Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan
The emergence of hypervirulent and carbapenem-resistant hypermucoviscous <i>Klebsiella pneumoniae</i> strains presents a significant public health challenge due to their increased virulence and resistance to multiple antibiotics. This study evaluates the antibiotic susceptibility pattern...
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2025-01-01
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| author | Azra Taj Ali Khan Ihtisham Ul Haq Woranich Hinthong Susana Campino Aisha Gohar Noman Khan Muhammad Kashif Ihsan Ullah Taane G. Clark |
| author_facet | Azra Taj Ali Khan Ihtisham Ul Haq Woranich Hinthong Susana Campino Aisha Gohar Noman Khan Muhammad Kashif Ihsan Ullah Taane G. Clark |
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| description | The emergence of hypervirulent and carbapenem-resistant hypermucoviscous <i>Klebsiella pneumoniae</i> strains presents a significant public health challenge due to their increased virulence and resistance to multiple antibiotics. This study evaluates the antibiotic susceptibility patterns and virulence profiles of classical and hypervirulent <i>K. pneumoniae</i> strains isolated from various clinical samples. A total of 500 clinical samples were collected from patients at the Mardan Medical Complex and Ayub Medical Complex in KPK between July 2022 and June 2024. Among these, 64 <i>K. pneumoniae</i> strains were isolated and subsequently subjected to antimicrobial susceptibility testing (AST) and phenotypic virulence detection. Among the 64 isolates, 21 (32.8%) exhibited hypermucoviscosity, a characteristic associated with increased pathogenicity. Hemagglutination was observed in 35 (54.1%) of the isolates, indicating the presence of surface adhesins that facilitate bacterial adherence to host tissues. A high prevalence of biofilm formation was noted, with 54 (84%) isolates capable of forming biofilms, which are known to protect bacteria from antibiotics and the host immune response. Most isolates (59/64, 92.1%) were resistant against ampicillin, highlighting its limited efficacy against these strains. Conversely, the lowest resistance was observed for tigecycline, with only 15% (10/64) of the isolates showing resistance, indicating its potential utility as a treatment option. The study also found that 38 (59.3%) of the isolates were extended-spectrum beta-lactamase (ESBL) producers, 42 (65.6%) were multidrug-resistant (MDR), 32 (50%) were extensively drug-resistant (XDR), and 13 (20.3%) were resistant to carbapenems. The genetic study revealed biofilm producer and enhancer genes (<i>mrkD</i>, <i>pgaABCD</i>, <i>fimH</i>, <i>treC</i>, <i>wzc</i>, <i>pilQ</i>, and <i>luxS</i>) mainly in the hypervirulent strains. These hypervirulent strains also show a high number of resistance genes. The findings of this study underscore the critical need for the active surveillance of antimicrobial resistance and virulence determinants in <i>K. pneumoniae</i>. The coexistence of high levels of antibiotic resistance and virulence factors in these isolates poses a severe threat to public health, as it can lead to difficult-to-treat infections and increased morbidity and mortality. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-cbe9f2d4831c4b7fabd6462995da12782025-01-24T13:44:49ZengMDPI AGPathogens2076-08172025-01-011417910.3390/pathogens14010079Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, PakistanAzra0Taj Ali Khan1Ihtisham Ul Haq2Woranich Hinthong3Susana Campino4Aisha Gohar5Noman Khan6Muhammad Kashif7Ihsan Ullah8Taane G. Clark9Institute of Pathology and Diagnostic Medicines, IPDM, Khyber Medical University Peshawar, Peshawar 25000, PakistanInstitute of Pathology and Diagnostic Medicines, IPDM, Khyber Medical University Peshawar, Peshawar 25000, PakistanDepartment of Physical Chemistry and Technology of Polymers, Silesian University of Technology, 44-100 Gliwice, PolandFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UKFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UKMicrobiology Department, Bacha Khan Medical College Mardan, Mardan 23200, PakistanAl Rasheed Hospital & Kidney Center, Opposite Gilani Mart, Maneshra Road, Abbottabad 22020, PakistanPublic Health Reference Laboratory, Khyber Medical University Peshawar, Peshawar 25000, PakistanInstitute of Pathology and Diagnostic Medicines, IPDM, Khyber Medical University Peshawar, Peshawar 25000, PakistanFaculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UKThe emergence of hypervirulent and carbapenem-resistant hypermucoviscous <i>Klebsiella pneumoniae</i> strains presents a significant public health challenge due to their increased virulence and resistance to multiple antibiotics. This study evaluates the antibiotic susceptibility patterns and virulence profiles of classical and hypervirulent <i>K. pneumoniae</i> strains isolated from various clinical samples. A total of 500 clinical samples were collected from patients at the Mardan Medical Complex and Ayub Medical Complex in KPK between July 2022 and June 2024. Among these, 64 <i>K. pneumoniae</i> strains were isolated and subsequently subjected to antimicrobial susceptibility testing (AST) and phenotypic virulence detection. Among the 64 isolates, 21 (32.8%) exhibited hypermucoviscosity, a characteristic associated with increased pathogenicity. Hemagglutination was observed in 35 (54.1%) of the isolates, indicating the presence of surface adhesins that facilitate bacterial adherence to host tissues. A high prevalence of biofilm formation was noted, with 54 (84%) isolates capable of forming biofilms, which are known to protect bacteria from antibiotics and the host immune response. Most isolates (59/64, 92.1%) were resistant against ampicillin, highlighting its limited efficacy against these strains. Conversely, the lowest resistance was observed for tigecycline, with only 15% (10/64) of the isolates showing resistance, indicating its potential utility as a treatment option. The study also found that 38 (59.3%) of the isolates were extended-spectrum beta-lactamase (ESBL) producers, 42 (65.6%) were multidrug-resistant (MDR), 32 (50%) were extensively drug-resistant (XDR), and 13 (20.3%) were resistant to carbapenems. The genetic study revealed biofilm producer and enhancer genes (<i>mrkD</i>, <i>pgaABCD</i>, <i>fimH</i>, <i>treC</i>, <i>wzc</i>, <i>pilQ</i>, and <i>luxS</i>) mainly in the hypervirulent strains. These hypervirulent strains also show a high number of resistance genes. The findings of this study underscore the critical need for the active surveillance of antimicrobial resistance and virulence determinants in <i>K. pneumoniae</i>. The coexistence of high levels of antibiotic resistance and virulence factors in these isolates poses a severe threat to public health, as it can lead to difficult-to-treat infections and increased morbidity and mortality.https://www.mdpi.com/2076-0817/14/1/79antibiotic resistancevirulencebiofilm<i>K. pneumoniae</i>hypervirulentmultidrug resistant |
| spellingShingle | Azra Taj Ali Khan Ihtisham Ul Haq Woranich Hinthong Susana Campino Aisha Gohar Noman Khan Muhammad Kashif Ihsan Ullah Taane G. Clark Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan Pathogens antibiotic resistance virulence biofilm <i>K. pneumoniae</i> hypervirulent multidrug resistant |
| title | Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan |
| title_full | Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan |
| title_fullStr | Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan |
| title_full_unstemmed | Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan |
| title_short | Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent <i>Klebsiella pneumoniae</i> Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan |
| title_sort | antibiotic susceptibility patterns and virulence profiles of classical and hypervirulent i klebsiella pneumoniae i strains isolated from clinical samples in khyber pakhtunkhwa pakistan |
| topic | antibiotic resistance virulence biofilm <i>K. pneumoniae</i> hypervirulent multidrug resistant |
| url | https://www.mdpi.com/2076-0817/14/1/79 |
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