Rao Shamitha S, Fernandes Anisha M
Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Scientifica (Cairo). 2025 Aug 3;2025:8545710. doi: 10.1155/sci5/8545710. eCollection 2025.
Hypervirulent (hvKp) is emerging and gaining notoriety due to the acquisition of drug resistance. Differentiation of hvKp from classical (cKp) is essential for prompt initiation of therapy to prevent metastasis, detection of occult abscesses, and site-specific management for better patient outcomes. A total of 300 isolates from various clinical specimens were collected from 256 patients to determine their clinical profiles, antibiograms, risk factors, and patient outcomes. Hypermucoviscosity was demonstrated via a phenotypic string test. The hvKp pathotype was classified by molecular detection of the virulence genes and/or aerobactin-. infections affected the older age group (> 50 years) of both sexes, with a male preponderance (62.89%). Urinary tract infections were the most common clinical presentation (37.33%). Among the 300 isolates, 17 (5.66%) possessed hypervirulence genes, and 281 (93.66%) isolates were string test positive. Pyogenic liver abscess was more frequently observed in hvKp infections (5.88%) than in cKp infections (1.76%). Multiple sites were involved in 35.29% of the hvKp infections. ( < 0.05). Hypertension was the common comorbidity observed in the majority of the 256 patients (61.32%). The ICU stay (64.70%) predisposed patients to hvKp infections ( < 0.05). Compared with hvKp, cKp presented high rates of resistance to antibiotics. Although extended-spectrum beta-lactamase (ESBL) producers were significantly more common in cKp, 41.1% of hvKp strains were ESBLs. Carbapenem resistance and multidrug resistance were observed in 35.29% of the hvKp strains. The mortality rate in patients infected with hvKp was 23.52%. The potential for occult abscess and metastasis with life-threatening complications necessitates prompt, accurate identification of hvKp. Convergence of hvKp and cKp with shared traits poses a diagnostic and therapeutic dilemma for clinicians. The combination of genetic markers such as with has high reported diagnostic accuracy. Further studies are needed to better characterize hvKp in the clinical laboratory.
高毒力肺炎克雷伯菌(hvKp)因获得耐药性而不断出现并日益受到关注。区分hvKp与经典肺炎克雷伯菌(cKp)对于及时开始治疗以预防转移、检测隐匿性脓肿以及进行针对性治疗以改善患者预后至关重要。从256名患者的各种临床标本中总共收集了300株分离株,以确定其临床特征、抗菌谱、危险因素和患者预后。通过表型拉丝试验证实了高黏液性。通过对毒力基因和/或气杆菌素的分子检测对hvKp致病型进行分类。感染影响了50岁以上的老年人群,男女皆有,男性占优势(62.89%)。尿路感染是最常见的临床表现(37.33%)。在300株分离株中,17株(5.66%)具有高毒力基因,281株(93.66%)分离株拉丝试验呈阳性。与cKp感染(1.76%)相比,hvKp感染中更常观察到化脓性肝脓肿(5.88%)。35.29%的hvKp感染涉及多个部位(P<0.05)。高血压是256名患者中大多数人常见的合并症(61.32%)。入住重症监护病房(ICU)(64.70%)使患者易患hvKp感染(P<0.05)。与hvKp相比,cKp对抗生素的耐药率较高。虽然产超广谱β-内酰胺酶(ESBL)的菌株在cKp中明显更常见,但41.1%的hvKp菌株是ESBLs。35.29%的hvKp菌株观察到对碳青霉烯类耐药和多重耐药。感染hvKp的患者死亡率为23.52%。隐匿性脓肿和转移以及危及生命的并发症的可能性使得必须迅速、准确地识别hvKp。hvKp和cKp具有共同特征的融合给临床医生带来了诊断和治疗难题。诸如[具体基因标记1]与[具体基因标记2]等基因标记的组合据报道具有较高的诊断准确性。需要进一步研究以更好地在临床实验室中对hvKp进行特征描述。