Low incidence of hypervirulent clinical klebsiella pneumoniae producing carbapenemases among Jordanian hospitalized patients

Abstract

Background:  Klebsiella species are widely present in the environment and colonize mucosal surfaces of humans. The organism is responsible for various community and hospital-acquired infections. Increased incidence of isolates producing K .pneumoniae carbapenemases (KPCs)  in infected patients has become a significant problem in many countries, especially those new hypervirulent clinical variant (hvKP).  This prospective study was intended to detect the incidence, virulence factors and carbapenems resistant gene (blakpc2) in K. pneumoniae isolates among Jordanian patients.Methods:  A total of 104 klebsiella species isolates were collected randomly from three major hospitals in Amman, Jordan, over the period from September 2012 to October 2013. These isolates were investigated for incidence of  K.pneumoniae , antimicrobial susceptibility and detection of virulence factors and kpc gene using PCR .Results: A total of 75 (72%) of the collected isolates were confirmed as K. pneumoniae using PCR, and 74% of these were MDR to at least 3 antibiotic classes. The percentage of the virulence factors K1, K2, K5, rmpA and aerobactin were 0%, 4%, 0%, 5.3% and 10.7%, respectively. Resistant to cabapenems was detected in 18/75 (24% ) of K . pneumoniae isolates, and 10 (13.3%) of these have the kpc genes .Conclusion: This study confirms the high incidence rate of MDR K. pneumoniae and low incidence of (KPCs) isolates in Jordanian patients.  There were few isolates associated with virulence factor genes causing hvKP, and no significant correlation demonstrated between the presence of virulence factors and kpc gene in these isolates.