Genotypic identification of hypervirulent Klebsiella pneumoniae in Anbar, Iraq.

Aims: The aim of this study was to identify hypervirulent clinical Klebsiella pneumoniae isolates from Anbar (Iraq) and differentiate them from classical isolates using molecular markers and capsule serotyping. Methodology and results: Between June and December 2022, we gathered a total of 100 K. pneumoniae isolates from patients with hospital-acquired infections in four prominent hospitals located in Anbar province. We performed the identification of all isolates using biochemical tests and the VITEK2 compact system. Hypervirulent genes were detected using PCR and multiplex PCR. Five virulent genes, namely, iucA, iroB, rmpA, rmpA2 and peg344, were considered in the study. Each isolate was serotyped using six capsular serotypes, K1, K2, K5, K20, K54 and K57. Three genes, iucA, iroB and rmpA were detected by PCR. The most prevalent gene identified was iucA (23%). Serotyping results identified four capsular types among the 100 isolates, with K2 (71.2%) being the most predominant type. Of the 100 isolates, 18 (18%) K. pneumonia isolates were identified as hypervirulent. According to the presence of the virulent genes, four virulent types (VP) were determined, namely, VP1, VP2, VP3 and VP4, with VP3 being the most common among the four types. Conclusion, significance and impact of study: Eighteen hypervirulent K. pneumoniae strains were identified using molecular markers. The results indicate that hypervirulent K. pneumoniae infections are emerging in Anbar province and need active monitoring to minimize spreading through the region. [ABSTRACT FROM AUTHOR]