AUTHOR=Saki Morteza , Amin Mansour , Savari Mohammad , Hashemzadeh Mohammad , Seyedian Seyed Saeid 

TITLE=Beta-lactamase determinants and molecular typing of carbapenem-resistant classic and hypervirulent Klebsiella pneumoniae clinical isolates from southwest of Iran

JOURNAL=Frontiers in Microbiology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2022.1029686

DOI=10.3389/fmicb.2022.1029686

ISSN=1664-302X

ABSTRACT=<p>This study investigated the molecular epidemiology of carbapenem-resistant classic <italic>Klebsiella pneumoniae</italic> (CR-cKp) and carbapenem-resistant hypervirulent <italic>Klebsiella pneumoniae</italic> (CR-hvKp) isolates in southwestern Iran. From 2019 to 2021, 136 (88.9%) cKp and 17 (11.1%) hvKp isolates were identified using biochemical tests and polymerase chain reaction (PCR). Antibiotic resistance, beta-lactamases, and clonal relatedness of carbapenem-resistant isolates were investigated using disk diffusion, PCR, and enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR), respectively. The different markers of hvKp isolates were as follows: string test (35.3%, <italic>n</italic> = 6/17), <italic>magA</italic> (11.8%, <italic>n</italic> = 2/17), <italic>rmpA</italic> (11.8%, <italic>n</italic> = 2/17), <italic>rmpA2</italic> (52.9%, <italic>n</italic> = 9/17), <italic>iucA</italic> (52.9%, <italic>n</italic> = 9/17), and <italic>peg344</italic> (35.3%, <italic>n</italic> = 6/17). Also, 55.1% (<italic>n</italic> = 75/136) of cKp and 47.1% (<italic>n</italic> = 8/17) of hvKp isolates were CR-cKp and CR-hvKp, respectively. All CR-hvKp (100.0%, <italic>n</italic> = 8) isolates were MDR. Colistin, tetracycline, and tigecycline were the most effective antibiotics. The occurrence of beta-lactamase genes in 75 CR-cKp and 8 CR-hvKp isolates was as follows: <italic>bla</italic><sub>NDM</sub> (41.3, 25.0%), <italic>bla</italic><sub>IMP</sub> (4.0, 0.0%), <italic>bla</italic><sub>VIM</sub> (8.0, 0.0%), <italic>bla</italic><sub>GES</sub> (14.7, 25.0%), <italic>bla</italic><sub>OXA–48–like</sub> (20.0, 0.0%), <italic>bla</italic><sub>CTX–M</sub> (26.7, 12.5%), <italic>bla</italic><sub>SHV</sub> (24.0, 12.5%), <italic>bla</italic><sub>TEM</sub> (10.7, 0.0%), <italic>bla</italic><sub>FOX</sub> (6.7, 0.0%), <italic>bla</italic><sub>DHA</sub> (6.7, 0.0%), <italic>bla</italic><sub>CMY</sub> (5.3, 0.0%), <italic>bla</italic><sub>LAT</sub> (12.0, 0.0%), and <italic>bla</italic><sub>ACT</sub> (8.0, 0.0%). ERIC-PCR showed a high diversity among isolates. In this study, the occurrence of MDR CR-hvKp isolates harboring <italic>bla</italic><sub>NDM</sub> and <italic>bla</italic><sub>GES</sub> was detected for the first time in southwestern Iran. To prevent the spread of CR-hvKp and reduce selection pressure, long-term surveillance and more effective treatment strategies should be implemented.</p>