Infection and Drug Resistance (Feb 2023)
Study on Virulence Genes, Drug Resistance and Molecular Epidemiology of Klebsiella pneumoniae with High Virulence in Inner Mongolia, China
Abstract
Hong-Fu Li,1,2,* Li-Xia Zhang,2,* Wen-Lan Zhang,2,* Jing Li,2,* Ya-Qian Li,2,* Tong-Ping Hu2 1Department of Clinical Laboratory, Zhuhai Third People’s Hospital, Zhuhai, People’s Republic of China; 2Department of Clinical laboratory, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Inner Mongolia, People’s Republic of China*These authors contributed equally to this workCorrespondence: Tong-Ping Hu, Department of Clinical laboratory, the First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, No. 41, of Linyin Road, Kundulun District, Baotou City, Baotou, 014000, People’s Republic of China, Tel +86 13296922365, Email [email protected]: The purpose of this study was to analyse the clinical, microbiological and molecular epidemiological characteristics of patients with pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae (KPN) in Inner Mongolia, China.Methods: The KPN isolates from 78 KPN-PLA cases admitted to a tertiary teaching hospital in Baotou, Inner Mongolia, from 2016 to 2019 were studied systematically and described comprehensively. The virulence factors, drug resistance and sequence types of KPN in different samples were identified by a wire-drawing test, polymerase chain reaction, a drug susceptibility test and multi-site sequence typing.Results: There were more male than female KPN-PLA patients (P< 0.05). The mortality rate was 2.5%, and KPN-PLA was significantly associated with diabetes mellitus (P< 0.05). Most of the KPN isolates in the puncture fluid of patients with KPN-PLA were hypervirulent KPN (HvKP). The positive rate of the KPN-PLA specimens was higher than that of the blood and urine specimens. The KPN isolates of the urine specimens had higher drug resistance than the other two (P< 0.05). The hypermucoviscous KPN, aerobic actin (aero) (+), K1 and K2 serotypes accounted for 80.8%, 89.7%, 56.4% and 26.9%, respectively. In addition to ironB (3.8%), the detection rates of virulence factors rmpA, irp2, entB, iucD, aero, wcaG, iutA, kfu, ybtA, iron, fimH and mrkD were higher (69.2%– 100.0%). The positive rate of KPN isolates of the KPN-PLA puncture fluid was higher than that of the blood and urine samples (P< 0.05). In addition, ST23 was found to be the dominant ST (32.1%) of KPN-PLA in the Baotou region.Conclusion: In the KPN-PLA specimens, the KPN isolates were more virulent than those in the blood and urine specimens, and a carbapenem-resistant HvKP strain emerged. This research will help improve the understanding of HvKP and provide useful suggestions for KPN-PLA treatments.Keywords: Klebsiella pneumoniae, virulence factor, capsular serotype, bacterial drug resistance, multilocus sequence typing
