Phenotypic and Genotypic Detection of Hypervirulent Klebsiella pneumoniae Isolated from Hospital-Acquired Infections

Hypervirulent <i>Klebsiella pneumoniae</i> is a highly pathogenic variant of <i>Klebsiella pneumonae</i>, which represents a global public health issue because it is very virulent and spreads easily. The objectives of this study were to assess the predominance of hvKp among health care-associated infections in intensive care units of Tanta University Hospital and to compare hvKp with classical <i>K. pneumoniae</i> (cKp) in terms of antibiotic resistance, virulence, and molecular features. The study included 300 patients suffering from HAIs from different ICUs of Tanta University Hospitals. <i>K. pneumoniae</i> isolates were identified and subjected to string testing and antibiotic susceptibility testing, and the tissue culture assay for biofilm formation and polymerase chain reaction (PCR) tests were performed for the identification of capsular genes (<i>K1</i>, <i>K2</i>, <i>K57</i>) and virulence genes (<i>rmpA</i>, <i>rmpA2</i>, <i>iuc A</i>). Fifty-seven <i>K. pneumonaie</i> isolates were isolated. A total of 21 (36.8%) of them were hvKp and 36 (63.15%) were cKp. Significantly higher antibiotic resistance was detected in the cKp group. There was a significant difference between biofilm formation between cKp and hvKp isolates (<i>p</i> < 0.004*). <i>iucA</i>, <i>rmpA2</i>, and <i>K1</i> genes were significantly associated with hvKp. The string test shows 100% sensitivity and negative predictive value for the detection of hvKp. Consequently, using the string test alone for the screening of hvKp is required. However, combining aerobactin-positive with hypermucoviscous isolates while screening for hvKp is crucial.