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Serotyping of Klebsiella pneumoniae and Its Relation with Capsule-Associated Virulence Genes, Antimicrobial Resistance Pattern, and Clinical Infections: A Descriptive Study in Medical Practice

Authors Hasani A, Soltani E, Ahangarzadeh Rezaee M, Pirzadeh T, Ahangar Oskouee M, Hasani A, Gholizadeh P, Noie Oskouie A, Binesh E

Received 28 December 2019

Accepted for publication 11 June 2020

Published 24 June 2020 Volume 2020:13 Pages 1971—1980

DOI https://doi.org/10.2147/IDR.S243984

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Alka Hasani,1– 3 Elghar Soltani,1,2 Mohammad Ahangarzadeh Rezaee,1,2 Tahereh Pirzadeh,2 Mahin Ahangar Oskouee,2 Akbar Hasani,4 Pourya Gholizadeh,2 Arezoo Noie Oskouie,2 Ehsan Binesh5

1Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical, Sciences, Tabriz, Iran; 3Sina Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; 4Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 5Department of Infectious Disease, School of Medicine, Shahroud University of Medical Science, Shahroud, Iran

Correspondence: Elghar Soltani
Immunology Research Center and Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Tel +989366295410
Fax +984133808693
Email elghar_soltani@yahoo.com

Objective: Klebsiella pneumoniae, one of the clinical superbugs, causes diverse infections because of its variable capsular antigens. This study focused on K. pneumoniae and aimed to assess any correlation between capsular serotype, capsule-associated virulence genes, and evaluate its resistance to conventional antibiotics in order to gain insight into any regional differences.
Materials and Methods: A total of 61 K. pneumoniae collected from various clinical specimens were confirmed genotypically. Clinical and demographic data for all patients were reviewed. All isolates were subjected to antimicrobial susceptibility tests. Capsular serotyping and capsule-associated virulence genes were studied using the molecular method.
Results: All typeable isolates were typed into K5, K20, and K54 serotypes, and among them, K54 was observed to be predominant. The most common capsule-associated virulence genes comprised uge (93.4%), ycfM (91.8%), and wabG (88.5%), while wcaG (29.5%) and rmpA (21.3%) were noted at much lower prevalence rates. The gene wcaG was significantly associated with K54 positive isolates (p = 0.001), while rmpA was associated with K20 positive isolates (p = 0.01).
Conclusion: Serotype K54 had a high frequency in isolates collected from patients with pulmonary diseases, while serotype K20 was associated with burn patients. Carbapenems and levofloxacin were the best therapeutic options for the treatment of infections with serotypes K20 and K54.

Keywords: Klebsiella pneumoniae, capsular serotype, virulence factor, extended-spectrum beta-lactamase, multidrug-resistance, multiplex-PCR

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