Bacteriological and Molecular Detection of Klebsiella oxytoca and its Resistance to Antibiotics among Clinical Specimens from Kirkuk, Iraq

Document Type : Original Articles


Department of Biology, Faculty of Education for Pure Science, University of Kirkuk, Kirkuk, Iraq


Klebsiella spp. are gram-negative bacteria that are considered serious public health problems causing urinary tract infections, bloodstream infections, pneumonia infections, and soft tissue infections. This study was designed to investigate the prevalence of Klebsiella oxytoca (K. oxytoca) among clinical samples and determine their resistance against various antimicrobial medicines with molecular identification of K. oxytoca by polymerase chain reaction (PCR) technique using a specific sequence of pehX gene. A total of 250 clinical samples including throat, wound, and vaginal swabs were obtained. Participants were of both genders and different ages. The samples were streaked on the blood and MacConkey agars. Antibiotic sensitivity test was made by modified Kirby-Bauer disc diffusion technique. Molecular identification of K. oxytoca was performed for all isolates. Out of 250 clinical samples, K. oxytoca was reported in 32 (12.8%) cases. The highest prevalence was observed in 18(18%) cases of throat swabs, 16 (16%) cases of wound swabs, and 6 (6%) cases of vagina swabs. By the way, female cases were more affected 22 (14.5%) with K. oxytoca than male cases 10 (10.10%).  Infected participants aged 15-40 years were more affected with K. oxytoca (23, 12.73%) compared to patients aged 41-65 years (9, 9.67%). The highest resistance pattern of K. oxytoca was 100% against Augmentin, Ampicillin, Cephalothin, Piperacillin, and Rifampin on one hand, and 62.50%, 59.37%, 53.12%, 53.12%, and 50% against Ceftazidime, Cefixime, Cefotaxime, Trimethoprim, and Aztreonam on the other hand, respectively. The highest sensitivity was observed against Amikacin and Imipenem (9.37%) and it was 21.87%, 21.87%, 25%, 25%, 28.12%, 28.12%, and 28.12% against Meropenem, Chloramphenicol, Nalidixic acid, Ciprofloxacin, Tobramycin, Gentamicin, and Doxycycline, respectively. Through molecular identification of K. oxytoca, all isolates showed a PCR product with 344-bp specific primer (pehX) that performed the K. oxytoca.


Main Subjects

  1. Zedan TH. Molecular Discrimination of Klebsiella oxytoca using Polymerase Chain Reaction Targeted Polygalacturonase (pehX) Gene. Int J Curr Microbiol App Sci. 2017;6(6):2092-8.
  2. Izdebski R, Fiett J, Urbanowicz P, Baraniak A, Derde LP, Bonten MJ, et al. Phylogenetic lineages, clones and beta-lactamases in an international collection of Klebsiella oxytoca isolates non-susceptible to expanded-spectrum cephalosporins. J Antimicrob Chemother. 2015;70(12):3230-7.
  1. Chander Y, Ramakrishnan M, Jindal N, Hanson K, Goyal SM. Differentiation of Klebsiella pneumoniae and K. oxytoca by multiplex polymerase chain reaction. Int J Appl ResVet Med. 2011;9(2):138.
  2. Weberhofer P. The Role of Klebsiella oxytoca in Antibiotic-Associated Colitis: Comparison of Polymerase Chain Reaction as a New Detection Method for K. oxytoca to Conventional API 20 E Testing: Medizinische Universiät; 2008.
  3. Chakraborty S, Mohsina K, Sarker PK, Alam MZ, Karim MIA, Sayem SMA. Prevalence, antibiotic susceptibility profiles and ESBL production in Klebsiella pneumoniae and Klebsiella oxytoca among hospitalized patients. Period Biol. 2016;118(1).
  4. Ahmed Hasan S, Fakhraddin Raheem T, Mohammed Abdulla H. Phenotypic, Antibiotyping, and Molecular Detection of Klebsiella Pneumoniae Isolates from Clinical Specimens in Kirkuk, Iraq. Arch Razi Inst. 2021;76(4):1061.
  5. Munita JM, Arias CA. Mechanisms of Antibiotic Resistance. Microbiol Spectr. 2016;4(2).
  6. Younis A, Elbialy A, Abo Remila E, Ammar A. Molecular Detection of Genus Klebsiella and Genotypic Identification of Klebsiella pneumoniae and Klebsiella oxytoca by Duplex Polymerase Chain Reaction in Poultry. Glob Vet. 2017;18(3):234-41.
  7. Hasan SA, Abass KS. Prevalence of Gram Negative Bacteria Isolated from Patients with Burn Infection and their Antimicrobial Susceptibility Patterns in Kirkuk City, Iraq. Indian J Public Health Res Dev. 2019;10(8).
  8. Hasan SA, Najati AM, Abass KS. Isolation and identification of multi-drug resistant “pseudomonas aeruginosa” from burn wound infection in Kirkuk City, Iraq. Eurasia J Biosci. 2019;13(2):1045-50.
  1. Hasan SA, Najati AM, Abass KS. Prevalence and antibiotic resistance of “pseudomonas aeruginosa” isolated from clinical samples in Kirkuk City, Iraq. Eurasia J Biosci. 2020;14(1):1821-5.
  2. Hasan SA, Saleh I, Ali H. Bacteriological and Molecular Detection of Staphylococcus Aureus and its Resistance to Methicillin among Specimens from Kirkuk Community. Ann Rom Soc Cell Biol. 2021;25(7):461-73.
  3. Al-Khikani FH. Antimicrobial Resistance Profile Among Major Bacterial Pathogens in Southern Babil, Iraq. Galician Med J. 2020;27(3):202036.
  4. AL-Khikani FHO, Abadi RM, Ayit AS. Emerging carbapenemase Klebsiella oxytoca with multidrug resistance implicated in urinary tract infection. Biom Biotechnol Res J. 2020;4(2):148.
  1. Kovtunovych G, Lytvynenko T, Negrutska V, Lar O, Brisse S, Kozyrovska N. Identification of Klebsiella oxytoca using a specific PCR assay targeting the polygalacturonase pehX gene. Res Microbiol. 2003;154(8):587-92.
  2. Kline KA, Falker S, Dahlberg S, Normark S, Henriques-Normark B. Bacterial adhesins in host-microbe interactions. Cell Host Microbe. 2009;5(6):580-92.
  3. Park JS, Hong KH, Lee HJ, Choi SH, Song SH, Song KH, et al. Evaluation of three phenotypic identification systems for clinical isolates of Raoultella ornithinolytica. J Med Microbiol. 2011;60(Pt 4):492-9.
  4. Stojowska-Swedrzynska K, Krawczyk B. A new assay for the simultaneous identification and differentiation of Klebsiella oxytoca strains. Appl Microbiol Biotechnol. 2016;100(23):10115-23.
  5. Turton JF, Perry C, Elgohari S, Hampton CV. PCR characterization and typing of Klebsiella pneumoniae using capsular type-specific, variable number tandem repeat and virulence gene targets. J Med Microbiol. 2010;59(5):541-7.