BIOLOGICAL PROPERTIES OF KLEBSIELLA PNEUMONIAE WITH CLASSICAL AND HYPERMUCOID PHENOTYPE ISOLATED FROM INTENSIVE CARE UNIT PATIENTS



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Abstract

Abstract

Introduction. There are conflicting data on the biological properties of hypermucoid Klebsiella pneumoniae, so in practice there are difficulties in differentiating their pathotype. Goal. Comparison of phenotypic properties for subpopulations of hypermucoid and classical K.pneumoniae isolated from intensive care unit patients. Materials and Methods. The "main" group (n=24) consisted of patients with hypermucoid K.pneumoniae, the "control" group (n=24) consisted of patients infected with classical klebsiella. Isolation of K.pneumoniae from different biomaterial sources was performed by bacteriological method, identification – with ErbaScan microbiological analyzer using Entero-Rapid 24 (Erba Lachema, Czech Republic). Lipase production was studied on Tributryn Agar Base (HIMEDIA, India), protease – on Micro-GELATINase (NICF, St. Petersburg), hemolysins – on 5% blood MPA (FBUN GSC PMB, Obolensk), presence of extended-spectrum β-lactamases (ESBLs) was investigated by the double-disc method, and sensitivity to phages by the SPOT test. Parametric and nonparametric statistical methods were used to process the data. The differences were considered significant at p<0.05. Results. The detection rate of K.pneumoniae with a hypermucoid phenotype in intensive care unit patients was 23.1%; in 66.7% of cases these bacteria were isolated from sputum. Hypermucoid K.pneumoniae had a similar frequency of virulence factors production such as lipase (70.8% and 54.2%, respectively; p=0.927), hemolysins (45.8% and 50%, respectively; p=0.773), proteases (12.5% and 33.3%, respectively; p=0.086). In hypermucoid and classical klebsiella, there were no differences in the frequency of ESBLs production (75% and 62.5%, respectively; OR=1.8; 95% CI 0.521-6.218, p=0.351) and the frequency of bacteriophage resistance (p>0.05). In infectious processes associated with hypermucoid klebsiella strains, the level of patient leukocytes was significantly lower than in case of classical klebsiella infections (9.7·109 l vs. 11.6·109 l; p=0.028). However, regardless of the pathogen phenotype, patients had similar lengths of stay in the intensive care unit (12.5-16 days; p=0.29) and mortality rates (58.2-62.5%; p=0.77).

Conclusion. Hypermucoid K.pneumoniae show a similar frequency of producing invasion factors, extended-spectrum beta-lactamases, and bacteriophage resistance to classical strains, which determines common approaches in the treatment of patients. The hypermucoid phenotype of bacteria is associated with lower levels of leukocytes, which must be taken into account to assess infection severity in patients.

About the authors

Olesya A. Isaenko

Kemerovo State Medical University;
Kuzbass Clinical Hospital of Emergency Medicine named after M. A. Podgorbunsky

Email: olesisaenko@mail.ru
ORCID iD: 0009-0002-1556-4397

applicant for the Department of Microbiology and Virology;

head of the bacteriological laboratory

Россия, 22а, Voroshilova Street, Kemerovo, 650056; 650991, Kemerovo region – Kuzbass, N. Ostrovsky str., 22

Yuliyа Zakharova

Kemerovo State Medical University

Email: yvz@bk.ru
ORCID iD: 0000-0002-3475-9125

MD, PhD, Professor, Department of Microbiology and Virology

Россия, 650056, Kemerovo region - Kuzbass, Kemerovo, st. Voroshilova, 22 A

Tatyana S. Kuprienko

Kemerovo State Medical University;
Kuzbass Clinical Hospital of Emergency Medicine named after M. A. Podgorbunsky

Author for correspondence.
Email: rts0621@yandex.ru
ORCID iD: 0009-0004-9107-2989

Resident Department of Microbiology and Virology; 
bacteriological laboratory trainee doctor
Россия, 22а, Voroshilova Street, Kemerovo, 650056; 650991, Kemerovo region – Kuzbass, N. Ostrovsky str., 22

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