Detection of virulence factors and antimicrobial susceptibility pattern of clinically significant Klebsiella pneumoniae isolates in a tertiary care hospital

Abstract

Introduction: Klebsiella pneumoniae is associated with a variety of infections across all age groups, both in community and hospital settings. Many strains of K. pneumoniae produce virulence factors such as a capsule, siderophores, biofilm, and hypermucoviscosity, which facilitate adhesion, invasion, and colonization. Additionally, the rising antibiotic resistance in K. pneumoniae strains poses a significant challenge, limiting treatment options. This study aims to identify the virulence factors and assess the antimicrobial susceptibility of clinically significant K. pneumoniae isolates. Materials and Methods: K. pneumoniae isolates were obtained from urine, sputum, blood, cerebrospinal fluid, pus swabs/aspirates, and tissue samples. Standard biochemical tests were performed for identification. Capsule formation, hypermucoviscosity, siderophore production, and biofilm formation were detected phenotypically. Antibiotic susceptibility testing was carried out using the disk diffusion method, and primary and confirmatory tests were conducted for extended-spectrum beta-lactamases (ESBL) and carbapenemase production. Results: Capsule formation, hypermucoviscosity, siderophore production, and biofilm formation were detected in 100%, 15%, 40%, and 15% of the isolates, respectively. Of the isolates, 40% were multidrug-resistant, 55% produced ESBL, 8% expressed AmpC beta-lactamase, and 10% produced carbapenemase. Conclusion: Capsule formation was the most prevalent virulence factor, followed by siderophore production. The majority of K. pneumoniae isolates demonstrated susceptibility to amikacin, piperacillin-tazobactam, and carbapenems. However, 40% of the isolates were multidrug-resistant, with ESBL production being the most common resistance mechanism.

Keywords

• Biofilms
• ESBL
• K..pneumoniae
• virulence factors