal Dissemination of Multidrug-Resistant and Hypervirulent Klebsiella pneumoniae Clonal Complex in a Chinese Hospital. Pathogens. 2022 Oct 18;11(10):1202.