Araştırma Makalesi

Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates

Cilt: 50 Sayı: 4 22 Aralık 2025
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Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates

Öz

Purpose: This study aimed to (i) determine the prevalence of capsule serotypes and virulence genes in Klebsiella pneumoniae clinical isolates obtained from the Çukurova region of Turkey, and (ii) assess their relationship with carbapenemase and extended-spectrum β-lactamase (ESBL) production. Materials and Methods: A total of 353 K. pneumoniae isolates were recovered from various clinical specimens of both inpatients and outpatients. Carbapenem susceptibility and ESBL production were initially evaluated using an automated antimicrobial susceptibility testing system and subsequently confirmed by the Kirby–Bauer disc diffusion assay and the combined disc method, following EUCAST 2025 guidelines. Genomic DNA was extracted from overnight cultures, and species identification was verified using PCR targeting the 16S–23S ITS region. Capsule serotypes and virulence-associated genes were detected through specific PCR-based assays. Results: Carbapenemase and ESBL production were identified in 26.1% (n = 92) and 23.2% (n = 82) of isolates, respectively, with 17.3% (n = 61) co-producing both enzymes. Capsule serotypes were detected in 11.6% of isolates, predominantly K2 (5.1%, n = 18) and K5 (6.5%, n = 23), whereas K1 was not found. The frequencies of virulence genes were as follows: mrkD (90%), fimH-1 (80%), ybtS (92%), iutA (78%), rmpA (10%), and iroN (2%). A statistically significant association was observed between antimicrobial resistance phenotypes and selected virulence genes, including mrkD, ybtS, and iutA. Conclusion: The findings reveal the distribution of capsule serotypes and virulence determinants among K. pneumoniae isolates circulating in the Çukurova region. These results highlight the importance of sustained molecular surveillance to inform infection control strategies and optimize antimicrobial stewardship.

Anahtar Kelimeler

Carbapenemase, Capsule Serotype, ESBL, Hospital-Acquired Infections, Klebsiella pneumoniae, Virulence Genes.

Destekleyen Kurum

none

Proje Numarası

none

Etik Beyan

Karar 09-Hatay Mustafa Kemal Üniversitesi Deneysel Araştırmalar Uygulama ve Araştırma Merkezi Dr. Öğr. Üyesi H. Suphi Bayraktar' ın 'Klebsiella pneumoniae izolatlarında karbapenemaz ve ESBL durumu ile kapsül serotipleri ve virulans genlerinin klinik dağılımının incelenmesi' başlıklı çalışması, gerekçesi, amacı, yöntemi ve yaklaşımı dikkate alınarak incelenmiş ve etik kurallara uygun bulunmuştur. Çalışmanın başvuru dosyasında belirtilen merkezlerde gerçekleştirilmesinde etik ve bilimsel açıdan herhangi bir sakınca bulunmadığına, Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu' nun 27/08/2025 tarihinde yapılan toplantısına katılan üyelerin oy birliğiyle karar verilmiştir.

Teşekkür

Bu çalışmanın yürütülmesinde gerekli izinleri ve desteklerinden ötürü Hatay Eğitim ve Araştırma Hastanesi Başhekimliği ve Hatay Mustafa Kemal Üniversitesi Deneysel Araştırmalar Uygulama ve Araştırma Merkezi Müdürlüğü' ne teşekkürlerimizi sunarız.

Kaynakça

  1. Asokan S, Jacob T, Jacob J, AlSosowa AA, Cherian T, Peijnenburg WJGM et al. Klebsiella pneumoniae: A growing threat in the era of antimicrobial resistance. Microbe. 2025;7:100333.
  2. Du C, Zhang H, Zhang Y, Zhang H, Zheng J, Liu C et al. Prognostic factors and nomogram for Klebsiella pneumoniae infections in intensive care unit. Infect Drug Resist. 2025;18:1237–51.
  3. Itani R, Khojah HMJ, Kibrit R, Raychouni H, Shuhaiber P, Dib C et al. Risk factors associated with multidrug-resistant Klebsiella pneumoniae infections: A multicenter observational study in Lebanese hospitals. BMC Public Health. 2024;24:2958.
  4. Moradi F, Akbari M, Vakili-Ghartavold R, Ostovari M, Hadi N. Molecular characterization of superbugs Klebsiella pneumoniae harboring extended-spectrum β-lactamase and carbapenemase resistance genes among hospitalized patients in southwestern Iran, Western Asia. Heliyon. 2024;10:e36858.
  5. Ilyas R, Asghar S, Zehra M, Usmani Y, Khan RMA, Mirani ZA et al. Molecular assessment of carbapenem-resistant and ESBL Klebsiella pneumoniae clinical isolates to decipher the correlation of antimicrobial resistance with virulence traits. Infect Genet Evol. 2025;133:105785.
  6. Soltani E, Hasani A, Ahangarzadeh Rezaee M, Zaare Nahandi M, Hasani A, Gholizadeh P. An alliance of carbapenem-resistant Klebsiella pneumoniae with precise capsular serotypes and clinical determinants: A disquietude in hospital setting. Can J Infect Dis Med Microbiol. 2022;2022:6086979.
  7. Wang X, Wang J, Jiang X, Huang Z, Huang L, Wei Q et al. Molecular epidemiological analysis and research on resistance and virulence of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital from 2016 to 2023. BMC Microbiol. 2025;25:217.
  8. Fang CT, Chuang YP, Shun CT, Chang SC, Wang JT. A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med. 2004;199:697–705.
  9. Singh RP, Kapoor A, Sinha A, Ma Y, Shankar M. Virulence factors of Klebsiella pneumoniae: Insights into canonical and emerging mechanisms driving pathogenicity and drug resistance. Microbe. 2025;7:100289.
  10. Zierke L, Mourad R, Kohler TP, Müsken M, Hammerschmidt S. Influence of the polysaccharide capsule on virulence and fitness of Klebsiella pneumoniae. Front Microbiol. 2025;16:1450984.

Kaynak Göster

APA
Baykara, B., Bayraktar, H. S., & Selimli, F. (2025). Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates. Cukurova Medical Journal, 50(4), 1153-1162. https://doi.org/10.17826/cumj.1781009
AMA
1.Baykara B, Bayraktar HS, Selimli F. Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates. Cukurova Med J. 2025;50(4):1153-1162. doi:10.17826/cumj.1781009
Chicago
Baykara, Başak, Hamdullah Suphi Bayraktar, ve Fariz Selimli. 2025. “Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates”. Cukurova Medical Journal 50 (4): 1153-62. https://doi.org/10.17826/cumj.1781009.
EndNote
Baykara B, Bayraktar HS, Selimli F (01 Aralık 2025) Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates. Cukurova Medical Journal 50 4 1153–1162.
IEEE
[1]B. Baykara, H. S. Bayraktar, ve F. Selimli, “Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates”, Cukurova Med J, c. 50, sy 4, ss. 1153–1162, Ara. 2025, doi: 10.17826/cumj.1781009.
ISNAD
Baykara, Başak - Bayraktar, Hamdullah Suphi - Selimli, Fariz. “Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates”. Cukurova Medical Journal 50/4 (01 Aralık 2025): 1153-1162. https://doi.org/10.17826/cumj.1781009.
JAMA
1.Baykara B, Bayraktar HS, Selimli F. Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates. Cukurova Med J. 2025;50:1153–1162.
MLA
Baykara, Başak, vd. “Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates”. Cukurova Medical Journal, c. 50, sy 4, Aralık 2025, ss. 1153-62, doi:10.17826/cumj.1781009.
Vancouver
1.Başak Baykara, Hamdullah Suphi Bayraktar, Fariz Selimli. Investigation of carbapenemase and ESBL status, capsule serotypes, and clinical distribution of virulence genes in Klebsiella pneumoniae isolates. Cukurova Med J. 01 Aralık 2025;50(4):1153-62. doi:10.17826/cumj.1781009