Biological Properties and Antibiotic Resistance of <i>Klebsiella pneumoniae</i> and Its Role in the Etiological Structure of Community-Acquired Pneumonia Pathogens

Abstract

Background . In a novel coronavirus pandemic, the most common complications of viral pneumonia are secondary infections of bacterial and fungal etiology. At the same time, the spread of multidrug-resistant bacteria remains a global threat to public health. One of such microorganisms of the Enterobacteriaceae family is Klebsiella pneumoniae, which belongs to dangerous resistant pathogens of the ESKAPE group. The aim of the study was the comparative analysis of the biological properties of classical and hypermucoid strains of K.pneumoniae isolated from patients with community-acquired pneumonia (CAP): characterization of their sensitivity to antibacterial drugs, Klebsiella bacteriophage, and a disinfectant (polyhexamethylene guanidine hydrochloride), as well as assessment of the strains’ virulence in the model of experimental infection in white mice. Material and methods. 56 strains of Klebsiella isolated in diagnostic quantities from patients’ sputum samples were studied. Species identification of cultures was carried out using bacteriological and mass spectrometric methods. The sensitivity of bacteria to antibiotics, bacteriophage, and the disinfectant was determined in accordance with regulatory documents. Results. In the course of the study, 243 gram-negative cultures were isolated, of which 30% were bacteria of the genus Klebsiella spp. An analysis of their species composition showed that K.pneumoniae occupied a dominant place in the structure. Based on colony morphology, Burri-Gins smear staining, and a positive string test, 14 strains with a hypermucoid phenotype were identified. These strains differed from the classic K.pneumoniae strain by the presence of a thicker capsule in smears, virulence in white mice (DCL≤103 mc), and increased resistance to commercial Klebsiella bacteriophage. At the same time, they were characterized by a wider spectrum of sensitivity to antibiotics. There were no significant differences in sensitivity to the disinfectant in strains of both morphotypes. Conclusion . The results obtained demonstrated the important role of K.pneumoniae in the etiological structure of CAP pathogens.