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  • 1 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, , Iran
  • | 2 Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, , Iran
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Abstract

In this study, we focused on the emergence of extensively drug-resistant (XDR), pandrug-resistant (PDR), and hypervirulent Klebsiella pneumoniae (hvKP) in Iran. During 2018 to 2020 a total of 52 K. pneumoniae isolates were collected from different clinical specimens. The hvKP isolates were identified by PCR amplification of virulence and capsular serotype-specific genes. Hypermucoviscous K. pneumoniae (hmKP) were identified by string test. Carbapenem-resistant hvKP (CR-hvKP), multidrug-resistant hvKP (MDR-hvKP), extensively drug-resistant hvKP (XDR-hvKP), and pandrug-resistant hvKP (PDR-hvKP) were determined by disc diffusion method, Carba-NP test and PCR method. XDR-hvKP isolates were typed by multilocus sequence typing (MLST). Among all K. pneumoniae isolates 14 (26.9%) were identified as hvKP and 78.6% (11/14) of them were hmKP however, none of the classic K. pneumoniae (cKP) isolates were hmKP. The predominant capsular serotype of hvKP was K2 (42.85%) followed by K1 (35.71%). The prevalence of MDR-hvKP, XDR-hvKP and PDR-hvKP isolates were 6 (42.9%), 5 (35.7%) and 1 (7.1%), respectively. ESBL production was found in 85.7% of hvKP isolates and most of them carried bla TEM gene (78.6%) and 6 isolates (42.9%) were CR-hvKP. Among hvKP isolates, 1 (7.1%), 2 (14.3%), 3 (21.4%), 8 (28.6%), and 11 (78.6%) carried bla NDM-6, bla OXA-48, bla CTX-M, bla SHV, and bla TEM genes, respectively. According to MLST analysis, 2, 1, 1, and 1 XDR-hvKP isolates belonged to ST15, ST377, ST442, and ST147, respectively. The occurrence of such isolates is deeply concerning due to the combination of hypervirulence and extensively drug-resistance or pandrug-resistance.

  • 1.

    Liu YC , Cheng DL , Lin CL . Klebsiella pneumoniae liver abscess associated with septic endophthalmitis. Arch Intern Med 1986; 146(10): 19131916.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Podschun R , Ullmann U . Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 1998; 11(4): 589603.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Sharahi JY , Hashemi A , Ardebili A , Davoudabadi S . Molecular characteristics of antibiotic-resistant Escherichia coli and Klebsiella pneumoniae strains isolated from hospitalized patients in Tehran, Iran. Ann Clin Microbiol Antimicrob 2021; 20(1): 32.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Buppajarntham S , Shah M , Junpaparp P . Tumor-like pyogenic liver abscess caused by Klebsiella pneumoniae in diabetes. Endocrine 2014; 47(2): 656657.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Vila A , Cassata A , Pagella H , Amadio C , Yeh KM , Chang FY , et al. Appearance of Klebsiella pneumoniae liver abscess syndrome in Argentina: case report and review of molecular mechanisms of pathogenesis. Open Microbiol J 2011; 5: 107113.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Gundestrup S , Struve C , Stahlhut SG , Hansen DS . First case of liver abscess in Scandinavia due to the international hypervirulent Klebsiella pneumoniae clone ST23. Open Microbiol J 2014; 8: 2224.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Hyun JI , Kim YJ , Jeon YH , Kim SI , Park YJ , Kang MW , et al. A case of ventriculitis associated with renal abscess caused by serotype K1 Klebsiella pneumoniae. Infect Chemother 2014; 46(2): 120124.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Vandevelde A , Stepanovic B . On a boat: a case in Australia of endophthalmitis and pyogenic liver, prostatic, and lung abscesses in a previously well patient due to Klebsiella pneumoniae. Case Rep Infect Dis 2014; 2014: 137248.

    • Search Google Scholar
    • Export Citation
  • 9.

    Siu LK , Yeh KM , Lin JC , Fung CP , Chang FY . Klebsiella pneumoniae liver abscess: a new invasive syndrome. Lancet Infect Dis 2012; 12(11): 881887.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Fang CT , Chuang YP , Shun CT , Chang SC , Wang JT . A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med 2004; 199(5): 697705.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Shon AS , Bajwa RP , Russo TA . Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: a new and dangerous breed. Virulence 2013; 4(2): 107118.

  • 12.

    Prokesch BC , TeKippe M , Kim J , Raj P , TeKippe EM , Greenberg DE . Primary osteomyelitis caused by hypervirulent Klebsiella pneumoniae. Lancet Infect Dis 2016; 16(9): e190e195.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Rossi B , Gasperini ML , Leflon-Guibout V , Gioanni A , de Lastours V , Rossi G , et al. Hypervirulent Klebsiella pneumoniae in cryptogenic liver abscesses, Paris, France. Emerg Infect Dis 2018; 24(2): 221229.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Hoashi K , Harada S , Ishii Y , Aoki K , Ishikawa S , Oshiro Y , et al. Community-acquired liver abscess caused by capsular genotype K2-ST375 hypervirulent Klebsiella pneumoniae isolates. IDCases 2019; 17: e00577.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Shi YF , Wang YK , Wang YH , Liu H , Shi XH , Li XJ , et al. Metastatic infection caused by hypervirulent Klebsiella pneumonia and co-infection with Cryptococcus meningitis: a case report. World J Clin Cases 2019; 7(22): 38123820.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Liu YM , Li BB , Zhang YY , Zhang W , Shen H , Li H , et al. Clinical and molecular characteristics of emerging hypervirulent Klebsiella pneumoniae bloodstream infections in mainland China. Antimicrob Agents Chemother 2014; 58(9): 53795385.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Li W , Sun G , Yu Y , Li N , Chen M , Jin R , et al. Increasing occurrence of antimicrobial-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in China. Clin Infect Dis 2014; 58(2): 225232.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Yu WL , Ko WC , Cheng KC , Lee HC , Ke DS , Lee CC , et al. Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis 2006; 42(10): 13511358.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Yu WL , Ko WC , Cheng KC , Lee CC , Lai CC , Chuang YC . Comparison of prevalence of virulence factors for Klebsiella pneumoniae liver abscesses between isolates with capsular K1/K2 and non-K1/K2 serotypes. Diagn Microbiol Infect Dis 2008; 62(1): 16.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Struve C , Roe CC , Stegger M , Stahlhut SG , Hansen DS , Engelthaler DM , et al. Mapping the evolution of hypervirulent Klebsiella pneumoniae. mBio 2015; 6(4): e00630.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Russo TA , Olson R , MacDonald U , Beanan J , Davidson BA . Aerobactin, but not Yersiniabactin, Salmochelin, or Enterobactin, enables the growth/survival of hypervirulent (hypermucoviscous) Klebsiella pneumoniae ex vivo and in vivo. Infect Immun 2015; 83(8): 33253333.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Nassif X , Sansonetti PJ . Correlation of the virulence of Klebsiella pneumoniae K1 and K2 with the presence of a plasmid encoding aerobactin. Infect Immun 1986; 54(3): 603608.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Chen YT , Chang HY , Lai YC , Pan CC , Tsai SF , Peng HL . Sequencing and analysis of the large virulence plasmid pLVPK of Klebsiella pneumoniae CG43. Gene 2004; 337: 189198.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Russo TA , Olson R , Fang CT , Stoesser N , Miller M , MacDonald U , et al. Identification of biomarkers for differentiation of hypervirulent Klebsiella pneumoniae from classical K. pneumoniae. J Clin Microbiol 2018; 56(9).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Fang CT , Lai SY , Yi WC , Hsueh PR , Liu KL , Chang SC . Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 2007; 45(3): 284293.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Wei DD , Wan LG , Deng Q , Liu Y . Emergence of KPC-producing Klebsiella pneumoniae hypervirulent clone of capsular serotype K1 that belongs to sequence type 11 in Mainland China. Diagn Microbiol Infect Dis 2016; 85(2): 192194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Feng Y , Lu Y , Yao Z , Zong Z . Carbapenem-resistant hypervirulent Klebsiella pneumoniae of sequence type 36. Antimicrob Agents Chemother 2018; 62(7).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Zhang R , Lin D , Chan EW , Gu D , Chen GX , Chen S . Emergence of carbapenem-resistant serotype K1 hypervirulent Klebsiella pneumoniae strains in China. Antimicrob Agents Chemother 2016; 60(1): 709711.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Fu L , Tang L , Wang S , Liu Q , Liu Y , Zhang Z , et al. Co-location of the blaKPC-2, blaCTX-M-65, rmtB and virulence relevant factors in an IncFII plasmid from a hypermucoviscous Klebsiella pneumoniae isolate. Microb Pathog 2018; 124: 301304.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Cejas D , Fernandez Canigia L , Rincon Cruz G , Elena AX , Maldonado I , Gutkind GO , et al. First isolate of KPC-2-producing Klebsiella pneumonaie sequence type 23 from the Americas. J Clin Microbiol 2014; 52(9): 34833485.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Andrade LN , Vitali L , Gaspar GG , Bellissimo-Rodrigues F , Martinez R , Darini AL . Expansion and evolution of a virulent, extensively drug-resistant (Polymyxin B-resistant), QnrS1-, CTX-M-2-, and KPC-2-producing Klebsiella pneumoniae ST11 international high-risk clone. J Clin Microbiol 2014; 52(7): 25302535.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Pajand O , Darabi N , Arab M , Ghorbani R , Bameri Z , Ebrahimi A , et al. The emergence of the hypervirulent Klebsiella pneumoniae (hvKp) strains among circulating clonal complex 147 (CC147) harbouring blaNDM/OXA-48 carbapenemases in a tertiary care center of Iran. Ann Clin Microbiol Antimicrob 2020; 19(1): 12.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Compain F , Babosan A , Brisse S , Genel N , Audo J , Ailloud F , et al. Multiplex PCR for detection of seven virulence factors and K1/K2 capsular serotypes of Klebsiella pneumoniae. J Clin Microbiol 2014; 52(12): 43774380.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Shah RK , Ni ZH , Sun XY , Wang GQ , Li F . The determination and correlation of various virulence genes, ESBL, serum bactericidal effect and biofilm formation of clinical isolated classical Klebsiella pneumoniae and hypervirulent Klebsiella pneumoniae from respiratory tract infected patients. Pol J Microbiol 2017; 66(4): 501508.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Fang FC , Sandler N , Libby SJ . Liver abscess caused by magA+ Klebsiella pneumoniae in North America. J Clin Microbiol 2005; 43(2): 991992.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Turton JF , Baklan H , Siu LK , Kaufmann ME , Pitt TL . Evaluation of a multiplex PCR for detection of serotypes K1, K2 and K5 in Klebsiella sp. and comparison of isolates within these serotypes. FEMS Microbiol Lett 2008; 284(2): 247252.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Chen T , Dong G , Zhang S , Zhang X , Zhao Y , Cao J , et al. Effects of iron on the growth, biofilm formation and virulence of Klebsiella pneumoniae causing liver abscess. BMC Microbiol 2020; 20(1): 36.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Siu LK , Fung CP , Chang FY , Lee N , Yeh KM , Koh TH , et al. Molecular typing and virulence analysis of serotype K1 Klebsiella pneumoniae strains isolated from liver abscess patients and stool samples from noninfectious subjects in Hong Kong, Singapore, and Taiwan. J Clin Microbiol 2011; 49(11): 37613765.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Lee CH , Liu JW , Su LH , Chien CC , Li CC , Yang KD . Hypermucoviscosity associated with Klebsiella pneumoniae-mediated invasive syndrome: a prospective cross-sectional study in Taiwan. Int J Infect Dis: IJID: official Publ Int Soc Infect Dis 2010; 14(8): e688e692.

    • Search Google Scholar
    • Export Citation
  • 40.

    Russo TA , Olson R , Macdonald U , Metzger D , Maltese LM , Drake EJ , et al. Aerobactin mediates virulence and accounts for increased siderophore production under iron-limiting conditions by hypervirulent (hypermucoviscous) Klebsiella pneumoniae. Infect Immun 2014; 82(6): 23562367.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Yang Y , Liu JH , Hu XX , Zhang W , Nie TY , Yang XY , et al. Clinical and microbiological characteristics of hypervirulent Klebsiella pneumoniae (hvKp) in a hospital from North China. J Infect Developing Countries 2020; 14(6): 606613.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Lorenz TC . Polymerase chain reaction: basic protocol plus troubleshooting and optimization strategies. J Vis Exp 2012; 63: e3998.

  • 43.

    Lee HC , Chuang YC , Yu WL , Lee NY , Chang CM , Ko NY , et al. Clinical implications of hypermucoviscosity phenotype in Klebsiella pneumoniae isolates: association with invasive syndrome in patients with community-acquired bacteraemia. J Intern Med 2006; 259(6): 606614.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44.

    Weinstein MP . Performance standards for antimicrobial susceptibility testing. Clinical and Laboratory Standards Institute. 2019.

  • 45.

    Williamson DA , Sidjabat HE , Freeman JT , Roberts SA , Silvey A , Woodhouse R , et al. Identification and molecular characterisation of New Delhi metallo-beta-lactamase-1 (NDM-1)- and NDM-6-producing Enterobacteriaceae from New Zealand hospitals. Int J Antimicrob Agents 2012; 39(6): 529533.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46.

    Gupta V , Soni R , Jain N , Chander J . In vitro cost-effective methods to detect carbapenemases in Enterobacteriaceae. J Lab Physicians 2018; 10(1): 101105.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 47.

    Nordmann P , Poirel L , Dortet L . Rapid detection of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis 2012; 18(9): 15031507.

  • 48.

    Heffernan HM , Woodhouse RE , Pope CE , Blackmore TK . Prevalence and types of extended-spectrum beta-lactamases among urinary Escherichia coli and Klebsiella spp. in New Zealand. Int J Antimicrob Agents 2009; 34(6): 544549.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 49.

    Babini GS , Livermore DM . Are SHV beta-lactamases universal in Klebsiella pneumoniae? Antimicrob Agents Chemother 2000; 44(8): 2230.

  • 50.

    Mahrouki S , Chihi H , Bourouis A , Ben Moussa M , Belhadj O . First characterization of a Providencia stuartii clinical isolate from a Tunisian intensive care unit coproducing VEB-1-a, OXA-2, qnrA6 and aac(6’)-Ib-cr determinants. The Braz J Infect Dis: official Publ Braz Soc Infect Dis 2014; 18(2): 211214.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51.

    Feizabadi MM , Delfani S , Raji N , Majnooni A , Aligholi M , Shahcheraghi F , et al. Distribution of bla(TEM), bla(SHV), bla(CTX-M) genes among clinical isolates of Klebsiella pneumoniae at Labbafinejad Hospital, Tehran, Iran. Microb Drug Resist 2010; 16(1): 4953.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 52.

    Opazo A , Sonnevend A , Lopes B , Hamouda A , Ghazawi A , Pal T , et al. Plasmid-encoded PER-7 beta-lactamase responsible for ceftazidime resistance in Acinetobacter Baumannii isolated in the United Arab Emirates. J Antimicrob Chemother 2012; 67(7): 16191622.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 53.

    Alikhani MY , Karimi Tabar Z , Mihani F , Kalantar E , Karami P , Sadeghi M , et al. Antimicrobial resistance patterns and prevalence of blaPER-1 and blaVEB-1 genes among ESBL-producing Pseudomonas aeruginosa isolates in West of Iran. Jundishapur J Microbiol 2014; 7(1): e8888.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 54.

    Shariati A , Azimi T , Ardebili A , Chirani AS , Bahramian A , Pormohammad A , et al. Insertional inactivation of oprD in carbapenem-resistant Pseudomonas aeruginosa strains isolated from burn patients in Tehran, Iran. New Microbes and New Infect 2018; 21: 7580.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 55.

    Poirel L , Walsh TR , Cuvillier V , Nordmann P . Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis 2011; 70(1): 119123.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 56.

    Ellington MJ , Kistler J , Livermore DM , Woodford N . Multiplex PCR for rapid detection of genes encoding acquired metallo-beta-lactamases. J Antimicrob Chemother 2007; 59(2): 321322.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 57.

    Farajzadeh Sheikh A , Rostami S , Jolodar A , Tabatabaiefar MA , Khorvash F , Saki A , et al. Detection of metallo-beta lactamases among carbapenem-resistant Pseudomonas aeruginosa. Jundishapur J Microbiol 2014; 7(11): e12289.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 58.

    Berger S , Alauzet C , Aissa N , Henard S , Rabaud C , Bonnet R , et al. Characterization of a new blaOXA-48-carrying plasmid in Enterobacteriaceae. Antimicrob Agents Chemother 2013; 57(8): 40644067.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 59.

    Diancourt L , Passet V , Verhoef J , Grimont PA , Brisse S . Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol 2005; 43(8): 41784182.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 60.

    Hsu CR , Lin TL , Chen YC , Chou HC , Wang JT . The role of Klebsiella pneumoniae rmpA in capsular polysaccharide synthesis and virulence revisited. Microbiology (Reading) 2011; 157(Pt 12): 34463457.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 61.

    Lin TL , Yang FL , Yang AS , Peng HP , Li TL , Tsai MD , et al. Amino acid substitutions of MagA in Klebsiella pneumoniae affect the biosynthesis of the capsular polysaccharide. PLoS One 2012; 7(10): e46783.

    • Search Google Scholar
    • Export Citation
  • 62.

    Catalan-Najera JC , Garza-Ramos U , Barrios-Camacho H . Hypervirulence and hypermucoviscosity: two different but complementary Klebsiella spp. phenotypes? Virulence 2017; 8(7): 11111123.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 63.

    Lee CR , Lee JH , Park KS , Jeon JH , Kim YB , Cha CJ , et al. Antimicrobial resistance of hypervirulent Klebsiella pneumoniae: epidemiology, hypervirulence-associated determinants, and resistance mechanisms. Front Cell Infect Microbiol 2017; 7: 483.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 64.

    Rastegar S , Moradi M , Kalantar-Neyestanaki D , Ali Golabi D , Hosseini-Nave H . Virulence factors, capsular serotypes and antimicrobial resistance of hypervirulent Klebsiella pneumoniae and classical Klebsiella pneumoniae in southeast Iran. Infect Chemother 2019.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 65.

    Cubero M , Grau I , Tubau F , Pallares R , Dominguez MA , Linares J , et al. Hypervirulent Klebsiella pneumoniae clones causing bacteraemia in adults in a teaching hospital in Barcelona, Spain (2007-2013). Clin Microbiol Infect 2016; 22(2): 154160.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 66.

    Peirano G , Pitout JD , Laupland KB , Meatherall B , Gregson DB . Population-based surveillance for hypermucoviscosity Klebsiella pneumoniae causing community-acquired bacteremia in Calgary, Alberta. Can J Infect Dis Med Microbiol 2013; 24(3): e61e64.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 67.

    Jung SW , Chae HJ , Park YJ , Yu JK , Kim SY , Lee HK , et al. Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea. Epidemiol Infect 2013; 141(2): 334340.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 68.

    Hyun M , Lee JY , Ryu SY , Ryoo N , Kim HA . Antibiotic resistance and clinical presentation of health care-associated hypervirulent Klebsiella pneumoniae infection in Korea. Microb Drug Resist 2019; 25(8): 12041209.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 69.

    Liu C , Guo J . Hypervirulent Klebsiella pneumoniae (hypermucoviscous and aerobactin positive) infection over 6 years in the elderly in China: antimicrobial resistance patterns, molecular epidemiology and risk factor. Ann Clin Microbiol Antimicrob 2019; 18(1): 4.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 70.

    Liu C , Shi J , Guo J . High prevalence of hypervirulent Klebsiella pneumoniae infection in the genetic background of elderly patients in two teaching hospitals in China. Infect Drug Resist 2018; 11: 10311041.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 71.

    Ikeda M , Mizoguchi M , Oshida Y , Tatsuno K , Saito R , Okazaki M , et al. Clinical and microbiological characteristics and occurrence of Klebsiella pneumoniae infection in Japan. Int J Gen Med 2018; 11: 293299.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 72.

    Ma Y , Bao C , Liu J , Hao X , Cao J , Ye L , et al. Microbiological characterisation of Klebsiella pneumoniae isolates causing bloodstream infections from five tertiary hospitals in Beijing, China. J Glob Antimicrob Resist 2018; 12: 162166.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 73.

    Marr CM , Russo TA . Hypervirulent Klebsiella pneumoniae: a new public health threat. Expert Rev Anti Infect Ther 2019; 17(2): 7173.

  • 74.

    Shankar C , Veeraraghavan B , Nabarro LEB , Ravi R , Ragupathi NKD , Rupali P . Whole genome analysis of hypervirulent Klebsiella pneumoniae isolates from community and hospital acquired bloodstream infection. BMC Microbiol 2018; 18(1): 6.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 75.

    Wyres KL , Nguyen TNT , Lam MMC , Judd LM , van Vinh Chau N , Dance DAB , et al. Genomic surveillance for hypervirulence and multi-drug resistance in invasive Klebsiella pneumoniae from South and Southeast Asia. Genome Med 2020; 12(1): 11.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 76.

    Gu D , Dong N , Zheng Z , Lin D , Huang M , Wang L , et al. A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study. Lancet Infect Dis 2018; 18(1): 3746.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 77.

    Lu Y , Feng Y , McNally A , Zong Z . The occurence of colistin-resistant hypervirulent Klebsiella pneumoniae in China. Front Microbiol 2018; 9: 2568.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 78.

    Ferreira RL , da Silva BCM , Rezende GS , Nakamura-Silva R , Pitondo-Silva A , Campanini EB , et al. High prevalence of multidrug-resistant Klebsiella pneumoniae harboring several virulence and beta-lactamase encoding genes in a Brazilian intensive care unit. Front Microbiol 2018; 9: 3198.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 79.

    Chen L , Kreiswirth BN . Convergence of carbapenem-resistance and hypervirulence in Klebsiella pneumoniae. Lancet Infect Dis 2018; 18(1): 23.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 80.

    Liu Z , Gu Y , Li X , Liu Y , Ye Y , Guan S , et al. Identification and characterization of NDM-1-producing hypervirulent (hypermucoviscous) Klebsiella pneumoniae in China. Ann Lab Med 2019; 39(2): 167175.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 81.

    Li J , Ren J , Wang W , Wang G , Gu G , Wu X , et al. Risk factors and clinical outcomes of hypervirulent Klebsiella pneumoniae induced bloodstream infections. Eur J Clin Microbiol Infect Dis 2018; 37(4): 679689.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 82.

    Liu C , Du P , Xiao N , Ji F , Russo TA , Guo J . Hypervirulent Klebsiella pneumoniae is emerging as an increasingly prevalent K. pneumoniae pathotype responsible for nosocomial and healthcare-associated infections in Beijing, China. Virulence 2020; 11(1): 12151224.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 83.

    Huang YH , Chou SH , Liang SW , Ni CE , Lin YT , Huang YW , et al. Emergence of an XDR and carbapenemase-producing hypervirulent Klebsiella pneumoniae strain in Taiwan. J Antimicrob Chemother 2018; 73(8): 20392046.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 84.

    Zhu X , Sun C , Chen H , Zhan X , Liu C , Liu X , et al. Co-occurrence of three different plasmids in an extensively drug-resistant hypervirulent Klebsiella pneumoniae isolate causing urinary tract infection. J Glob Antimicrob Resist 2020; 23: 203210.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 85.

    Lam MMC , Wyres KL , Wick RR , Judd LM , Fostervold A , Holt KE , et al. Convergence of virulence and MDR in a single plasmid vector in MDR Klebsiella pneumoniae ST15. J Antimicrob Chemother 2019; 74(5): 12181222.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 86.

    Giske CG , Froding I , Hasan CM , Turlej-Rogacka A , Toleman M , Livermore D , et al. Diverse sequence types of Klebsiella pneumoniae contribute to the dissemination of blaNDM-1 in India, Sweden, and the United Kingdom. Antimicrob Agents Chemother 2012; 56(5): 27352738.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 87.

    Bean DC , Agarwal A , Cherian BP , Wareham DW . Hypermucoviscous polymyxin-resistant Klebsiella pneumoniae from Kolkata, India: genomic and phenotypic analysis. J Glob Antimicrob Resist 2019; 17: 12.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 88.

    Shelenkov A , Mikhaylova Y , Yanushevich Y , Samoilov A , Petrova L , Fomina V , et al. Molecular typing, characterization of antimicrobial resistance, virulence profiling and analysis of whole-genome sequence of clinical Klebsiella pneumoniae isolates. Antibiotics 2020; 9(5).

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 89.

    Klebsiella sequence typing. Available from: http://bigsdb.pasteur.fr (Accessed 10 April 2020).

 

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Senior editors

Editor-in-Chief: Prof. Dóra Szabó (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)

Managing Editor: Dr. Béla Kocsis (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)

Co-editor: Dr. Andrea Horváth (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)

Editorial Board

  • Prof. Éva ÁDÁM (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Sebastian AMYES (Department of Medical Microbiology, University of Edinburgh, Edinburgh, UK.)
  • Dr. Katalin BURIÁN (Institute of Clinical Microbiology University of Szeged, Szeged, Hungary; Department of Medical Microbiology and Immunobiology, University of Szeged, Szeged, Hungary.)
  • Dr. Orsolya DOBAY (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Ildikó Rita DUNAY (Institute of Inflammation and Neurodegeneration, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany)
  • Prof. Levente EMŐDY(Department of Medical Microbiology and Immunology, University of Pécs, Pécs, Hungary.)
  • Prof. Anna ERDEI (Department of Immunology, Eötvös Loránd University, Budapest, Hungary, MTA-ELTE Immunology Research Group, Eötvös Loránd University, Budapest, Hungary.)
  • Prof. Éva Mária FENYŐ (Division of Medical Microbiology, University of Lund, Lund, Sweden)
  • Prof. László FODOR (Department of Microbiology and Infectious Diseases, University of Veterinary Medicine, Budapest, Hungary)
  • Prof. József KÓNYA (Department of Medical Microbiology, University of Debrecen, Debrecen, Hungary)
  • Prof. Yvette MÁNDI (Department of Medical Microbiology and Immunobiology, University of Szeged, Szeged, Hungary)
  • Prof. Károly MÁRIALIGETI (Department of Microbiology, Eötvös Loránd University, Budapest, Hungary)
  • Prof. János MINÁROVITS (Department of Oral Biology and Experimental Dental Research, University of Szeged, Szeged, Hungary)
  • Prof. Béla NAGY (Centre for Agricultural Research, Institute for Veterinary Medical Research, Budapest, Hungary.)
  • Prof. István NÁSZ (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Kristóf NÉKÁM (Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary.)
  • Dr. Eszter OSTORHÁZI (Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary)
  • Prof. Rozália PUSZTAI (Department of Medical Microbiology and Immunobiology, University of Szeged, Szeged, Hungary)
  • Prof. Peter L. RÁDY (Department of Dermatology, University of Texas, Houston, Texas, USA)
  • Prof. Éva RAJNAVÖLGYI (Department of Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary)
  • Prof. Ferenc ROZGONYI (Institute of Laboratory Medicine, Semmelweis University, Budapest, Hungary)
  • Prof. Zsuzsanna SCHAFF (2nd Department of Pathology, Semmelweis University, Budapest, Hungary)
  • Prof. Joseph G. SINKOVICS (The Cancer Institute, St. Joseph’s Hospital, Tampa, Florida, USA)
  • Prof. Júlia SZEKERES (Department of Medical Biology, University of Pécs, Pécs, Hungary.)
  • Prof. Mária TAKÁCS (National Reference Laboratory for Viral Zoonoses, National Public Health Center, Budapest, Hungary.)
  • Prof. Edit URBÁN (Department of Medical Microbiology and Immunology University of Pécs, Pécs, Hungary; Institute of Translational Medicine, University of Pécs, Pécs, Hungary.)

 

Editorial Office:
Akadémiai Kiadó Zrt.
Budafoki út 187-187, A/3, H-1117 Budapest, Hungary

Editorial Correspondence:
Acta Microbiologica et Immunologica Hungarica
Institute of Medical Microbiology
Semmelweis University
P.O. Box 370
H-1445 Budapest, Hungary
Phone: + 36 1 459 1500 ext. 56101
Fax: (36 1) 210 2959
E-mail: amih@med.semmelweis-univ.hu

 Indexing and Abstracting Services:

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  • Science Citation Index Expanded
2020  
Total Cites 662
WoS
Journal
Impact Factor
2,048
Rank by Immunology 145/162(Q4)
Impact Factor Microbiology 118/137 (Q4)
Impact Factor 1,904
without
Journal Self Cites
5 Year 0,671
Impact Factor
Journal  0,38
Citation Indicator  
Rank by Journal  Immunology 146/174 (Q4)
Citation Indicator  Microbiology 120/142 (Q4)
Citable 42
Items
Total 40
Articles
Total 2
Reviews
Scimago 28
H-index
Scimago 0,439
Journal Rank
Scimago Immunology and Microbiology (miscellaneous) Q4
Quartile Score Medicine (miscellaneous) Q3
Scopus 438/167=2,6
Scite Score  
Scopus General Immunology and Microbiology 31/45 (Q3)
Scite Score Rank  
Scopus 0,760
SNIP
Days from  225
submission
to acceptance
Days from  118
acceptance
to publication
Acceptance 19%
Rate

2019  
Total Cites
WoS
485
Impact Factor 1,086
Impact Factor
without
Journal Self Cites
0,864
5 Year
Impact Factor
1,233
Immediacy
Index
0,286
Citable
Items
42
Total
Articles
40
Total
Reviews
2
Cited
Half-Life
5,8
Citing
Half-Life
7,7
Eigenfactor
Score
0,00059
Article Influence
Score
0,246
% Articles
in
Citable Items
95,24
Normalized
Eigenfactor
0,07317
Average
IF
Percentile
7,690
Scimago
H-index
27
Scimago
Journal Rank
0,352
Scopus
Scite Score
320/161=2
Scopus
Scite Score Rank
General Immunology and Microbiology 35/45 (Q4)
Scopus
SNIP
0,492
Acceptance
Rate
16%

 

Acta Microbiologica et Immunologica Hungarica
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Acta Microbiologica et Immunologica Hungarica
Language English
Size A4
Year of
Foundation
1954
Publication
Programme
2021 Volume 68
Volumes
per Year
1
Issues
per Year
4
Founder Magyar Tudományos Akadémia
Founder's
Address
H-1051 Budapest, Hungary, Széchenyi István tér 9.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 1217-8950 (Print)
ISSN 1588-2640 (Online)

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