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 β-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.