Antibiotic resistance and its correlation with biofilm formation and virulence genes in Klebsiella pneumoniae isolated from wounds

Abstract

Klebsiella pneumoniae is the most important species of the Klebsiella genus and often causes hospital infections. These bacteria have a high resistance to most of the available drugs, which has caused concern all over the world. In this study, we investigated the antibiotic resistance pro le and the ability to produce Extended-spectrum beta-lactamase (ESBL) among K. pneumoniae isolates, then we investigated the relationship between these two factors with bio lm formation and the prevalence of different virulence genes. In this study, 130 isolates of K. pneumoniae isolated from wounds were investigated. The antibiotic resistance of the isolates was evaluated by the disk diffusion method. The microtiter plate method was used to measure bio lm formation.The prevalence of virulence genes was detected by multiplex PCR.Among the examined isolates, 85.3% showed multidrug resistance. 87.6% of the isolates were ESBL-positive. Imipenem, Meropenem, and Fosfamycin were the most effective drugs. The ability of the isolates to produce bio lm was strong (80%), moderate (12.3%), and weak (7.6%), respectively. FimH, mrKD, entB and tolC virulence genes were observed in all isolates.High prevalence of antibiotic resistance (especially multidrug resistance), high prevalence of ESBL-producing isolates, the ability of all isolates to form a bio lm (especially strong bio lm) and the presence of FimH, mrKD, entB and tolC virulence genes in all isolate show the importance of these factors in the pathogenesis of K. pneumoniae isolates in Iraq.Despite the high prevalence of infections caused by K. pneuminae in Iraq, a comprehensive study in which the characteristics of this bacterium in terms of drug resistance, beta-lactamase enzyme production, bio lm formation and coding of virulence genes have not been investigated. This study aimed to investigate the factors involved in increasing the resistance and pathogenesis of K. pneuminae. Material and methods Identi cation of bacteria:This study analyzed 130 K. pneuminae isolated from wound swab samples collected from Ibn Al Katteeb hospitals, Al-Kindi Teaching Hospital and private medical clinics in Baghdad between February 2019 and April 2021. Among the patients, 81 were women between 6 and 64 years old (median,53 years) and 49 were male patients between the ages of 8 and 71 years (median,49 years). The samples were cultured on MacConkey agar medium. After 24 − 18 incubation at 37°C, the grown K. pneumoniae isolates were con rmed by microbiological methods, including gram staining and microscopic observation of bacilli, as well as biochemical tests (API-20E test strip) (bioMerieux, France). To de nitively con rm K. pneumoniae in the studied isolates, a PCR test was performed to trace the 16S rRNA gene. Antibiotic resistance pro leThe pattern of antibiotic resistance in the isolates was done using the disk diffusion method according to CLSI (2020) criteria. The isolates were cultured in Brain Heart Infusion (BHI) medium and incubated at 37°C for 18-24 hours. After the growth of bacteria and cre...