- All Journals
- Al-Qadisiyah University
- Basrah University
- Kirkuk University
- Mosul University
- The Iraqi Borad for Medical Specialization
- University of Anbar
- University of Technology
- Al Mustafa University
- Al-Zahraa University for Women
- Alnoor University
- Kunooz University
- Misan University
- Ninevah University
- Tikrit University
- University of Al-Hamdaniya
- University of Kerbala
Hypervirulent and the Multi-Drug Resistant Klebsiella oxytoca: A New Emerging Pathogen in Baghdad Hospitals, Iraq | ||
| Al- Anbar Medical Journal | ||
| Volume 20, Issue 1, June 2024, Pages 86-93 PDF (7.77 M) | ||
| Document Type: Original articles | ||
| DOI: 10.33091/amj.2024.143968.1409 | ||
| Authors | ||
| Rusul Emad1; Rand Hafidh* 2 | ||
| 1Department of Medical Laboratories, Gilgamesh University College of Medical and Health Technologies, Baghdad, Iraq. | ||
| 2Department of Microbiology, College of Medicine, University of Baghdad, Baghdad, Iraq. | ||
| Abstract | ||
| Background: The human microbiota, K. oxytoca, is resistant to multiple drugs, endangering the lives of patients. Hypervirulent strains evolved into multidrug-resistant strains due to the acquisition of mobile genetic elements. Objectives: To detect the antibiotic-resistant profile and the related virulence genes in the hypervirulent and non-hypervirulent strains isolated from clinical specimens. Materials and Methods: A total of 136 clinical samples were collected from patients at Baghdad City Hospitals, Iraq. The isolates were identified, and an antibiotics sensitivity test was carried out. The polymerase chain reaction typing method was used to detect the virulence genes. Results: The most frequent source of K. oxytoca was urine samples (36.03%), then blood samples (15.44%), particularly inpatient samples. About 12.5% of isolates were positive for the hypervirulent test (the string test). Isolates showed variable levels of resistance towards antibiotic groups. The blaCTX-M and aac(6')-Ib-cr genes were revealed in 88% of isolates, and the blaOXA-48 gene was in 44%. All the tested isolates were negative for the rmpA gene. Conclusion: K. oxytoca is recognized as one of the leading causes of hospital-acquired infections. The rapid identification of antibiotics-resistant, hypervirulent isolates that present a considerable threat to human health is highly recommended in the local hospitals. | ||
| Keywords | ||
| Antibiotic resistant genes; Hypervirulent; K. oxytoca; Multiple drugs resistance; Non-hypervirulent | ||
| References | ||
|
[1] A. A. Jasim and Z. H. A. Al-Asady, “Molecular detection f Klebsiella Oxytoca Isolated from clinical sources,” Plant Arch., vol. 20, no. 1, pp. 2104–2108, 2020.
[2] J. Stewart, L. M. Judd, A. Jenney, K. E. Holt, K. L. Wyres, and J. Hawkey, “Epidemiology and genomic analysis of Klebsiella oxytoca from a single hospital network in Australia,” BMC Infect. Dis., vol. 22, no. 1, pp. 1–10, 2022.
[3] S. Ahmed Hasan and M. Mohammed Bakr, “Bacteriological and Molecular Detection of Klebsiella oxytoca and its Resistance to Antibiotics among Clinical Specimens from Kirkuk, Iraq.,” Inst. Razi. Arch., vol. 77, no. 5, 2022.
[4] J. Yang, H. Long, Y. Hu, Y. Feng, A. McNally, and Z. Zong, “Klebsiella oxytoca complex: update on taxonomy, antimicrobial resistance, and virulence,” Clin. Microbiol. Rev., vol. 35, no. 1, pp. e00006-21, 2022.
[5] R. Herruzo, G. Ruiz, S. Gallego, J. Diez, A. Sarria, and F. Omeñaca, “VIM-Klebsiella oxytoca outbreak in a neonatal intensive care unit. This time it wasn’t the drain,” J. Prev. Med. Hyg., vol. 58, no. 4, p. E302, 2017.
[6] B. Yadav, S. Mohanty, and B. Behera, “Occurrence and Genomic Characteristics of Hypervirulent Klebsiella pneumoniae in a Tertiary Care Hospital, Eastern India,” Infect. Drug Resist., pp. 2191–2201, 2023.
[7] K. L. Wyres, M. M. C. Lam, and K. E. Holt, “Population genomics of Klebsiella pneumoniae,” Nat. Rev. Microbiol., vol. 18, no. 6, pp. 344–359, 2020.
[8] M. Damian, C.-R. Usein, A.-M. Palade, S. Ceciu, and M. Cosman, “Molecular epidemiology and virulence characteristics of Klebsiella pneumoniae strains isolated from hospital-associated infections,” Open Epidemiol. J., vol. 2, no. 1, 2009.
[9] C. A. Hogan, N. Watz, I. Budvytiene, and N. Banaei, “Rapid antimicrobial susceptibility testing by VITEK® 2 directly from blood cultures in patients with Gram-negative rod bacteremia,” Diagn. Microbiol. Infect. Dis., vol. 94, no. 2, pp. 116–121, 2019.
[10] H. Alkofide et al., “Multidrug-resistant and extensively drug-resistant enterobacteriaceae: prevalence, treatments, and outcomes–a retrospective cohort study,” Infect. Drug Resist., pp. 4653–4662, 2020.
[11] J. Sambrook and D. W. Russell, Molecular Cloning: Ch. 8. In Vitro amplification of DNA by the polymerase chain reaction, vol. 2. Cold Spring Harbor Laboratory Press, 2001.
[12] W. P. Herridge, P. Shibu, J. O’Shea, T. C. Brook, and L. Hoyles, “Bacteriophages of Klebsiella spp., their diversity and potential therapeutic uses,” J. Med. Microbiol., vol. 69, no. 2, p. 176, 2020.
[13] R. Emad, R. R. Hafidh, and M. Z. Zaman, “Identification of Klebsiella oxytoca by VITEK-2 System in Baghdad Hospitals,” J. Fac. Med. Baghdad, vol. 65, no. 4, 2023.
[14] G. Sibi, P. Kumari, and N. Kabungulundabungi, “Antibiotic sensitivity pattern from pregnant women with urinary tract infection in Bangalore, India,” Asian Pac. J. Trop. Med., vol. 7, pp. S116–S120, 2014.
[15] F. A. Mahdi, A. S. Saadoon, and H. S. Haider, “Prevalence and Antibacterial Resistance of Gram Negative Bacteria Causing Respiratory Tract Infection In Critically Ill Patients.,” J. Fac. Med. Baghdad, vol. 56, no. 3, pp. 273–277, 2014.
[16] M. Liébana-Rodríguez et al., “Outbreaks by Klebsiella oxytoca in neonatal intensive care units: Analysis of an outbreak in a tertiary hospital and systematic review,” Enfermedades Infecc. y Microbiol. Clin. (English ed.), 2023.
[17] G. Li, S. Sun, Z. Y. Zhao, and Y. Sun, “The pathogenicity of rmpA or aerobactin-positive Klebsiella pneumoniae in infected mice,” J. Int. Med. Res., vol. 47, no. 9, pp. 4344–4352, 2019.
[18] N. J. Kandela, “Detection of Extended Spectrum Beta-Lactamase (ESβL) and Klebocin Production from Klebsiella pneumoniae Local Isolates from Urinary Tract Infections,” Al Mustansiriyah J. Pharm. Sci., vol. 9, no. 1, pp. 21–42, 2011.
[19] S. Vergara-López, M. C. Domínguez, M. C. Conejo, Á. Pascual, and J. Rodríguez-Baño, “Wastewater drainage system as an occult reservoir in a protracted clonal outbreak due to metallo-β-lactamase-producing Klebsiella oxytoca,” Clin. Microbiol. Infect., vol. 19, no. 11, pp. E490–E498, 2013.
[20] W.-L. Yu, C.-P. Fung, W.-C. Ko, and Y.-C. Chuang, “Polymerase chain reaction analysis for detecting capsule serotypes K1 and K2 of Klebsiella pneumoniae causing abscesses of the liver and other sites,” J. Infect. Dis., vol. 195, no. 8, p. 1235, 2007.
[21] W.-L. Yu et al., “Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan,” Clin. Infect. Dis., vol. 42, no. 10, pp. 1351–1358, 2006.
[22] E. Ruppé et al., “CTX-M β-lactamases in Escherichia coli from community-acquired urinary tract infections, Cambodia,” Emerg. Infect. Dis., vol. 15, no. 5, p. 741, 2009.
[23] B. Arikan and A. Aygan, “Resistance variations of third generation of Cephalosporins in some of the Enterobacteriaceae members in hospital sewage,” Int J Agric Biol, vol. 11, pp. 93–96, 2009.
[24] P. Nordmann and L. Poirel, “The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide,” Clin. Microbiol. Infect., vol. 20, no. 9, pp. 821–830, 2014.
[25] R. R. Watkins and R. A. Bonomo, “Increasing prevalence of carbapenem-resistant Enterobacteriaceae and strategies to avert a looming crisis,” Expert Rev. Anti. Infect. Ther., vol. 11, no. 6, pp. 543–545, 2013.
[26] V. Silago et al., “Existence of multiple ESBL genes among phenotypically confirmed ESBL producing Klebsiella pneumoniae and Escherichia coli concurrently isolated from clinical, colonization and contamination samples from neonatal units at Bugando Medical Center, Mwanza, Tanzania,” Antibiotics, vol. 10, no. 5, p. 476, 2021.
[27] C.-J. Lin, L. K. Siu, L. Ma, Y.-T. Chang, and P.-L. Lu, “Molecular Epidemiology of Ciprofloxacin-Resistant Extended-Spectrum β-Lactamase–Producing Klebsiella pneumoniae in Taiwan,” Microb. Drug Resist., vol. 18, no. 1, pp. 52–58, 2012.
[28] D. L. Paterson et al., “Antibiotic therapy for Klebsiella pneumoniae bacteremia: implications of production of extended-spectrum β-lactamases,” Clin. Infect. Dis., vol. 39, no. 1, pp. 31–37, 2004.
| ||
|
Statistics Article View: 1,094 PDF Download: 943 |
||