This study aimed to screen antibiotic resistance and virulence genes in carbapenem-resistant hypermucoviscous Klebsiella pneumoniae isolates from an Egyptian hospital. Among 38 previously confirmed carbapenem-nonsusceptible K. pneumoniae isolates, a string test identified three isolates as positive for hypermucoviscosity. Phenotypic characterization and molecular detection of carbapenemase- and virulence-encoding genes were performed. PCR-based multilocus sequence typing and phylogenetics were used to determine the clonality and global epidemiology of the strains. The coexistence of virulence and resistance genes in the isolates was analyzed statistically using a chi-square test. Three isolates showed the presence of carbapenemase-encoding genes (bla_NDM, bla_VIM, and bla_IMP), adhesion genes (fim-H-1 and mrkD), and siderophore genes (entB); the isolates belonged to sequence types (STs) 101, 1310, and 1626. The relatedness between these sequence types and the sequence types of globally detected hypermucoviscous K. pneumoniae that also harbor carbapenemases was determined. Our analysis showed that the resistance and virulence profiles were not homogenous. Phylogenetically, different clones clustered together. There was no significant association between the presence of resistance and virulence genes in the isolates. There is a need for periodic surveillance of the healthcare settings in Egypt and globally to understand the true epidemiology of carbapenem-resistant, hypermucoviscous K. pneumoniae.

中文翻译：

---

埃及医院分离的高粘液粘性碳青霉烯酶编码肺炎克雷伯菌的分子特征


本研究旨在筛选来自埃及一家医院的碳青霉烯类耐药性高粘稠肺炎克雷伯菌分离株的抗生素耐药性和毒力基因。在先前确认的 38 株对碳青霉烯类不敏感的肺炎克雷伯菌分离株中，串线试验鉴定出 3 株分离株为高粘膜粘稠度阳性。对碳青霉烯酶和毒力编码基因进行表型表征和分子检测。基于 PCR 的多位点序列分型和系统发育学用于确定菌株的克隆性和全球流行病学。使用卡方检验对分离株中毒力和抗性基因的共存进行统计分析。三个分离株显示存在碳青霉烯酶编码基因（ bla _NDM 、 bla _VIM和bla _IMP ）、粘附基因（ fim-H-1和mrkD ）和铁载体基因（ entB ）；这些分离株属于序列类型 (ST) 101、1310 和 1626。确定了这些序列类型与全球检测到的也含有碳青霉烯酶的高粘液性肺炎克雷伯菌的序列类型之间的相关性。我们的分析表明，耐药性和毒力分布并不均匀。从系统发育上来说，不同的克隆聚集在一起。分离株中耐药性和毒力基因的存在之间没有显着关联。有必要对埃及和全球的医疗机构进行定期监测，以了解耐碳青霉烯类、高粘稠度肺炎克雷伯菌的真实流行病学。