Correlation Between Antimicrobial Resistance And Virulence Genes In Klebsiella Pneumoniae Isolates From Egypt.

Objectives: To genotypically assess the relationship between certain resistance and virulence determinants. Method: The cross-sectional study was conducted at Kafrelsheikh University, Egypt, from March 2019 to May 2021, and comprised pathologicalsamples, like blood,sputum, urine, vaginalswabs and wound swabs, that had been taken from patients who had never received treatment. The sample were collected from Kafrelsheikh and Mansoura University hospitals, and Klebsiella pneumoniae isolates were obtained. Resistance and virulence determinants were tested phenotypically. Uniplex polymerase chain reaction was used to evaluate the presence of several resistance accompanied genes and virulence genes in the isolates. Disc diffusion method was used to assess the isolates' susceptibility in accordance with the Clinical and Laboratory Standards Institute criteria for identifying diverse resistance patterns. RESULTS: There were 23 isolatesfrom 16 patients. Of the tested isolates, 22(95.65%)showed drug resistance; 19(82.6%) had multidrug resistance, and 3(13.04%) had extensive drug resistance. There was no case of pan drug resistance. CTX-M-15, NDM, CTX-M-1, VIM-1 and qnr B genes were detected in 14(60.86%), 13(56.5%), 6(26.08%), 6(26.08%) and 6(26.08%) isolates, respectively. Moreover, 6(26.08%) isolates exhibited extended-spectrum ß-lactamase producers, and 12(52.17%) ofsuch isolates contained both CTX-M-1 and CTX-M-15 genes, 6 and 33.3% contained CTX-M-1, CTX M-15 and fox genes. Type 3 fimbriae adhesin mrkD and mucoviscosity regulatory gene uge were found in the tested isolates. However, gene of iron uptake system kfu wasfound in 8(34.78%) isolates, and increased serum survival protein is and mucoviscosity accompanied gene magA were detected in 3(13.04%) isolates. A direct correlation was found among 5 from 8 Klebsiella pneumoniae virulence genes and antimicrobial resistance genes. CONCLUSIONS: There was a direct correlation between the existence of virulence factors and resistance to antimicrobials.

Immune Response And Pathophysiological Features Of Klebsiella Pneumoniae In Mice.

Objectives: To assess the bacterial colonisation of mice organs and faeces infected with 3 strains of Klebsiella pneumoniae, to measure levels of tumour necrosisfactor-alpha, tumour necrosisfactor-beta and interleukin-6 in mice serum, and to evaluate immune response of mice infected with Klebsiella pneumoniae. Method: The animalstudy was conducted at Kafreslsheikh University, Egypt, in 2021, and comprised mice 5-7 weeks old who were infected with 3 strains of Klebsiella pneumoniae; K80uge+ (uri, kfu+, mrkD+; K68 gyrA+(gyrase A), mrkD+; and K84 uge+, kfu+, mrkD+". They were monitored for 14 days. The bacterial colonisation of mice livers, lungs, spleens and faeces were determined using culture on MacConkey agar. The percentage of neutrophils detected as cluster of differentiation 11b+ and cluster of differentiation 45+ in the mice serum was determined by flow cytometry. Levels of tumour necrosis factor-alpha and tumour necrosis factor-beta were measured using enzyme-linked immunosorbent assay. RESULTS: There were 4 sets of female mice [1 control and 3 infected groups for which 3 K. pneumoniae strains (K80 uge+, kfu+, mrkD+; K68 gyrA+, mrkD+; and K84 "uge+, kfu+, mrkD+)] weighing 13-24gm was used. Colonisation of mice organs and faeces was high after 24 hours then declined rapidly after 3 days, 10 days and 14 days in case of infection with capsulated and non-capsulated strains of bacteria. Livers, lungs and spleens showed maximum inflammation after 24 hours, then declined rapidly. Both cytokine production and organ inflammation increased after one day of infection. There was a significant correlation between the produced cytokines and histopathological changesin liver, lung and spleen. The neutrophils increase in case of infection with K84 and K80 was more than non-capsulated K68. CONCLUSIONS: Neutrophils were found to play an important role in the clearance and treatment of Klebsiella pneumoniae.