Distribution, characterization and antibiotic resistance of hypervirulent Klebsiella pneumoniae (hvKp) strains versus classical strains (CKp) causing healthcare associated infections in Sohag University Hospitals.

Background: Klebsiella pneumoniae has two different pathotypes: hypervirulent Klebsiella pneumoniae (hvkp) and classical Klebsiella pneumoniae (ckp), hvkp is more potent than ckp causing vast types of severe disseminated infections. This cross sectional study done to detect frequency of hvkp versus ckp, their antibiotic resistance and risk factors associated with their infections. Methods: Samples were collected from admitted patients cultured on MacConkey agar, pink colonies were confirmed to be Klebsiella pneumonia and sensitivity were done by Vitek 2. String test was done for hypermucoviscosity and PCR to detect virulence genes. Results: 100 samples were collected from 2020 to 2023, 64 of them revealed hvkp which were isolated from old age with mean± SD of 62.7±20.5, most of isolates were from ICU from pneumonia patients. There was a significant difference in ceftriaxone, cefoxitin, gentamycin and tobramycin resistance between hvkp, ckp with p value 0.03, 0.04 ,0.01 and 0.02 respectively, 24% of hvkp strains were ESBL producers. Fourteen (14%) were pandrug resistant, 14(14%) were extremely drug resistant and 36(36%) were multidrug resistant. iucA was the most frequent virulence gene 62% followed by fimH (42%). Diabetes mellitus, hypertension and cardiovascular disease were the most significant risk factors associated with hvkp infection. Conclusion: hvkp is a serious pathogen that utilizes a battery of virulence factors for survival and pathogenesis, also has an ability to acquire drug resistance through transfer of genetic material, so we have to shed light on new strategies to improve diagnosis, treatment and prevention of hvkp causing infections. [ABSTRACT FROM AUTHOR]