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Table 2 Demographic data of patients, phenotypic and molecular characteristics of the hvKp isolates included in this study

From: The face of hypervirulent Klebsiella pneumoniae isolated from clinical samples of two Iranian teaching hospitals

Hospital

Ward

Source

String test

Virulence factor genes

Capsule serotype

ompK36 typing

Antibiotic resistance pattern

Antibiotic resistance genes

MIC (µg/ml)

CAZ IMI

A

Internal

Tracheal

Neg

iucA, iutA, ybt

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

Blood

Neg

iucA, iutA, ybt

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Emergency

Urine

Pos

iucA, kfu, ybt

ND

B

ND

blaSHV

ND

ND

A

ICU

Tracheal

Neg

iucA

K20

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaOXA-48 and blaNDM-1

ND

ND

A

Surgery

Abscess

Pos

iucA, ybt

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

ND

A

Surgery

Abscess

Pos

iucA

ND

C

ND

blaSHV

ND

ND

A

Surgery

Abdominal Secretions

Pos

peg-344, iucA, iutA, iro, ybt

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP

blaSHV and blaCTX-M-15

16

< 2

A

ICU

Tracheal

Neg

iucA

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaOXA-48 and blaNDM-1

ND

ND

A

ICU

Urine

Pos

iucA, kfu

ND

B

Susceptible

ND

ND

ND

A

ICU

Blood

Neg

iucA, ybt

ND

A

CTX

blaSHV

ND

ND

A

ICU

Synovial fluid

Neg

iucA, kfu

ND

B

Susceptible

ND

ND

ND

A

Out-patient

Urine

Pos

iucA, ybt

ND

C

GN, CTX, CAZ

blaTEM and blaSHV

ND

ND

A

ICU

Abscess

Neg

iucA, iutA

K20

C

CTX, GN, IMI, CRO, CAZ

blaTEM

ND

ND

A

Internal

Urine

Neg

iucA

ND

A

ND

blaTEM and blaSHV

ND

ND

A

ICU

Urine

Pos

iucA, kfu, ybt

K2

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Internal

Urine

Neg

iucA, ybt

ND

D

ND

blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Out-patient

Urine

Pos

iucA, ybt

ND

C

Susceptible

ND

ND

ND

A

Internal

Urine

Pos

iucA, kfu, ybt

ND

C

ND

blaSHV and blaCTX-M-15

ND

ND

A

Out-patient

Urine

Neg

iucA, iutA, ybt, rmpA

ND

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaCTX-M-15 and blaNDM-1

ND

ND

A

Out-patient

Urine

Pos

iucA, kfu

ND

A

ND

blaTEM, blaSHV and blaCTX-M-15

ND

ND

A

Out-patient

Urine

Pos

iucA, ybt

K20

B

ND

blaSHV and blaCTX-M15

ND

ND

A

Internal

Urine

Neg

iucA, kfu

ND

C

ND

blaSHV

ND

ND

A

Internal

Sputum

Pos

peg-344, iucA, iutA, ybt, rmpA

K20

C

CTX, CAZ

ND

ND

ND

A

Surgery

Abdominal Secretions

Pos

iucA

ND

A

ND

blaSHV, blaOXA-48 and blaNDM-1

ND

ND

A

Emergency

Urine

Pos

iucA, kfu, ybt

K2

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Out-patient

Urine

Pos

iucA, kfu, ybt

K2

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Surgery

Urine

Pos

iucA, kfu, ybt

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

ND

A

Emergency

Urine

Pos

iucA, kfu

ND

A

ND

blaSHV

ND

ND

A

ICU

Blood

Pos

iucA, kfu

ND

D

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaSHV, blaOXA-48 and blaNDM-1

ND

ND

A

ICU

Wound

Neg

iucA, ybt

ND

D

Susceptible

ND

ND

ND

A

Graft

Urine

Neg

iucA, kfu, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP

blaTEM, blaCTX-M-15 and blaOXA-48

ND

ND

A

Out-patient

Urine

Pos

iucA, kfu

ND

C

CTX, GN, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M15

ND

ND

A

Graft

Urine

Neg

iucA, ybt, allS, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48, blaNDM-1

> 16

4

A

ICU

Abscess

Neg

iucA

ND

C

Susceptible

ND

ND

ND

A

ICU

Urine

Neg

iucA

ND

C

CTX, FEP, CAZ

blaSHV

ND

ND

A

ICU

Blood

Neg

iucA

ND

D

ND

blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

Abscess

Pos

iucA, iutA, ybt, rmpA

K20

C

ND

blaTEM, blaCTX-M15 and blaNDM-1

64

> 4

A

Internal

Tracheal

Neg

iucA, ybt

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

Tracheal

Neg

iucA, iutA

ND

C

CTX, GN, FEP, CRO, AK, CAZ

blaSHV

ND

ND

A

Surgery

Wound

Neg

iucA, kfu, ybt

ND

C

CTX, CRO, CIP

blaSHV

ND

ND

A

Internal

Abscess

Neg

iucA, ybt

ND

D

CTX, GN, IMI, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Surgery

Abscess

Neg

iucA, ybt

ND

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaCTX-M-15 and blaOXA-48

ND

ND

A

Emergency

Urine

Neg

iucA, kfu, ybt

ND

C

Susceptible

ND

ND

ND

A

Internal

Sputum

Pos

iucA, iutA, ybt

K20

C

CTX, GN, FEP, CRO, CAZ

blaTEM, blaSHV and blaCTX-M-15

ND

ND

A

Out-patient

Urine

Neg

iucA, kfu, ybt

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP

blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

Abscess

Pos

iucA, ybt

ND

D

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

> 16

8

A

Emergency

Blood

Neg

iucA, kfu

ND

B

AK

ND

ND

ND

A

ICU

Tracheal

Neg

iucA, ybt

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

Blood

Pos

iucA, ybt

ND

D

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Neurology

Urine

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Emergency

Urine

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Internal

Wound

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

16

2

A

Emergency

Urine

Pos

iucA, iutA, ybt, rmpA

ND

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

32

> 4

A

ICU

BAL

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

Surgery

Urine

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, FEP, CRO, CAZ, CIP, MRP

blaTEM, blaSHV and blaCTX-M15

ND

ND

A

ICU

Blood

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV and blaCTX-M15

> 16

> 4

A

Internal

Urine

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

ND

ND

A

ICU

Tracheal

Pos

iucA, iutA, rmpA

ND

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

BAL

Pos

iucA, iutA, ybt, rmpA

K20

D

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaCTX-M-15 and blaOXA-48

64

> 4

A

Emergency

Urine

Pos

iucA, iutA, ybt

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP

blaTEM and blaCTX-M15

ND

ND

A

ICU

CSF

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

ND

ND

A

ICU

Tracheal

Pos

iucA, ybt

K20

D

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

ND

A

ICU

Blood

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

ND

ND

B

Infectious

Sputum

Neg

IutA, ybt

ND

C

CTX, GN, FEP, CRO, CAZ, CIP

blaCTX-M-15

ND

ND

B

Infectious

Sputum

Pos

iucA, ybt

ND

D

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

64

8

B

ICU

Urine

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

16

B

Infectious

Urine

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

> 16

> 4

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

4

B

ICU

Tracheal

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

64

> 4

B

ICU

Urine

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, FEP, CRO, CAZ, CIP, AZM

blaTEM, blaSHV and blaCTX-M-15

ND

< 2

B

ICU

Tracheal

Neg

iucA, kfu, ybt

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaNDM-1

> 16

> 4

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

4

B

Surgery

Wound

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, FEP, CRO, AK, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

ND

ND

B

ICU

Blood

Pos

peg-344, IucA, iutA, iro, kfu, ybt, magA, allS

K1

C

CTX, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

> 16

< 2

B

ICU

Tracheal

Neg

iucA, ybt, rmpA

K20

C

CTX, FEP, CRO, CAZ, CIP

blaTEM, blaSHV, blaCTX-M-15

ND

2

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

ND

2

B

ICU

Urine

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, FEP, CRO, CAZ, CIP

blaTEM, blaSHV, blaCTX-M-15

ND

2

B

Surgery

Urine

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, FEP, CRO, CAZ, CIP

blaTEM, blaSHV and blaCTX-M-15

ND

ND

B

ICU

Tracheal

Pos

iutA, iro, rmpA

ND

C

CTX, GN, FEP, CRO, AK, CAZ, CIP

blaCTX-M-15

ND

ND

B

ICU

Tracheal

Neg

iutA

ND

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP

blaTEM and blaSHV

ND

ND

B

Internal

Urine

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

4

B

Internal

Tracheal

Pos

iucA, iutA, kfu, ybt, rmpA

K20

D

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP

blaTEM, blaSHV, blaCTX-M-15 and blaOXA-48

ND

> 4

B

Emergency

Urine

Pos

iucA, iutA, kfu, ybt, rmpA

K20

C

CTX, FEP, CRO, AK, CAZ, CIP

blaSHV and blaCTX-M-15

ND

ND

B

Surgery

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, FEP, CRO, CAZ, CIP

blaSHV and blaCTX-M-15

ND

ND

B

ICU

Tracheal

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M15, blaOXA-48 and blaNDM-1

32

> 4

B

Infectious

Tracheal

Neg

iutA, ybt

ND

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

> 4

B

ICU

Tracheal

Neg

iucA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

32

4

B

ICU

Tracheal

Neg

iutA

K20

A

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15 and blaNDM-1

ND

> 4

B

ICU

Tracheal

Neg

iucA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

> 4

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

< 1

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

16

B

ICU

CSF

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

128

> 4

B

ICU

Urine

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

< 4

B

ICU

BAL

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

4

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

64

> 4

B

ICU

Tracheal

Pos

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

> 4

B

Surgery

Blood

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

256

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

16

B

Surgery

Wound

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

ND

B

ICU

Tracheal

Pos

iucA, iutA, iro, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, AK, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

8

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaTEM, blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

8

B

ICU

Tracheal

Neg

iucA, iutA, ybt, rmpA

K20

C

CTX, GN, IMI, FEP, CRO, CAZ, CIP, MRP, AZM

blaSHV, blaCTX-M-15, blaOXA-48 and blaNDM-1

ND

8

  1. *M, male; F, female; ICU, Intensive Care Unit; BAL, bronchoalveolar lavage; CSF, cerebrospinal fluid; Pos, positive; Neg, negative; iucA and iutA, aerobactin genes; ybt, yersiniabactin; rmpA, regulator of mucoid phenotype; Kfu, Klebsiella iron uptake; magA, mucoviscosity-associated gene; iroB, salmochelin iron uptake systems; allS, allantoin metabolism gene; peg-344, metabolic transporter; AK, amikacin; GN, gentamicin; CTX, cefotaxime; CAZ, ceftazidime; CRO, ceftriaxone; IMI, imipenem; MRP, meropenem; FEP, cefepime; CIP, ciprofloxacin;; AZM, aztreonam; MIC, minimum inhibitory concentration; ND, not determined
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Annals of Clinical Microbiology and Antimicrobials

ISSN: 1476-0711

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