The Increased Prevalence of rmpA Gene in Klebsiella pneumoniae Isolates Coharboring bla NDM and bla OXA-48-like Genes.

The emergence of carbapenemase-producing Klebsiella pneumoniae poses a substantial risk to public health. It is essential to comprehend the influence of carbapenemase on the virulence characteristics of K. pneumoniae in order to devise successful strategies for combating these infections. In this study, we explored the distribution disparity of virulence determinants between carbapenemase-producing (CP-Kp, n = 52) and carbapenemase-nonproducing (CN-Kp, n = 43) isolates. The presence of carbapenemases was detected via the modified carbapenem inactivation method and confirmed by PCR. The New Delhi metallo-β-lactamase ( bla _NDM ) and Oxacillinase-48-like ( bla _OXA-48-like ) genes were the most prevalent (94.23% and 76.92%, respectively) in CP-Kp isolates. Coexistence of bla _NDM and bla _OXA-48-like was observed in 71.15% of isolates, whereas 5.77% coharbored bla _NDM and bla _KPC . PCR analysis revealed the presence of several virulence genes, including adhesins ( fimH , 92.63%, mrkD , 97.89%), capsule-associated virulence ( uge , 90.53%), the K2 capsule serotype ( k2 , 6.32%), the iron acquisition system ( kfu , 23.16%), and the regulator of mucoid phenotype ( rmpA , 28.42%). A significantly higher prevalence of rmpA was detected in the CP-Kp compared with the CN-Kp (24/52 vs. 3/43, p < 0.0001), indicating a potential association between rmpA and carbapenemase acquisition. In addition, the majority of rmpA (22/24) positive isolates in the CP-Kp isolates coharbored bla _NDM and either bla _OXA-48-like or bla _KPC .