Clinical and Molecular Characterisation of Multi Drug Resistant Hypervirulent Klebsiella pneumoniae (MDR-HvKp) Isolated from Patient Attending ATBU Teaching Hospital Bauchi

Nazeef Idris Usman; Ahmed Faruk Umar; Mahmud Yerima Iliyasu

doi:10.5455/EJMID.20240613123830

Abstract
Background and Aim: K. pneumoniae exhibits increasing multidrug resistance and a global rise in hypervirulent strains, particularly prevalent in various African countries, posing significant challenges in managing infections ranging from pneumonia to neonatal septicemia and urinary tract infections. The study aimed to identify and detect virulence characteristics of MDR-HvKp from clinical samples.
Method: Two hundred and fourteen (214) clinical samples were identified and drug resistance was measured using the Vitek 2 system, the isolates were phenotypically characterized for mucoviscosity and hypermucoviscosity using a string test and mucoid sedimentation test. The isolated K. pneumoniae were further assessed for the presence of rmpA, magA, BlaCTX-M, and BlaKPC-2 genes using PCR, Gel electrophoresis, and Sequencing, the rmpA gene sequence peculiar to K. pneumoniae was used for phylogenetic analysis using NCBI BLAST for nucleotide suite.
Result: Twenty-four (24) K. pneumoniae were identified, phenotypically and molecularly characterized for drug resistance and virulence genes. The prevalence of K. pneumoniae was recorded at 24(17.3%), with higher rates observed among females 15(10.79%) compared to male patients with 9(6.47%), while the difference in prevalence between genders was not statistically significant, p = 0.06 (χ2 = 2.59), this is also similar to marital status with p = 0.025 (χ2 = 5.37). A total of 11(45.83%) K. pneumoniae were isolated from urine 59(42.45%), which is the highest followed by sputum 29(20.86%), blood 26(18.70%), and swab 25(17.99%); HvKp strain Kp128 demonstrated mucoviscosity and carried genes associated with mucoid phenotype and resistance, Antibiotic susceptibility testing revealed resistance to several antibiotics, particularly beta-lactams and carbapenems.
Conclusion: The study reveals a rising prevalence of MDR-HvKp strains in Nigerian and Bauchi state in particular, emphasizing the critical need for effective management strategies against infections across diverse clinical settings.

Key words: ATBU, Bauchi, Multidrug Resistant, Hypervirulent Klebsiella pneumoniae,