Microbiological and Clinical Characteristics of Klebsiella Pneumoniae Infection in Hyderabad, South India

ABSTRACT

Introduction: A new hypervirulent (hypermucoviscous)variant of Klebsiella pneumoniae has emerged. First describedin the Asian Pacific Rim, it now increasingly recognizedin Western countries. The dispute in the prevalence ofK. pneumoniae with these hypervirulent characteristicsbetween the infection and colonization condition are not wellunderstood. The objective of this study was to contrast theclinico-microbiological characteristics of K. pneumoniaeisolated from different samples.Material and methods: This retrospective study wasconducted at Department of Medicine, Osmania GeneralHospital, Hyderabad — a multi-speciality tertiary-careteaching hospital in Hyderabad, South India for the period ofSeptember 2016 to October 2017. 100 Patients whose sputumor urine tested positive for the presence of K. pneumoniaeisolates were randomly included in the study. Collectedpatient data included age, sex, underlying disease and useof immunosuppressant drugs. The samples were defined ascommunity isolates and hospital isolates depending uponcertain criteria. The cases were divided into infection andcolonization cases. All statistical analyses were performedusing JMP Pro version 12 software.Results: Of the 100 cases investigated, 55 and 45 cases showedthe presence of K. pneumoniae in the sputum and urine,respectively. Of the 100 K. pneumoniae isolates, 21(21%)showed capsular serotype K1 or K2, whereas 28(28%) showedhypermucoviscosity. The prevalence of virulence genes allS,magA, mrkD, rmpA, wabG, kfu-BC, and uge was 16.3%,13%, 81.9%, 18.6%, 90.3%, 38.5%, and 80.5%, respectively.Analysis of microbiological characteristics revealed thatonly rmpA was significantly more frequent in the infectioncases than in the colonization/asymptomatic cases in both thesputum and urine groups.Conclusion: The rmpA-positive K. pneumoniae isolates weredominant in the infection cases compared with those in thecolonization/asymptomatic cases, suggesting that rmpA mayplay a crucial role in the development of UTI and pneumonia.