Hypervirulent and the Multi-Drug Resistant Klebsiella oxytoca: A New Emerging Pathogen in Baghdad Hospitals, Iraq

Abstract

Background: The human microbiota, K.oxytoca , is resistant to multiple drugs, endangering the lives of patients. Hypervirulent strains evolved into multidrug-resistant strains due to the acquisition of mobile genetic elements. Objectives: To detect the antibiotic-resistant profile and the related virulence genes in the hypervirulent and non-hypervirulent strains isolated from clinical specimens. Materials and methods: A total of 136 clinical samples were collected from patients at Baghdad City Hospitals, Iraq. The isolates were identified, and an antibiotics sensitivity test was carried out. The polymerase chain reaction typing method was used to detect the virulence genes. Results: The most frequent source of K. oxytoca was urine samples (36.03%), then blood samples (15.44%), particularly inpatient samples. About 12.5% of isolates were positive for the hypervirulent test (the string test). Isolates showed variable levels of resistance towards antibiotic groups. The bla CTX-M and aac(6’)-Ib-cr genes were revealed in 88% of isolates, and the bla OXA-48 gene was in 44%. All the tested isolates were negative for the rmpA gene. Conclusion: K. oxytoca is recognized as one of the leading causes of hospital-acquired infections. The rapid identification of antibiotics-resistant, hypervirulent isolates that present a considerable threat to human health is highly recommended in the local hospitals.