Molecular characterization of carbapenem resistance and hypervirulence determinants of Klebsiella pneumoniae circulating in a tertiary hospital in Cyprus.

Authors

Montaser M Y Amro, Aysegul Bostanci, Buket Baddal

Published in

Molecular biology reports. Volume 53. Issue 1. Sep 08, 2026. Epub Sep 08, 2026.

Abstract

The emergence of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a major global public health concern. Infections caused by CR-Kp strains that also possess hypervirulence traits present significant challenges for clinical management and are associated with increased morbidity and mortality. This study aimed to investigate the prevalence of β-lactamase genes and hypervirulence-associated markers among clinical CR-Kp isolates collected in Cyprus.
A total of 96 K. pneumoniae isolates were investigated. Species-level identification and antimicrobial susceptibility testing were performed using the VITEK-2 system. Carbapenem resistance was assessed using the Modified Hodge test (MHT). Hypermucoviscous phenotype was determined by string test. The presence of carbapenemase genes (bla_OXA-48, bla_NDM, bla_IMP, and bla_VIM) and hypervirulence-associated genes (iucA, peg-344 and iroB) were investigated by conventional polymerase chain reaction.
Among isolates, 75 (78.1%) were identified as CR-Kp by the MHT test. Among CR-Kp isolates, 84.0% (63/75) were positive for bla_OXA-48, 8.0% (6/75) for bla_IMP, 4.0% (3/75) for bla_VIM, and 2.7% (2/75) for bla_NDM. Co-existence of carbapenemases (bla_OXA-48/bla_NDM, bla_OXA-48/bla_IMP, bla_OXA-48/bla_VIM) was also observed in eight isolates. Based on string test, 32 (42.7%) of the CR-Kp isolates exhibited a hypermucoviscous phenotype. Aerobactin synthesis gene iucA was detected in 44 (58.7%) isolates, whereas the metabolic transporter gene peg-344 and iroB gene were not found in any of the examined isolates.
This is the first report describing CR-Kp isolates with hypervirulence-associated characteristics in Cyprus. The emergence of these convergent strains in the region highlights the need for continuous molecular surveillance and stringent infection control measures in order to avert their future dissemination in the healthcare environment.

PMID:
42709288
Bibliographic data and abstract were imported from PubMed on 09 Sep 2026.

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