Abstract

Deepinder Singh*, Ashima Katyal, Madhu Sharma and Uma Chaudhary

ABSTRACT

Introduction: Microbial invasion of the blood stream constitutes one of the most serious conditions in the infectious disease. Klebsiella pneumoniae is among the most common cause of nosocomial gram-negative bacteremia. It is responsible for 4-15% of septicemia in adults and 3-20% of neonatal septicemia (both early and late onset) especially in premature infants and ICU, thereby increasing the disease burden, morbidity and mortality. Aims and objectives: 1) To study various virulence determinants of Klebsiella pneumoniae. 2) To compare the virulence factors with the antibiogram. Methods: A prospective study was conducted over a period of 1 year (Oct, 15 to Sep, 16) in the department of microbiology, PGIMS, Rohtak. Total blood cultures received were 15,141. Out of which 110 Klebsiella pneumoniae were isolated & were subjected for various virulence factors determination like capsule, hyperviscosity (mucoid), biofilm production, siderophore production as per standard microbiological procedures. Antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method with various antimicrobial agents as per CLSI guidelines. The virulence factors were compared with their antimicrobial susceptibility pattern. Results: Eighty four (76%) isolates were capsulated. String test was positive in 79 (72%) of the isolates, biofilm production was seen in 73 (66%) and siderophore production was seen in 6(5%). The least effective drugs were gentamicin and amoxy-clav (11% & 15% respectively) whereas meropenem (81%) and imipenem (84%) were the most effective antimicrobial agents. It was seen that the number of virulence factors produced were more in resistant isolates. Discussion and Conclusion: Therefore, this study shows the importance of determining various virulence factors and delineates correlation of virulent strains with their antibiotic susceptibility patterns in blood culture isolates of Klebsiella pneumoniae, this will aid in better management of patients, thereby reducing morbidity as well as mortality.