Taha Marwa S, Elkolaly Reham M, Elhendawy Mohammed, Elatrozy Hytham, Amer Asmaa Fawzy, Helal Rehab Abd El Fattah, Salem Hanan, El Feky Yomna G, Harkan Ahmed, Mashaal Raghda Gabr, Allam Alzahraa A, Oraiby Amira E, Abdeen Nashwa S M, Bahey Marwa Gamal
Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.
Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.
Microorganisms. 2024 Dec 1;12(12):2469. doi: 10.3390/microorganisms12122469.
Hypervirulent is a highly pathogenic variant of , which represents a global public health issue because it is very virulent and spreads easily. The objectives of this study were to assess the predominance of hvKp among health care-associated infections in intensive care units of Tanta University Hospital and to compare hvKp with classical (cKp) in terms of antibiotic resistance, virulence, and molecular features. The study included 300 patients suffering from HAIs from different ICUs of Tanta University Hospitals. isolates were identified and subjected to string testing and antibiotic susceptibility testing, and the tissue culture assay for biofilm formation and polymerase chain reaction (PCR) tests were performed for the identification of capsular genes (, , ) and virulence genes (, , ). Fifty-seven isolates were isolated. A total of 21 (36.8%) of them were hvKp and 36 (63.15%) were cKp. Significantly higher antibiotic resistance was detected in the cKp group. There was a significant difference between biofilm formation between cKp and hvKp isolates ( < 0.004*). , , and genes were significantly associated with hvKp. The string test shows 100% sensitivity and negative predictive value for the detection of hvKp. Consequently, using the string test alone for the screening of hvKp is required. However, combining aerobactin-positive with hypermucoviscous isolates while screening for hvKp is crucial.
高毒力肺炎克雷伯菌是肺炎克雷伯菌的一种高致病性变体，它极具毒性且易于传播，这使其成为一个全球公共卫生问题。本研究的目的是评估坦塔大学医院重症监护病房中医疗保健相关感染患者中高毒力肺炎克雷伯菌的优势情况，并在抗生素耐药性、毒力和分子特征方面将高毒力肺炎克雷伯菌与经典肺炎克雷伯菌（cKp）进行比较。该研究纳入了坦塔大学医院不同重症监护病房中300例患有医院获得性感染（HAIs）的患者。对肺炎克雷伯菌分离株进行鉴定，并进行拉丝试验和抗生素敏感性试验，同时进行生物膜形成的组织培养测定以及聚合酶链反应（PCR）试验，以鉴定荚膜基因（kpsMTII、kpsMTIII、kpsM）和毒力基因（wabG、iutA、aerobactin）。共分离出57株肺炎克雷伯菌分离株。其中共有21株（36.8%）为高毒力肺炎克雷伯菌，36株（63.15%）为经典肺炎克雷伯菌。在cKp组中检测到显著更高的抗生素耐药性。cKp和hvKp分离株之间的生物膜形成存在显著差异（P<0.004*）。wabG、iutA和aerobactin基因与高毒力肺炎克雷伯菌显著相关。拉丝试验对高毒力肺炎克雷伯菌的检测显示出100%的敏感性和阴性预测值。因此，仅使用拉丝试验来筛查高毒力肺炎克雷伯菌是必要的。然而，在筛查高毒力肺炎克雷伯菌时，将气杆菌素阳性与高黏液性分离株相结合至关重要。
