Prevalence of Cytotoxin-producing Klebsiella oxytoca Isolated from Medical City Complex, Baghdad, Iraq

Mustaf, Haneen Ali; Hafidh, Rand R; Alsodani, Mohammed Hannon

doi:10.33091/amj.2025.154811.1977

	Prevalence of Cytotoxin-producing Klebsiella oxytoca Isolated from Medical City Complex, Baghdad, Iraq
Al- Anbar Medical Journal
Volume 21, Issue 2, April 2025, Pages 104-109 PDF (361 K)
Document Type: Original articles
DOI: 10.33091/amj.2025.154811.1977
Authors
Haneen Ali Mustaf¹; Rand R Hafidh^* ²; Mohammed Hannon Alsodani³
¹Department of Biology, College of Science, University of Diyala, Diyala, Iraq.
²Department of Microbiology, College of Medicine, University of Baghdad, Baghdad, Iraq.
³Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq.
Abstract
Background: Klebsiella oxytoca (K. oxytoca) is a progressively noted pathogen in healthcare services. K. oxytoca can produce cytotoxins, which play a role in the pathogenesis of bacteria and are the main virulence factors. K. oxytoca can make cytotoxin, a biofilm, resistance, and a hypermucoviscous phenotype, all of which are important for the virus's ability to infect others. Objective: To investigate the occurrence of the toxin-producing K. oxytoca (pehX, npsA, and npsB) genes from different Iraqi isolates that were multi-drug resistant, could produce a biofilm, and had a hypermucoviscous phenotype. Materials and methods: A total of 100 K. oxytoca isolates were collected from hospitals in Baghdad, Iraq. The isolates were identified by manual and biochemical tests. The string test was used to determine the hypermucoviscousity. The antibiotic sensitivity test was uncovered using the Kirby-Bauer method. Biofilm formation was detected by the qualitative Congo red agar method and the quantitative microtiter plate method (MTP). K. oxytoca galacturonase-specific gene (pehX) and the cytotoxin marker genes (npsA and npsB) were detected using real-time polymerase chain reaction. Results: K. oxytoca was isolated from 62/100 inpatients and 38/100 outpatients. Antibiotic sensitivity tests showed different levels of resistance. The pehX gene was positive in 35/50 of the isolates. The npsA/npsB PCR targets were positive in 12/35 isolates. Of these 12 isolates, 3/12 (25%) were from urine and 2/12 (16.7%) from blood. Conclusion: Cytotoxin-producing K. oxytoca was a common emerging pathogen in Iraqi patients. Biofilm formation, hypermucoviscous, and antibiotic resistance increase the virulence of this bacterium.
Keywords
Biofilm; Cytotoxin; Hypermucoviscous; K. oxytoca; npsA gene; npsB gene; pehX gene

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