The Increased Prevalence of rmpA Gene in Klebsiella pneumoniae Isolates Coharboring bla NDM and bla OXA-48-like Genes.

The emergence of carbapenemase-producing Klebsiella pneumoniae poses a substantial risk to public health. It is essential to comprehend the influence of carbapenemase on the virulence characteristics of K. pneumoniae in order to devise successful strategies for combating these infections. In this study, we explored the distribution disparity of virulence determinants between carbapenemase-producing (CP-Kp, n = 52) and carbapenemase-nonproducing (CN-Kp, n = 43) isolates. The presence of carbapenemases was detected via the modified carbapenem inactivation method and confirmed by PCR. The New Delhi metallo-β-lactamase ( bla NDM ) and Oxacillinase-48-like ( bla OXA-48-like ) genes were the most prevalent (94.23% and 76.92%, respectively) in CP-Kp isolates. Coexistence of bla NDM and bla OXA-48-like was observed in 71.15% of isolates, whereas 5.77% coharbored bla NDM and bla KPC . PCR analysis revealed the presence of several virulence genes, including adhesins ( fimH , 92.63%, mrkD , 97.89%), capsule-associated virulence ( uge , 90.53%), the K2 capsule serotype ( k2 , 6.32%), the iron acquisition system ( kfu , 23.16%), and the regulator of mucoid phenotype ( rmpA , 28.42%). A significantly higher prevalence of rmpA was detected in the CP-Kp compared with the CN-Kp (24/52 vs. 3/43, p < 0.0001), indicating a potential association between rmpA and carbapenemase acquisition. In addition, the majority of rmpA (22/24) positive isolates in the CP-Kp isolates coharbored bla NDM and either bla OXA-48-like or bla KPC .