The Determination and Correlation of Various Virulence Genes, ESBL, Serum Bactericidal Effect and Biofilm Formation of Clinical Isolated Classical Klebsiella pneumoniae and Hypervirulent Klebsiella pneumoniae from Respiratory Tract Infected Patients

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Abstract
Klebsiella pneumoniae strains that are commonly recognized by clinicians and microbiologists are termed as classical K. pneumoniae (c KP ). A strain with capsule-associated mucopolysaccharide web is known as hypervirulent K. pneumoniae (hv KP ) as it enhances the serum resistant and biofilm production. Aim is to determine and correlate various virulence genes, ESBL, serum bactericidal effect and biofilm formation of clinical isolated c KP and hv KP from respiratory tract infected patients. A total of 96 K. pneumoniae strains were isolated from sputum of respiratory tract infected patients. The isolates were performed string test, AST, ESBL virulence gene, serum bactericidal and biofilm assays. Out of 96 isolates, 39 isolates (40.6%) were identified with hypervirulent phenotypes. The number of c KP exhibiting resistance to the tested antimicrobials and ESBLs were significantly higher than that of the hv KP strains. The virulence genes of K. pneumoniae such as K1, K2, rmp A, uge , kfu and aerobactin were strongly associated with hv KP than c KP . However, no significant difference was found in FIM-1 and MrKD3 genes. ESBL producing c KP and hv KP were significantly associated with strong biofilm formation (both P < 0.05) and highly associated with bactericidal effect of serum (both P < 0.05) than c KP strains. However, neither biofilm formation nor bactericidal effect of serum was found with significant difference in between ESBL producing c KP and ESBL producing hv KP strains (both P > 0.05). Although the hv KP possess more virulence gene, but they didn’t show any significant difference between biofilm formation and bactericidal effect of serum compared with ESBL producing c KP strains.

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