Comparative study of microbiological characteristics and clinical outcomes in classical and hypervirulent Klebsiella Pneumoniae>/i> isolates | ||
| Microbes and Infectious Diseases | ||
| Articles in Press, Accepted Manuscript, Available Online from 18 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mid.2025.434029.3355 | ||
| Authors | ||
| Laila Tahir Mahmoud Sultan* 1; Raghda Ahmed Zaki Talaat1; Mona Osama Abu Ramadan1; Ragia Samir Sharshar2; Eman E. Hegazy1 | ||
| 1Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University, Egypt | ||
| 2Department of Chest Diseases , Faculty of Medicine, Tanta University, Egypt | ||
| Abstract | ||
| Background: Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging Intensive Care Unit (ICU) pathogen linked to severe infections and increased mortality. This study aimed to assess the prevalence of hvKp among hospital-acquired infections among ICU patients, investigates their antimicrobial resistance, and compare hvKp with classical K. pneumoniae (cKp) regarding resistance, virulence, and clinical outcomes. Methods: A cross-sectional study was conducted on 130 non-repetitive Klebsiella pneumoniae isolates from patients at Chest Diseases ICU, Tanta University Hospitals. K. pneumoniae isolates were assessed for antibiotic susceptibility, phenotypic hypervirulence detection using a string test, tellurite resistance, and serum resistance. Molecular detection of the virulence genes rmpA and iucA was performed via conventional Polymerase Chain Reaction. Clinical data, including comorbidities and outcomes (recovery, hospitalization, or death), were analyzed. Results: Among the 130 isolates investigated, 43 (33.1%) carried the iucA gene, and 107 (82.3%) carried rmpA, with co-existence of both genes in 35 (26.9%) isolates. The string test was positive in 40 (93%) of iucA positive strains. Significantly higher frequencies of tellurite and serum resistance were observed in hvKp compared to cKp. Both cKp and hvKp isolates exhibited comparable resistance profiles, with no statistically significant differences noted. Patients infected with hvKp had higher rates of complications and mortality. Notably, blood stream infections and resistance patterns were associated with the worst outcomes. Conclusions: Combining phenotypic and molecular markers enhances early detection of hvKp and may support prompt clinical interventions to reduce morbidity and mortality. | ||
| Keywords | ||
| hvKp; cKp; antimicrobial resistance; virulence genes | ||
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