Characterization of Hypervirulent Extended-Spectrum β-Lactamase-Producing Among Urinary Tract Infections: The First Report from Iran.

Introduction: This study was conducted to identify the hypermucoviscosity, iron acquisition, and capsule serotypes of strains isolated from urinary tract infections among community-acquired patients (CA) and assess the frequency of plasmid-mediated quinolone resistance (PMQR) and extended-spectrum beta-lactamases (ESBL) genes between classic and hypervirulent strains.

Materials And Methods: A total of 105 were isolated from CA-UTI. Demographic data related to the underlying diseases and clinical manifestations were further collected. Antibiotic resistance pattern and molecular characterization were compared among ESBL-positive, ESBL-negative, hypervirulent, and classic isolates.

Results: The results revealed that 52.4% of the isolates were confirmed as ESBL producers and 11 (10.5%) were considered as hypervirulent (hvKp). Ciprofloxacin and nalidixic acid were the most inactive antibiotics with resistance rates of 68.6% and 64.8%, respectively. Molecular characterization revealed that 7.6% of all the isolates carried and 66.6% carried genes. The most frequent ESBL gene was 63.8%, followed by 59.0%, and 58.1%. ESBL genes were significantly more in hvKp than in cKp. Moreover, 61 (84.7%), 47 (65.2%), and 16 (22.2%) of isolates harbored , and . ESBL genes were detected in all hvKps, and was observed in 90.9% of hvKp ( value= 0.048, 95%).

Discussion: This study reported the high frequency of antimicrobial and multidrug resistance among hvKp isolates. Coexistence of PMQR and ESBL genes in hvkp indicates the necessity to enhance the clinical knowledge and management of hvKp infections.