Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 17:16:985-998.
doi: 10.2147/IDR.S396609. eCollection 2023.

Relationship Between Drug Resistance Characteristics and Biofilm Formation in Klebsiella Pneumoniae Strains

Binzhi Dan #  1 , Heping Dai #  1 , Dangui Zhou  1 , Hongfang Tong  1 , Mei Zhu  1
Affiliations

Relationship Between Drug Resistance Characteristics and Biofilm Formation in Klebsiella Pneumoniae Strains

Binzhi Dan et al. Infect Drug Resist. .

Abstract

Objective: To conduct epidemiological analysis of Klebsiella pneumoniae (K. pneumoniae) with hypervirulence, and to investigate its drug resistance phenotype, Extended-spectrum β-lactamase (ESBLs) gene, virulence factor, capsular serotype and biofilm formation, so as to provide theoretical basis for further understanding of the drug resistance mechanism of K. pneumoniae with hypervirulence.

Methods: K. Pneumoniae were isolated from clinical samples collected from inpatients. All strains were identified by VITEK2 Compact using fully automatic microbial analyzer, the minimal inhibitory concentration (MIC) of antibiotics was determined by microbroth dilution test. The double disk diffusion method was used to detect the production of ESBLs, modified carbapenem inactivation method (mCIM) was used to detect the production of carbapenemase, and hypermucoviscosity phenotype was detected by wire drawing test. PCR was used to detect ESBLs gene, virulence factor and capsular serotype. Crystal violet staining was used to detect the ability of biofilm formation.

Results: The ESBLs genes detected in this study included strains blaTEM 35 (36.5%), blaSHV 51 (53.1%), and blaCTX-M 49 (51.0%). Most strains carried multiple ESBLs genes, but not all of them produce ESBLs. K1 and K2 accounted for 14.6% and 11.5% respectively. Most (91.7%) strains carried the fimH gene, and the other virulence genes were ybtS (53.1%), entB (46.9%), rmpA (41.7%), aerobactin (32.3%), allS (15.6%), kfu (15.6%). Of all the Klebsiella pneumoniae strains, 33 (34.4%) exhibited ESBLs phenotype, 16 (16.7%) were carbapenemase-producing, and 20 (20.8%) with ESBLs phenotype tested were resistant to all four drugs. The correlation between ESBLs-producing strains and biofilm formation was significantly increased compared to strains without ESBLs phenotype (P=0.035).

Conclusion: Compared to hypervirulent Klebsiella pneumoniae (hvKP), classical Klebsiella pneumoniae (cKP) has a tendency to acquire antibiotic resistance. Our study showed that genes encoding rmpA, K1 or K2, and kfu were highly associated with hvKP.

Keywords: Klebsiella pneumoniae; antimicrobial resistance; epidemiology; hypermucoviscosity; virulence factors.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The value of biofilm formation of strains from different sources.
Figure 2
Figure 2
Agarose gel electrophoresis of ESBLs genes and virulence factors.
Figure 3
Figure 3
The results of double-disc synergy test (DDST) and modified carbapenem inactivation method (mCIM).
See this image and copyright information in PMC

References

    1. Issakhanian L, Behzadi P. Antimicrobial agents and urinary tract infections. Curr Pharm Des. 2019;25(12):1409–1423. doi:10.2174/1381612825999190619130216 - DOI - PubMed
    1. Sarshar M, Behzadi P, Ambrosi C, et al. FimH and anti-adhesive therapeutics: a disarming strategy against uropathogens. Antibiotics. 2020;9(7):58. doi:10.3390/antibiotics9070397 - DOI - PMC - PubMed
    1. Ahmadi Z, Noormohammadi Z, Ranjbar R, et al. Prevalence of Tetracycline Resistance Genes tet (A, B, C, 39) in Klebsiella pneumoniae Isolated from Tehran, Iran. Iranian J Med Microbiol. 2022;16(2):141–147. doi:10.30699/ijmm.16.2.141 - DOI
    1. Cusumano JA, Caffrey AR, Daffinee KE, et al. Weak biofilm formation among carbapenem-resistant Klebsiella pneumoniae. Diagn Microbiol Infect Dis. 2019;95(4):114877. doi:10.1016/j.diagmicrobio.2019.114877 - DOI - PubMed
    1. Khan F, Pham DTN, Oloketuyi SF, et al. Antibiotics Application Strategies to Control Biofilm Formation in Pathogenic Bacteria. Curr Pharm Biotechnol. 2020;21(4):270–286. doi:10.2174/1389201020666191112155905 - DOI - PubMed