Distribution and antibiotic susceptibility pattern of Hypervirulent Klebsiella pneumoniae (HvKp) strains isolated from hospitalized patients in North of Iran

Background and Aim : Hypervirulent Klebsiella pneumoniae (hvKp) is an increasingly recognized pathotype of K. pneumoniae characterized clinically by its ability to cause organ- or life-threatening infections in healthy hosts from the community. One of the concerns of physicians and health communities about the recent pathogen is the emergence of multidrug resistance (MDR) and Extended-Spectrum β-Lactamase (ESBL) phentotype. Therefore, the aim of this study is to isolation, identification and determination of antibiotic susceptibility pattern of HvKp strains isolated from hospitalized patients in North of IranMethods : In this study, ۹۰ clinical samples of K. pneumoniae were collected randomly from three teaching hospitals affiliated to Babol University of Medical Sciences in the form of microbial plates. Stringent tests were used to identify HVKP strains. In this study, K. pneumoniae ATCC ۱۳۸۸۳ and Escherichia coli ATCC۲۵۹۲۲ were used as positive and negative control, respectively. Antibiotic susceptibility of HvKp isolates was determined according to CLSI standards. Antibiotics used in disk diffusion test include ciprofloxacin, amikacin, trimethoprim /sulfamethoxazole, cefotaxime, ampicillin, aztreonam, imipenem, tetracycline, gentamicin, ceftazidime and cefepime. Finally, multiple resistance phenotypes (MDR) were identified.Results : From ۹۰ clinical samples of K. pneumoniae, ۴۰ isolates of HvKp strains were isolated according to specific tests. According to susceptibility test, the highest resistance rate was observed against ampicillin (۱۰۰%) followed by trimethoprim /sulfamethoxazole (۶۷/۷%), cefotaxime (۵۶/۶%), ceftazidime (۵۲/۲%), aztreonam (۴۷/۷%), tetracycline (۴۴/۴%), gentamicin (۴۳/۳%), cefepime (۳۶/۶%), amikacin (۳۵/۵%), ciprofloxacin (۲۵/۵%) and imipenem (۱۲/۲%). Moreover, all isolates were MDR.Conclusion : HvKp, especially ESBL-hvKp and MDR-hvKp, is emerging in the hospitalized patients. It is essential to enhance clinical awareness and management of hvKp infections.

Keywords:

Klebsiella pneumoniae , Antibiotic resistance , Hypervirulent , HvKp