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Sample: Clinical specimens (blood, urine, sputum, wound swabs) will be collected aseptically and transported to the microbiology laboratory for analysis.
Culture: Specimens will be inoculated on MacConkey agar and incubated at 35-37°C for 18-24 hours. Colonies with typical K. pneumoniae morphology (mucoid, lactose-fermenting) will be selected for further testing
Identification of isolates will be done by:
Colony morphology, Gram staining, and conventional biochemical tests (eg, indole, citrate utilization, urease, Voges-Proskauer) .
Antimicrobial susceptibility testing of the isolates :
Antimicrobial susceptibility testing was performed and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, M100 document (latest edition)."
MIC determination for cifederecol using E-test .
Phenotypic Detection of hvKP:
Detection of siderophore genes by Simple qualitative PCR .
Klebsiella pneumoniae ( K.pneumoniae ) is a Gram-negative, encapsulated, non-motile bacterium of the Enterobacteriaceae family and a major pathogen responsible for a broad spectrum of healthcare- and community-acquired infections, including pneumonia, urinary tract infections, bloodstream infections, and pyogenic liver abscesses
Sample: Clinical specimens (blood, urine, sputum, wound swabs) will be collected aseptically and transported to the microbiology laboratory for analysis.
Culture: Specimens will be inoculated on MacConkey agar and incubated at 35-37°C for 18-24 hours. Colonies with typical K. pneumoniae morphology (mucoid, lactose-fermenting) will be selected for further testing
Identification of isolates will be done by:
Colony morphology, Gram staining, and conventional biochemical tests (eg, indole, citrate utilization, urease, Voges-Proskauer) .
Antimicrobial susceptibility testing of the isolates :
Antimicrobial susceptibility testing was performed and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) guidelines, M100 document (latest edition)."
MIC determination for cifederecol using E-test .
Phenotypic Detection of hvKP:
Detection of siderophore genes by Simple qualitative PCR .
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| • Cefiderocol susceptible CR-hvKP isolates | Clinical carbapenem-resistant hypervirulent Klebsiella pneumoniae isolates that test positive for siderophore genes. These isolates will be evaluated for susceptibility to cefiderocol using standard antimicrobial susceptibility testing methods. |
| |
| Cefiderocol resistant CR-hvKP isolates | Clinical isolates of carbapenem-resistant hypervirulent Klebsiella pneumoniae collected from clinical samples. Isolates will be tested for the presence of siderophore genes and their susceptibility to cefiderocol using standard antimicrobial susceptibility testing methods. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cefiderocol susceptibility testing | Diagnostic Test | Determination of cefiderocol susceptibility in carbapenem-resistant hypervirulent Klebsiella pneumoniae isolates using antimicrobial susceptibility testing according to CLSI guidelines. |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of cefiderocol-susceptible CR-hvKP isolates (%) | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of siderophore-associated genes among CR-hvKP isolates (%) | 6 months | |
| Difference in cefiderocol susceptibility rates between siderophore gene-positive and siderophore gene-negative CR-hvKP isolates (%) | 6 months |
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Inclusion Criteria:
- 1. Patients with hypervirulant K. pneumoniae infection from various clinical specimens (blood, urine, sputum, wound swabs, etc.) Confirmed by culture and initial laboratory testing .
2. Age and sex range: any age and any sex.
Exclusion Criteria:
- Patients who received antibiotic treatment in the 48 hours prior to sample collection.
2. Patients with incomplete clinical data or inadequate samples.
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All selected patients subjected to complete history all samples transported to medical microbiology department
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lobna Rashad | Contact | +20 114 7448161 | lobna.rashad@med.sohag.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine | Sohag | Egypt |
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Bacterial isolates of carbapenem-resistant hypervirulent Klebsiella pneumoniae from clinical specimens. Genomic DNA will be extracted and stored for molecular detection of siderophore and virulence genes.