الفهرس 
Title : Molecular characterization of Capsular Polysaccharide Genes and their role in Virulence of Klebsiella pneumoniae Isolates in hospitalized patients in Egyp
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Abstract
In recent years, hypervirulent Klebsiella pneumoniae (hvKp) has emerged as an
extremely problematic pathogen. The virulence factors armed with multidrugresistant
determinants in hvKp are greatly worrisome. This study aimed to examine
antibiotic resistance genes, representative virulence determinants among 100 K.
pneumoniae isolates with an emphasis on capsular types of the isolates in attempt
to detect any correlation between the antibiotic profiles and the representative
virulence factors. Hypermucoviscosity was detected by performing String test. The
antimicrobial profiles were screened by disc diffusion method for the respective
antibiotics. MIC was used to test colistin susceptibility. Phenotypic ESBL
production was tested by double-disk synergy test. Finally, PCR amplification of
(wzy_K1, wzy_K2, wzy_K5, rmpA, rmpA2, iutA, iroN and IncHI1B plasmid) and
(NDM, OXA-48, KPC, CTX-M-15, VIM, IMP, SPM) was performed. All the
recovered isolates were multidrug resistant (100%), but all of them were also
susceptible to tigecycline and colistin, with 83% of them resistant to meropenem.
Isolate K2 was the only detected capsular type in our collection. rmpA2 was the
most common hypervirulence gene detected (64%), followed by IncHI1B plasmid
(39%) and iutA (32%); and iroN were also identified. All the studied isolates
harbored OXA-48-like (100%) followed by NDM (43%). Forty three isolates were
ESBL producers; 18 of them harbored CTX-M-15. All the isolates with K2 capsular
type harbored OXA-48-like gene. Our results demonstrated the significant
association between K2 capsular type and all the virulent determinants and NDM
and CTX-M-15 genes; as well as the coexistence of more than virulence gene
together with antibiotic resistant determinant in the same isolate; providing an
insight into evolution of virulence genes and resistance coexistence in a tertiary
healthcare setting in Cairo, Egypt.