January 1, 2025Open Access

Identification of Antimicrobial Resistance Patterns, Type VI Secretion System, and Virulence Factors in Clinical Isolates of Klebsiella pneumoniae: A Cross‐Sectional Study

Key Points

Eighty-three klebsiella pneumoniae isolates were assessed, revealing that 83.13% were classic and 16.87% hypervirulent strains, highlighting a significant prevalence of cKp.
All isolates exhibited multidrug resistance, with 18.07% showing resistance to carbapenems, underscoring therapy challenges in clinical settings.
PCR was used to identify virulence and antimicrobial resistance genes, while seeking correlations with the presence of type VI secretion system genes.
Findings emphasize the importance of ongoing surveillance and targeted treatments to manage hypervirulent and resistant klebsiella pneumoniae effectively.

Abstract

Background: Klebsiella pneumoniae is an opportunistic pathogen linked to a range of severe infections. It is classified into classic K. pneumoniae (cKp) and hypervirulent K. pneumoniae (hvKp) forms, with hvKp showing enhanced virulence. This study examines Type VI secretion system (T6SS) presence and virulence factors in cKp and hvKp strains while assessing antimicrobial resistance. Methods: Eighty‐three K. pneumoniae isolates were collected from hospitalized patients in Ilam, Iran, between June and December 2023. Antimicrobial susceptibility testing was conducted using the disk diffusion method. Hypervirulent K. pneumoniae isolates were identified by string test, tellurite resistance, and presence of peg-344 , iucA , and iutA using polymerase chain reaction (PCR). Furthermore, PCR detected virulence, β ‐lactamases, and T6SS genes. Results: Of 83 isolates, 16.87% and 83.13% were hvKp and cKp, respectively. All isolates were multidrug‐resistant (MDR), with 18.07% exhibiting carbapenem resistance. The pattern of antibiotic resistance in hvKp and cKp is not significantly different, except for ciprofloxacin, tetracycline, and azithromycin. Also, there was no significant difference between T6SS‐positive and T6SS‐negative isolates except for ciprofloxacin. T6SS presence did not significantly correlate with virulence or resistance genes, except for ciprofloxacin resistance ( p = 0.0219). Conclusion: Surveillance, infection control, and targeted therapies are essential to combat hypervirulent and drug‐resistant K. pneumoniae .

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