Phenotypic and genotypic characterization of hypervirulent Klebsiella pneumoniae isolated from neonates in Bangladesh

Abstract

A systematic assessment of 11 observational studies reported that 596 (42.8%) of 1392 Klebsiella pneumoniae infection cases were hypervirulent (hvKp) strains. Additionally, a research study conducted in Bangladesh reported that 19% of their Klebsiella pneumoniae isolates were hvKp strains. Unlike usual Klebsiella pneumoniae infections, hvKp strains increasingly affect healthy people, making them more vulnerable. To understand gene variations and the presence of hvKp strains, datasets from NCBI were retrieved for bioinformatics analyses. Following that, the hvKp strain was identified by BLAST and Kleborate on 50 CHRF Klebsiella pneumoniae isolates. Two isolates with hypervirulent genes were discovered to have virulence scores of 4 and 5. Out of 19 samples, the string test was positive for 3 samples, and all of them exhibited multi-drug resistance. Moreover, it was discovered that all three patients were diagnosed with sepsis or neonatal sepsis following the detection of meningitis. Additionally, clinical manifestations revealed that a total of four patients were diagnosed with meningitis (one fatal case), and three with pneumonia or severe pneumonia. Subsequently, antibiotic susceptibility tests showed that over 41% of isolates were resistant to 13 antibiotics, with limited treatment options. Finally, the findings highlight the variations in hypervirulent gene sequences and suggest that the current virulence gene database is not comprehensive. Therefore, a repository for hvKp serotypes should be developed, and the database should be updated frequently.