Association between Pneumonia Development and Virulence Gene Expression in Carbapenem-Resistant Isolated from Clinical Specimens.

We investigated the virulence gene expression of carbapenem-resistant (CRAB) isolated from the respiratory samples of patients with CRAB pneumonia and those with CRAB colonization to identify the virulence genes contributing to CRAB pneumonia's development and mortality. Patients with CRAB identified from respiratory specimens were screened at a tertiary university hospital between January 2018 and January 2019. Patients were classified into CRAB pneumonia or CRAB colonization groups according to predefined clinical criteria. isolated from respiratory specimens was examined for the expression levels of , , , , , and by quantitative reverse-transcription polymerase chain reaction. Among 156 patients with CRAB from respiratory specimens, 17 and 24 met the criteria for inclusion in the pneumonia and colonization groups, respectively. The expression level of was significantly higher in the pneumonia group than in the colonization group (1.45 vs. 0.63, =0.03). The expression levels of (1.97 vs. 0.86, =0.02), (1.06 vs. 0.10, < 0.01), (1.62 vs. 1.01, < 0.01), and (3.14 vs. 2.14, =0.03) were significantly higher in patients with 30-day mortality than in the surviving patients. Elevated expression of (adjusted odds ratio = 5.93, =0.03) and (adjusted odds ratio = 7.36, =0.02) were associated with 30-day mortality after adjusting for age and the Charlson score. and may serve as putative targets for novel therapeutic strategies.