Birgani Arta Hafezi, Goli Hamid Reza, Siadat Seyed Davar, Fateh Abolfazl, Nikbin Vajihe Sadat, Sakhaee Fatemeh, Ashrafian Fatemeh, Haghshenas Mohammad Reza, Gholami Mehrdad
Department of Medical Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran.
AMB Express. 2025 Mar 5;15(1):36. doi: 10.1186/s13568-025-01845-1.
Resistant and virulent strains of Klebsiella pneumoniae (K. pneumoniae) are rapidly disseminated among both hospitalized patients and communities, therefore, the identification of the genes responsible for virulence and resistance, along with the clonal relatedness of these strains, could be beneficial in the management of the dissemination of these strains among patients. The aim of the present study was to assess antibiotic susceptibility, virulence and resistance genes, as well as the genetic relatedness of K. pneumoniae strains isolated from patients admitted to four hospitals in Mazandaran, Iran. A total of 95 K. pneumoniae were gathered from hospitalized patients. All isolates were confirmed using biochemical and conventional microbiological methods, followed by the assessment of susceptibility patterns through disk diffusion and the detection of resistance and virulence genes using conventional PCR. The genetic diversity of clinical isolates was determined using the Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR) technique. The resistance frequencies varied, with the highest being for ampicillin/sulbactam (95.8%) and the lowest for fosfomycin (3.2%). Only one strain displayed a non-MDR profile against all antibiotics tested. Virulence-associated genes were detected, such as mrkD (90.5%), fimH (80%), entB (92.6%), iutA (25.3%), and ybtS (68.4%). Genes associated with efflux pumps and outer membrane porins included acrAB (98.9%), tolC (95.8%), mdtK (83.2%), ompK35 (95.8%), and ompK36 (92.6%). Based on ERIC-PCR patterns with a 90% similarity, the isolates were categorized into 17 distinct clusters. While the majority of isolates had a same profile and were grouped in the predominant pattern, 11 isolates were identified as singletons. Our study indicates that the prevalence of MDR K. pneumoniae carrying virulence genes and exhibiting close relatedness underscores the urgent need for effective strategies to control and prevent infections caused by K. pneumoniae.
肺炎克雷伯菌（K. pneumoniae）的耐药菌株和毒力菌株在住院患者和社区中迅速传播，因此，鉴定负责毒力和耐药性的基因以及这些菌株的克隆相关性，可能有助于管理这些菌株在患者中的传播。本研究的目的是评估从伊朗马赞德兰省四家医院收治的患者中分离出的肺炎克雷伯菌菌株的抗生素敏感性、毒力和耐药基因以及遗传相关性。总共从住院患者中收集了95株肺炎克雷伯菌。所有分离株均采用生化和传统微生物学方法进行确认，随后通过纸片扩散法评估药敏模式，并使用传统PCR检测耐药和毒力基因。使用肠杆菌重复基因间共识PCR（ERIC-PCR）技术确定临床分离株的遗传多样性。耐药频率各不相同，氨苄西林/舒巴坦最高（95.8%），磷霉素最低（3.2%）。只有一株对所有测试抗生素显示出非多重耐药（MDR）谱。检测到了与毒力相关的基因，如mrkD（90.5%）、fimH（80%）、entB（92.6%）、iutA（25.3%）和ybtS（68.4%）。与外排泵和外膜孔蛋白相关的基因包括acrAB（98.9%）、tolC（95.8%）、mdtK（83.2%）、ompK35（95.8%）和ompK36（92.6%）。基于相似性为90%的ERIC-PCR模式，分离株被分为17个不同的簇。虽然大多数分离株具有相同的谱并被归为主要模式，但有11株被鉴定为单株。我们的研究表明，携带毒力基因且具有密切相关性的多重耐药肺炎克雷伯菌的流行凸显了采取有效策略控制和预防肺炎克雷伯菌引起的感染的迫切需求。
