Klebsiella pneumonia is a pathogen and an agent that causes hospital-acquired infections. Klebsiella pneumonia is the first and most common causative agent in community-acquired infections and urinary tract diseases. This study aimed to detect common genes, (i.e., fimA, mrkA, and mrkD) in the isolates of K. pneumoniae, isolated from urine specimens using the polymerase chain reaction (PCR) method. The isolates of K. pneumoniae were collected from urine specimens in health centers in Wasit Governorate, Iraq, and diagnosed using Analytical Profile Index 20Eand 16S rRNA techniques. The microtiter plate (MTP) method was used to detect biofilm formation. A total of 56 isolates were identified as K. pneumonia cases. The results led to the detection of biofilms; accordingly, all K. pneumoniae isolates showed biofilm production by MTP, however, at different levels. The PCR method was employed to detect biofilm genes and showed that 49 (87.5%), 26 (46.4%), and 30 (53.6%) of isolates carried fimH, mrkA, and mrkD, respectively. Furthermore, susceptibility tests for different antibiotics revealed that K. pneumoniae isolates were resistant to amoxicillin-clavulanic acid (n=11, 19.5%), ceftazidime (n=13, 22.4%), ofloxacin (n=16, 28.1%), and tobramycin (n=27, 48.4%). It was also found all K. pneumonia isolates were sensitive to polymyxin B (92.6%), imipenem (88.3%), meropenem (79.4%), and amikacin (60.5%). |
- Almalki MA, Varghese R. Prevalence of catheter associated biofilm producing bacteria and their antibiotic sensitivity pattern. J King Saud Univ Sci. 2020;32(2):1427-33.
- Kumar MS, Das AP. Molecular identification of multi drug resistant bacteria from urinary tract infected urine samples. Microb Pathog. 2016;98:37-44.
- Amrane S, Lagier J-C. Fecal microbiota transplantation for antibiotic resistant bacteria decolonization. Hum Microbiome J. 2020;16:100071.
- Effah CY, Sun T, Liu S, Wu Y. Klebsiella pneumoniae: an increasing threat to public health. Ann Clin Microbiol Antimicrob. 2020;19(1):1.
- Paczosa MK, Mecsas J. Klebsiella pneumoniae: Going on the Offense with a Strong Defense. Microbiol Mol Biol Rev. 2016;80(3):629-61.
- Ronald A. The etiology of urinary tract infection: traditional and emerging pathogens. Dis Mon. 2003;49(2):71-82.
- Singhai M, Malik A, Shahid M, Malik MA, Goyal R. A study on device-related infections with special reference to biofilm production and antibiotic resistance. J Glob Infect Dis. 2012;4(4):193-8.
- Shadkam S, Goli HR, Mirzaei B, Gholami M, Ahanjan M. Correlation between antimicrobial resistance and biofilm formation capability among Klebsiella pneumoniae strains isolated from hospitalized patients in Iran. Ann Clin Microbiol Antimicrob. 2021;20(1):13.
- Clegg S, Murphy CN. Epidemiology and Virulence of Klebsiella pneumoniae. Microbiol Spectr. 2016;4(1).
- Bandeira M, Carvalho PA, Duarte A, Jordao L. Exploring Dangerous Connections between Klebsiella pneumoniae Biofilms and Healthcare-Associated Infections. Pathogens. 2014;3(3):720-31.
- Balestrino D, Ghigo JM, Charbonnel N, Haagensen JA, Forestier C. The characterization of functions involved in the establishment and maturation of Klebsiella pneumoniae in vitro biofilm reveals dual roles for surface exopolysaccharides. Environ Microbiol. 2008;10(3):685-701.
- Alcantar-Curiel MD, Blackburn D, Saldana Z, Gayosso-Vazquez C, Iovine NM, De la Cruz MA, et al. Multi-functional analysis of Klebsiella pneumoniae fimbrial types in adherence and biofilm formation. Virulence. 2013;4(2):129-38.
- Boddicker JD, Anderson RA, Jagnow J, Clegg S. Signature-tagged mutagenesis of Klebsiella pneumoniae to identify genes that influence biofilm formation on extracellular matrix material. Infect Immun. 2006;74(8):4590-7.
- Balestrino D, Haagensen JA, Rich C, Forestier C. Characterization of type 2 quorum sensing in Klebsiella pneumoniae and relationship with biofilm formation. J Bacteriol. 2005;187(8):2870-80.
- Chen KM, Chiang MK, Wang M, Ho HC, Lu MC, Lai YC. The role of pgaC in Klebsiella pneumoniae virulence and biofilm formation. Microb Pathog. 2014;77:89-99.
- Coque TM, Baquero F, Canton R. Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe. Euro Surveill. 2008;13(47).
- Grundmann H, Livermore DM, Giske CG, Canton R, Rossolini GM, Campos J, et al. Carbapenem-non-susceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts. Euro Surveill. 2010;15(46).
- Rawat D, Nair D. Extended-spectrum beta-lactamases in Gram Negative Bacteria. J Glob Infect Dis. 2010;2(3):263-74.
- Nirwati H, Sinanjung K, Fahrunissa F, Wijaya F, Napitupulu S, Hati VP, et al. Biofilm formation and antibiotic resistance of Klebsiella pneumoniae isolated from clinical samples in a tertiary care hospital, Klaten, Indonesia. BMC Proc. 2019;13(Suppl 11):20.
- Khatoon Z, McTiernan CD, Suuronen EJ, Mah TF, Alarcon EI. Bacterial biofilm formation on implantable devices and approaches to its treatment and prevention. Heliyon. 2018;4(12):e01067.
- Stahlhut SG, Struve C, Krogfelt KA, Reisner A. Biofilm formation of Klebsiella pneumoniae on urethral catheters requires either type 1 or type 3 fimbriae. FEMS Immunol Med Microbiol. 2012;65(2):350-9.
- Chakraborty P, Bajeli S, Kaushal D, Radotra BD, Kumar A. Biofilm formation in the lung contributes to virulence and drug tolerance of Mycobacterium tuberculosis. Nat Commun. 2021;12(1):1606.
- Seifi K, Kazemian H, Heidari H, Rezagholizadeh F, Saee Y, Shirvani F, et al. Evaluation of Biofilm Formation Among Klebsiella pneumoniae Isolates and Molecular Characterization by ERIC-PCR. Jundishapur J Microbiol. 2016;9(1):e30682.
- Karimi K, Zarei O, Sedighi P, Taheri M, Doosti-Irani A, Shokoohizadeh L. Investigation of Antibiotic Resistance and Biofilm Formation in Clinical Isolates of Klebsiella pneumoniae. Int J Microbiol. 2021;2021:5573388.
- Wang G, Zhao G, Chao X, Xie L, Wang H. The Characteristic of Virulence, Biofilm and Antibiotic Resistance of Klebsiella pneumoniae. Int J Environ Res Public Health. 2020;17(17).
- Peterson E, Kaur P. Antibiotic Resistance Mechanisms in Bacteria: Relationships Between Resistance Determinants of Antibiotic Producers, Environmental Bacteria, and Clinical Pathogens. Front Microbiol. 2018;9:2928.
- Giacomini E, Perrone V, Alessandrini D, Paoli D, Nappi C, Degli Esposti L. Evidence of Antibiotic Resistance from Population-Based Studies: A Narrative Review. Infect Drug Resist. 2021;14:849-58.
|