ResearchArticle
TheAssociationofthePhylogeneticTypingofthe Klebsiella
pneumoniae IsolateswithAntibioticResistance
ShabnamBaghbanijavid ,
1,2,3
HosseinSamadiKafil ,
2
SafarFarajniya ,
4
SeyedRezaMoaddab ,
5
HasanHosainzadegan ,
6
FatemehYeganehSefidan ,
2
MojtabaVarshouchi ,
1
HamedEbrahimzadehLeylabadlo ,
7
andRezaGhotaslou
1
1
Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2
Department of Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3
Student Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4
Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
5
Department of Laboratory Sciences, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
6
Department of Microbiology, Faculty of Medicine, Maragheh University of Medical Sciences, Maragheh, Iran
7
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Correspondence should be addressed to Reza Ghotaslou; rzgottaslo@yahoo.com
Received 28 June 2021; Revised 9 October 2021; Accepted 22 October 2021; Published 5 November 2021
Academic Editor: Yan-Ren Lin
Copyright © 2021 Shabnam Baghbanijavid et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Klebsiella pneumoniae complex (KPC) accounts for approximately one-third of all Gram-negative infections. Moreover, it is
highly resistant and can taxonomically be distributed into KpI, KpII, and KpIII phylogroups. is study aimed to investigate the
distribution of phylogenetic groups and the relationship between them and antibiotic resistance patterns. For this purpose, we
collected KPC isolates from Tabriz, Iran, between 2018 and 2020. Antimicrobial susceptibility testing was performed by disk
diffusion agar, and phylogenetic groups were then examined using gyrA restriction fragment length polymorphism (RFLP) and
parC PCR methods. A total of 100 KPC isolates were obtained from the clinical specimens (urine, respiratory secretion, blood,
wounds, and trachea). e enrolled patients included 47 men and 53 women aged from 1 to 91 years old. e highest sensitivity
was found related to fosfomycin as 85%, followed by amikacin as 66%. e three phylogenetically groups by the RFLP-PCR
method were found in KPC, 96% (96 isolates) as KpI, 3% (3 isolates) as KpII, and 1% (1isolate) as KpIII. e highest antibiotic
resistance was observed in KpI. It was shown that a valid identification of three phylogenetic groups of KPC can be done by
combining both gyrA PCR-RFLP and parC PCR. Of note, the KpI group was also observed as the dominant phylogenetic group
with the highest resistance to antibiotics.
1.Introduction
Edwin Klebs first described Klebsiella pneumoniae complex
(KPC) organisms in 1875, while studying the airways of
patients who died due to pneumonia [1]. Additionally, Carl
Friedlander formally described the species in 1882 [1, 2].
KPC is a Gram-negative bacterium from the Enter-
obacteriaceae family that can consequently cause various
types of infections in human beings and is also found in both
animals and plants [2]. KPC has a large adjunct genome of
plasmids and chromosomal gene loci. In addition, KPC
strains can be divided into multidrug-resistant, hyperviru-
lent, and opportunistic groups based on the accessory ge-
nome [3]. Unfortunately, no approved potential therapy
currently exists for some hypervirulent strains of this or-
ganism. erefore, KPC can be classified as ESKAPE or-
ganisms [4], which “is a group consisting of the six most
important microorganisms resistant to antimicrobials
worldwide (Enterococcus faecium, Staphylococcus aureus,
KPC, Acinetobacter baumannii, Pseudomonas aeruginosa,
and Enterobacter spp.)” [5]. Of note, the important virulence
factors of KPC were indicated to be resistant to serum,
Hindawi
Emergency Medicine International
Volume 2021, Article ID 1316992, 6 pages
https://doi.org/10.1155/2021/1316992