Evaluation of genes involved in the binding and invasion of Klebsiella pneumoniae including fimH-1, entB, iutA, rmpA and cnf-1 genes in patients with urinary tract infection

Introduction: Klebsiella pneumoniae is a member of the Enterobacteriaceae that causes nosocomial infections. The aim of this study was to identify the binding, invasive and pathogenic profiles of K. pneumoniae isolates in urinary tract infection. Materials and methods: This study was performed with 70 isolates. The antibiotic susceptibility testing was conducted by 12 antibiotics. The presence of virulence genes (fimH-1, mrkD, kpn, ycfM, entB, iutA, irp-1, irp-2, ybtS, fyuA, iroN, rmpA, magA, traT, hlyA and cnf-1) done by PCR. Results: The strains resistant to imipenem, also resistant to the cefotaxime/ceftazidime and azteronam. 96.4% of rmpA strains also had entB and 92.8% had ycfM gene. Of the 12 strains containing cnf1, all also had fimH and the mrkD gene. These strains had a high resistance the amoxicillin, tobramycin, ciprofloxacin and gentamicin. Strains containing the hlyA all had fimH and were high resistant to the amoxicillin/clavulanic acid, amikacin, and tobramycin. magA-containing strains had low resistance to amikacin and azteronam. Conclusion: It is recommended that imipenem resistant strains be resistant to cefotaxime, ceftazidime, and aztereonam, and that these antibiotics not be used to treat these strains. Interestingly, strains with the cnf-1 were all sensitive to imipenem, so imipenem is a good option for treating these strains. Strains that had the hlyA all had the fimH gene and had a very high resistance to the amoxicillin/clavulanic acid, amikacin and tobramycin. magA-containing strains all had entB and had low resistance to amikacin and aztereonam. Therefore, amikacin and aztereonam are recommended for the treatment of these strains containing.