Table 1.
Genetic and Phenotypic Traits of MDR Klebsiella pneumoniae Isolates
| Total n=200 (%) | MDR n=125 (%) | Non-MDR n=75 (%) | MDR ESBLs n=42 (%) | MDR CRKP n=72 (%) | MDR HMV n=30 (%) | ||||
|---|---|---|---|---|---|---|---|---|---|
| Specimen source | |||||||||
| Blood | 31 (16) | 21 (17) | 10 (13) | 9 (21) | 13 (18) | 3 (10) | |||
| Urine | 86 (43) | 47 (38) | 39 (52) | 15 (36) | 15 (21) | 18 (60) | |||
| Pus | 41 (21) | 28 (22) | 13 (17) | 8 (19) | 20 (28) | 5 (17) | |||
| Catheter tip | 9 (5) | 8 (6) | 1 (1) | 4 (10) | 5 (7) | 1 (3) | |||
| Body fluid | 16 (8) | 12 (10) | 4 (5) | 2 (5) | 10 (14) | 2 (7) | |||
| Bile | 2 (1) | 2 (2) | 0 (0) | 0 (0) | 2 (3) | 1 (3) | |||
| Nasal/Tracheal swab | 8 (4) | 6 (5) | 2 (3) | 3 (7) | 6 (8) | 0 (0) | |||
| Sputum | 5(3) | 0 (0) | 5 (7) | 0 (0) | 0 (0) | 0 (0) | |||
| Tissue | 2(1) | 1 (1) | 1 (1) | 1 (2) | 1 (1) | 0 (0) | |||
| Genetic determinants for: | |||||||||
| ESBLs | |||||||||
| *blaTEM | 60 (30) | 47 (38) | 13 (17) | 34 (81) | 23 (32) | 19 (63) | |||
| *blaSHV | 69 (35) | 49 (39) | 20 (27) | 32 (76) | 24 (33) | 24 (80) | |||
| *blaCTXM-14 | 30 (15) | 26 (21) | 4 (5) | 14 (33) | 12 (17) | 14 (47) | |||
| *blaCTXM-15 | 91 (46) | 67 (54) | 24 (32) | 36 (86) | 32 (44) | 29 (97) | |||
| *blaOXA | 39 (20) | 34 (27) | 5 (7) | 21 (50) | 15 (21) | 13 (43) | |||
| Carbapenemases | |||||||||
| blaNDM-1 | 78 (39) | 69 (55) | 9 (12) | 22 (52) | 52 (72) | 26 (87) | |||
| blaKPC | 9 (5) | 7 (6) | 2 (3) | 4 (10) | 7 (10) | 1(3) | |||
| blaOXA 48 type | 48(24) | 40 (32) | 8 (11) | 11 (26) | 30 (42) | 16 (53) | |||
| Colistin resistance | |||||||||
| mcr-1 | 24 (12) | 19 (15) | 5 (7) | 7 (17) | 11 (15) | 6 (20) | |||
| mcr-2 | 17 (9) | 13 (10) | 4 (5) | 4 (10) | 7 (10) | 5 (17) | |||
| Efflux pumps | |||||||||
| acrAB | 97 (49) | 62 (50) | 35 (47) | 25 (60) | 31 (43) | 20 (67) | |||
| tolC | 62 (31) | 48 (38) | 14 (19) | 20 (48) | 24 (33) | 13 (43) | |||
| Porins | |||||||||
| ompK35 | 111 (56) | 75 (60) | 36 (48) | 29 (69) | 44 (61) | 17 (57) | |||
| ompK36 | 110 (55) | 65 (52) | 45 (60) | 20 (48) | 35 (49) | 11 (37) | |||
| Virulence factors | |||||||||
| *rmpA | 21(11) | 16 (13) | 5 (7) | 6 (14) | 7 (10) | 16 (53) | |||
| iucA | 16 (8) | 13 (10) | 3 (4) | 7 (16) | 6 (8) | 7 (23) | |||
| Kfu | 6 (3) | 4 (3) | 2 (3) | 0 (0) | 1 (1) | 3 (10) | |||
| Bss | 31 (16) | 23 (18) | 8 (11) | 10 (24) | 10 (14) | 12 (40) | |||
| fimH | 38 (19) | 28 (22) | 10 (13) | 10 (24) | 20 (28) | 12 (40) | |||
| mrkD | 35 (18) | 21 (17) | 14 (19) | 8 (19) | 18 (25) | 9 (30) | |||
| ycfM | 43 (22) | 26 (21) | 17 (23) | 7 (17) | 14 (19) | 4 (13) | |||
| traT | 7 (4) | 5 (4) | 2 (3) | 1 (2) | 3 (4) | 1 (3) | |||
| Virulence phenotypes | |||||||||
| Capsule | 198 (99) | 123 (98) | 75 (100) | 42 (100) | 70 (97) | 30 (100) | |||
| Gelatinase | 24 (12) | 19 (15) | 5 (7) | 6 (14) | 7 (10) | 6 (20) | |||
| Blood hemolysis | 15 (8) | 10 (8) | 5 (7) | 2 (5) | 3 (4) | 3 (10) | |||
| Biofilm potential | 187(94) | 118 (94) | 69 (92) | 42 (100) | 68 (94) | 30 (100) | |||
| Haemagglutination | 200(100) | 125 (100) | 75 (100) | 42(100) | 72(100) | 30(100) | |||
| Hypermucoviscosity | 43 (22) | 30 (24) | 13 (17) | 12 (29) | 15 (21) | 30 (100) | |||
Notes: Numbers (and percentage with respect to value in the first row of the corresponding column) of MDR isolates displaying the corresponding phenotype or genetic locus are shown. All MDR strains are included in this category (including strains with ESBL, CRKP and HMV phenotypes). A significant p-value indicates strong association of a factor within the four population subgroups (MDR, MDR ESBLs, MDR CRKP and MDR HMV). The significant p-value of association calculated for ESBL factors (blaTEM, blaSHV, blaCTXM-14, blaCTXM-15) within the four population groups: MDR, MDR ESBLs, MDR CRKP and MDR HMV was found to be <0.00001*; for blaOXA the significant value was 0.003541*. 1Beta-lactamase genes (blaTEM, blaSHV, blaCTXM-14, blaCTXM-15, blaOXA); carbapenemase determinants: (blaNDM-1, blaKPC, blaOXA48-type); colistin resistance genes :(mcr-1, mcr-2); efflux pump genes: (acrAB, tolC) porin genes: (ompK35, ompK36) virulence determinants: (rmpA iucA, Kfu, Bss, fimH, mrkD ycfM, traT).
Abbreviations: MDR, multidrug-resistant; ESBL, extended spectrum beta-lactamase; CRKP, carbapenem resistant Klebsiella pneumoniae; HMV, Hypermucoviscous; MDR ESBLs, multidrug-resistant extended spectrum beta-lactamase; MDR CRKP, multidrug-mesistant carbapenem resistant Klebsiella pneumoniae; MDR HMV, multidrug-resistant hypermucoviscous.