{
    "abstract": "Klebsiella pneumoniae (K. pneumoniae) is a member of the ESKAPE group and is responsible for severe community and healthcare-associated infections. Certain Klebsiella species have very similar phenotypes, which presents a challenge in identifying K. pneumoniae. Multidrug-resistant K. pneumoniae is also a serious global problem that needs to be addressed. A total of 190 isolates were isolated from urine (n\u2009=\u200969), respiratory (n\u2009=\u200952), wound (n\u2009=\u200948) and blood (n\u2009=\u200921) samples collected from various hospitals in the Al-Qassim, Saudi Arabia, between March 2021 and October 2022. Our study aimed to rapidly and accurately detect K. pneumoniae using the Peptide Mass Fingerprinting (PMF) technique, confirmed by real-time PCR. Additionally, screening for antibiotic susceptibility and resistance was conducted. The primary methods for identifying K. pneumoniae isolates were culture, Gram staining, and the Vitek\u00ae 2 ID Compact system. An automated MALDI Biotyper (MBT) instrument was used for proteome identification, which was subsequently confirmed using SYBR green real-time polymerase chain reaction (real-time PCR) and microfluidic electrophoresis assays. Vitek\u00ae 2 AST-GN66 cards were utilized to evaluate the antimicrobial sensitivity of K. pneumoniae isolates. According to our results, Vitek\u00ae 2 Compact accurately identified 178 out of 190 (93.68%) K. pneumoniae isolates, while the PMF technique correctly detected 188 out of 190 (98.95%) isolates with a score value of 2.00 or higher. Principal component analysis was conducted using MBT Compass software to classify K. pneumoniae isolates based on their structure. Based on the analysis of the single peak intensities generated by MBT, the highest peak values were found at 3444, 5022, 5525, 6847, and 7537\u00a0m/z. K. pneumoniae gene testing confirmed the PMF results, with 90.53% detecting entrobactin, 70% detecting 16\u00a0S rRNA, and 32.63% detecting ferric iron uptake. The resistance of the K. pneumoniae isolates to antibiotics was as follows: 64.75% for cefazolin, 62.63% for trimethoprim/sulfamethoxazole, 59.45% for ampicillin, 58.42% for cefoxitin, 57.37% for ceftriaxone, 53.68% for cefepime, 52.11% for ampicillin-sulbactam, 50.53% for ceftazidime, 52.11% for ertapenem, and 49.47% for imipenem. Based on the results of the double-disk synergy test, 93 out of 190 (48.95%) K. pneumoniae isolates were extended-spectrum beta-lactamase. In conclusion, PMF is a powerful analytical technique used to identify K. pneumoniae isolates from clinical samples based on their proteomic characteristics. K. pneumoniae isolates have shown increasing resistance to antibiotics from different classes, including carbapenem, which poses a significant threat to human health as these infections may become difficult to treat.",
    "authors": [
        {
            "affiliation": "Department of Public Health, College of Applied Medical Sciences, Qassim University, Buraydah, 51452 , P.O. Box 6666, Saudi Arabia. e.marzouk@qu.edu.sa.",
            "firstname": "Eman",
            "initials": "E",
            "lastname": "Marzouk"
        },
        {
            "affiliation": "Department of Public Health, College of Applied Medical Sciences, Qassim University, Buraydah, 51452 , P.O. Box 6666, Saudi Arabia.",
            "firstname": "Adil",
            "initials": "A",
            "lastname": "Abalkhail"
        },
        {
            "affiliation": "Family Medicine Department, King Fahad Armed Hospital, 23311, Jeddah, Saudi Arabia.",
            "firstname": "Jamaan",
            "initials": "J",
            "lastname": "ALqahtani"
        },
        {
            "affiliation": "Pharmacy Department, Prince Sultan Armed Forces Hospital, 42375, Medina, Saudi Arabia.",
            "firstname": "Khalid",
            "initials": "K",
            "lastname": "Alsowat"
        },
        {
            "affiliation": "Dental Department, King Salman Armed Forces Hospital, 47521, Tabuk, Saudi Arabia.",
            "firstname": "Menwer",
            "initials": "M",
            "lastname": "Alanazi"
        },
        {
            "affiliation": "Department of Food Service, King Fahad Armed Forces Hospital, 23311, Jeddah, Saudi Arabia.",
            "firstname": "Feras",
            "initials": "F",
            "lastname": "Alzaben"
        },
        {
            "affiliation": "Psychiatry Department, Prince Sultan Military Medical City, 11632, Riyadh, Saudi Arabia.",
            "firstname": "Abdulaziz",
            "initials": "A",
            "lastname": "Alnasser"
        },
        {
            "affiliation": "Neurology department, king Fahad military hospital, 23311, Jeddah, Saudi Arabia.",
            "firstname": "Anas",
            "initials": "A",
            "lastname": "Alasmari"
        },
        {
            "affiliation": "Biology Department, College of Science, Jouf University, 42421, Sakaka, Saudi Arabia.\nBotany and Microbiology Department, Faculty of Science, Al-Azhar University, 71524, Assiut, Egypt.",
            "firstname": "Mohammed",
            "initials": "M",
            "lastname": "Rawway"
        },
        {
            "affiliation": "Department of Veterinary Preventive Medicine, College of Veterinary Medicine, Qassim University, 52571, Buraydah, Saudi Arabia.",
            "firstname": "Abdelmaged",
            "initials": "A",
            "lastname": "Draz"
        },
        {
            "affiliation": "Department of Veterinary Preventive Medicine, College of Veterinary Medicine, Qassim University, 52571, Buraydah, Saudi Arabia.",
            "firstname": "Akram",
            "initials": "A",
            "lastname": "Abu-Okail"
        },
        {
            "affiliation": "Department of Food Since, King Saud University, Riyadh, Saudi Arabia.",
            "firstname": "Abdulmohsen",
            "initials": "A",
            "lastname": "Altwijery"
        },
        {
            "affiliation": "Department of Botany and Microbiology, College of Science, King Saud University, 11451, Riyadh, Saudi Arabia.",
            "firstname": "Ihab",
            "initials": "I",
            "lastname": "Moussa"
        },
        {
            "affiliation": "Medical Administration, Armed Forces Medical Services, 12426, Riyadh, Saudi Arabia.",
            "firstname": "Sulaiman",
            "initials": "S",
            "lastname": "Alsughayyir"
        },
        {
            "affiliation": "Prince Sultan Military Medical City, 13525, Riyadh, Saudi Arabia.",
            "firstname": "Saleh",
            "initials": "S",
            "lastname": "Alamri"
        },
        {
            "affiliation": "Laboratory Department, Armed Forces Center for Health Rehabilitation, 21944, Taif, Saudi Arabia.",
            "firstname": "Mohammed",
            "initials": "M",
            "lastname": "Althagafi"
        },
        {
            "affiliation": "Physiotherapy Department, Armed Forces Center for Health Rehabilitation, 21944, Taif, Saudi Arabia.",
            "firstname": "Abdulrahman",
            "initials": "A",
            "lastname": "Almaliki"
        },
        {
            "affiliation": "Department of Public Health, College of Applied Medical Sciences, Qassim University, Buraydah, 51452 , P.O. Box 6666, Saudi Arabia.",
            "firstname": "Ahmed Elnadif",
            "initials": "AE",
            "lastname": "Elmanssury"
        },
        {
            "affiliation": "Department of Public Health, College of Applied Medical Sciences, Qassim University, Buraydah, 51452 , P.O. Box 6666, Saudi Arabia.",
            "firstname": "Ayman",
            "initials": "A",
            "lastname": "Elbehiry"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s13568-024-01710-7\n10.3390/app122110803\n10.1128/AAC.05100-14\n10.5897/AJMR2016.8051\n10.7717/peerj.15007\n10.3390/diagnostics12112645\n10.1016/j.bsheal.2021.11.001\n10.1080/22221751.2022.2030196\n10.3923/pjbs.2019.174.179\n10.3390/pathogens10091097\n10.1080/14787210.2018.1522249\n10.1016/j.envint.2023.108089\n10.1155/2022/5419874\n10.1099/jmm.0.081448-0\n10.26502/ami.936500105\n10.1016/j.mimet.2012.10.014\n10.1097/INF.0000000000002487\n10.1007/s10096-023-04577-x\n10.1016/j.resmic.2021.103835\n10.1089/mdr.2018.0027\n10.1016/j.tmaid.2022.102312\n10.18054/pb.2016.118.1.3160\n10.1016/j.biotechadv.2013.11.002\n10.1186/s12866-020-01727-5\n10.1002/jcla.24655\n10.1128/CMR.00072-12\n10.3390/pathogens12050634\n10.1016/j.cmi.2015.09.030\n10.3390/antibiotics12091465\n10.1016/j.cmi.2022.05.017\n10.1016/j.mimet.2022.106434\n10.1016/j.patbio.2012.10.004\n10.1186/s12864-023-09708-4\n10.1016/j.sjbs.2020.11.052\n10.1016/j.sjbs.2021.01.018\n10.3390/vaccines10122100\n10.3390/vaccines10111881\n10.3390/diagnostics13172825\n10.3390/antibiotics12020191\n10.1186/s13568-024-01675-7\n10.1186/s12879-023-08563-8\n10.3390/microbiolres14010008\n10.1016/j.micpath.2022.105746\n10.1128/JCM.42.8.3665-3669.2004\n10.1016/j.jfda.2019.01.001\n10.1038/s41598-023-38871-7\n10.9735/0975-5276.4.6.253-257\n10.1002/jin2.48\n10.2147/IDR.S275852\n10.1002/jcla.22002\n10.1038/s41598-023-31086-w\n10.5958/2320-3188.2020.00022.4\n10.1016/j.jiph.2020.12.001\n10.1016/j.meegid.2012.10.012\n10.1186/s12941-018-0302-9\n10.1089/mdr.2018.0414\n10.3389/fmicb.2019.00539\n10.1016/j.ijid.2019.11.024\n10.2147/IDR.S351755\n10.1038/s43856-023-00259-z\n10.1099/acmi.0.000096\n10.1128/MMBR.00078-15\n10.1002/jobm.201700008\n10.1016/j.cmi.2020.05.012\n10.1007/s13213-015-1083-4\n10.1128/CMR.11.4.589\n10.1007/s11274-022-03343-z\n10.4103/ijmm.IJMM_19_157\n10.1016/j.jgar.2020.12.015\n10.3390/antibiotics10111312\n10.1128/jcm.00776-18\n10.3390/antibiotics8030085\n10.1186/s40792-016-0201-2\n10.3389/fmicb.2022.1031688\n10.1155/2020/6398165\n10.1093/cid/ciaa1478\n10.1016/j.jmii.2017.07.003\n10.2147/IDR.S337611\n10.3390/molecules25204775\n10.1128/mbio.00089-19\n10.3390/ijerph17176278\n10.1038/srep38929\n10.1080/22221751.2022.2140607\n10.1016/j.mib.2015.11.007\n10.1128/jcm.01381-18\n10.1186/s12866-023-02974-y\n10.1086/503420\n10.3389/fmicb.2018.00289\n10.7717/peerj.16161",
    "journal": "AMB Express",
    "keywords": [
        "Klebsiella pneumoniae",
        "Antibiotic resistance",
        "Genomic analysis",
        "Proteome identification",
        "Public health"
    ],
    "methods": null,
    "publication_date": "2024-05-09",
    "pubmed_id": "38722429\n25801565\n32999783\n37013147\n22958584\n36359489\n35034585\n31930818\n34578130\n30207815\n37441817\n36105930\n25261063\n23154044\n31738343\n36806056\n34004273\n30142035\n35304330\n24211254\n32070273\n35949048\n23824373\n25275000\n37242304\n26806135\n37760762\n35623578\n35176354\n16758790\n23218835\n37828442\n33424412\n33911924\n36560510\n36366389\n37685363\n36830102\n38329626\n18062647\n37670240\n36064103\n15297514\n30987712\n37468757\n30443410\n33603418\n27239799\n36932105\n18787738\n33412373\n23159555\n30665418\n31613200\n34447478\n30988669\n31770618\n35241915\n36823379\n32974573\n27307579\n28397262\n32461145\n9767057\n35788443\n31745021\n33401014\n34827250\n29925642\n31252510\n37444780\n27457077\n36439817\n32382563\n12682115\n16192445\n33106864\n28736222\n34707380\n33080897\n20110386\n30914502\n32872324\n28004732\n36287114\n26803404\n30567749\n37660028\n16826492\n16619144\n29545778\n37780376",
    "results": null,
    "title": "Proteome analysis, genetic characterization, and antibiotic resistance patterns of Klebsiella pneumoniae clinical isolates.",
    "xml": "<Element 'PubmedArticle' at 0x788505c21d50>"
}