Detection of rmpA and magA genes in Hypervirulent Klebsiella pneumoniae Isolates from Tertiary Care Hospitals

Abstract

Background: Hypervirulent Klebsiella pneumoniae (hvKp) cause multiple dangerous infections. HvKp can be distinguished from classical K. pneumoniae (cKp) by hyper-mucoviscosity. Presence of multiple genes contribute to hypervirulent phenotype of K. pneumoniae as mucoviscosity-associated gene A (magA) and regulator of mucoid phenotype A (rmpA). Objectives: to detect hvKp frequency among strains of k.pneumoniae by using string test phenotypically, to use multiplex polymerase chain reaction for rmpA and magA genes detection. Methodology: Fifty isolates of k.pneumoniae, were obtained from hospitalized patients in El-zohour Hospital. Conventional identification and susceptibility to antimicrobials were performed. Results: Most strains were isolated from samples of urine. Thirty strains out of fifty (60%) were hvKp by using string test. magA and rmpA were present in 14 isolates (28%) and 29 isolates (58.0%) respectively among k.pneumoniae isolates. Out of thirty hvKp strains, magA and rmpA genes were present in 14 stains (46.7%) and 25 strains (83.3%) respectively and 12 strains (40%) were coharboring both genes and were string test positive. Conclusions: high frequency of hvKp among clinical samples. Prompt detection of hvKp in different clinical settings is needed through establishing effective diagnostic tools. String test is a sensitive tool for rmpA gene detection. Establishment of both proper preventive measures and antimicrobial stewardship programs may be helpful to overcome spreading of multidrug resistant hvKp.