The Open Microbiology Journal

ISSN: 1874-2858 ― Volume 14, 2020

Study of Various Virulence Genes, Biofilm Formation and Extended-Spectrum β-lactamase Resistance in Klebsiella pneumoniae Isolated from Urinary Tract Infections

Sanaa S. Hamam2, Reem M. El Kholy3, Maysaa E. S. Zaki1, *
1 Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2 Medical Microbiology & Immunology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
3 Clinical Pathology, Faculty of Medicine, Menoufia University- Menoufia, Egypt



The aims of the current study were to evaluate the capacity of K. pneumoniae isolated from hospital-acquired urinary tract infection to form biofilm, the relation of this capacity to various virulence genes and the prevalence of Extended Spectrum β-lactamases (ESBL) among these isolates by phenotypic and genotypic methods.

Material and Methods:

The study included 100 non-duplicate strains of K. pneumoniae isolated from 100 different urine samples from patients with hospital-acquired urinary tract infection. The isolated strains were studied for biofilm formation, ESBL production by phenotypic methods. Molecular studies were applied for the detection of ESβLs genes blaTEM, blaSHV, blaCTX-M and for detection of virulence genes fimH, uge, rmpA, mag A, wzy, kfa and aerobactin genes.


The majority of the isolates had the capacity to form a biofilm (81%), with ESBL prevalence rate 41%. The most prevalent gene among ESBL producing K. pneumoniae was blaCTX-M (73.2%) followed by blaSHV (53.6%) and blaTEM (51.2%). Among the virulence genes studied in K. pneumoniae isolates, the most prevalent gene was fimH (76%), uge (70%). There was significant association between ESBL production, and resistance to amikacin, cefepime, ceftazidime, gentamicin, imipenem and meropenem and biofilm production in K. pneumoniae isolates. There was significant association between blaCTX-M, blaSHV, fimH, mag, kfa, wzy, rmpA and aerobactin and biofilm production in K. pneumoniae.


The present study highlights the prevalence of virulence genes among biofilm-forming strains of K. pneumoniae isolated from hospital-acquired urinary tract infection. Moreover, there was association between biofilm formation and ESBL production. Further studies are required to elucidate the clinical impact of the association of these different mechanisms.

Keywords: ESBL, Biofilm, K. pneumoniae, PCR, Virulence genes, Phenotypic methods.

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 249
Last Page: 255
Publisher Id: TOMICROJ-13-249
DOI: 10.2174/1874285801913010249

Article History:

Received Date: 26/04/2019
Revision Received Date: 02/09/2019
Acceptance Date: 05/09/2019
Electronic publication date: 30/09/2019
Collection year: 2019

© 2019 Hamam et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Tel: 0020502258877;

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