{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T14:56:59Z","timestamp":1794409019477,"version":"4.9.0"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    ) is a major cause of urinary tract infections (UTIs) and poses a growing public health concern due to multidrug resistance and virulence potential. This study aimed to characterize antimicrobial resistance, biofilm formation, and virulence gene distribution among urinary\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates from North Lebanon and to explore correlations between these factors. A total of 153 non\u2010duplicate isolates from hospital and community settings were analyzed for antibiotic susceptibility, hypermucoviscosity, biofilm formation, and presence of key virulence (fimH, mrkD, magA, rmpA, entB, iucA, iroN, kfu) and \u03b2\u2010lactamase (blaTEM, blaSHV, blaCTX\u2010M) genes. Adhesion\u2010associated genes fimH and mrkD were highly prevalent, particularly in hospital\u2010acquired and strong biofilm\u2010producing isolates. Capsular and regulatory genes (magA) was more frequent in putative hypervirulent and community\u2010acquired strains, while siderophore genes entB and iucA were strongly associated with biofilm formation and hospital\u2010acquired infections. A significantly higher resistance to cephalosporins, along with an increased frequency of multidrug\u2010resistant phenotypes, was detected in hospital\u2010acquired, classical, and strong biofilm\u2010forming isolates. ESBL production was significantly more common in hospital\u2010acquired and biofilm\u2010forming isolates. Strong biofilm formation was largely associated with classical\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    and hospital\u2010acquired infections, whereas putative hypervirulent strains were primarily weak biofilm producers and community\u2010acquired. These findings highlight the interplay between virulence determinants, biofilm formation, and antibiotic resistance, emphasizing the need for targeted infection control and treatment strategies in North Lebanon.\n                  <\/jats:p>","DOI":"10.1002\/mbo3.70336","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T03:37:48Z","timestamp":1781753868000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Interplay Between Virulence Genes, Antimicrobial Resistance Profiles, and Biofilm Formation in\n                    <i>Klebsiella pneumoniae<\/i>\n                    Causing Urinary Tract Infections in North Lebanon"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0051-790X","authenticated-orcid":false,"given":"Mazen","family":"Zaylaa","sequence":"first","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayan","family":"Farha","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Faculty of Health Sciences Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Taleb","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Faculty of Health Sciences Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Saad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar El","family":"Gharbawy","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Sarraf","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Monla Hospital Tripoli Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibtihal","family":"Kassam","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Dar Al Shifa Hospital Tripoli Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadi","family":"Hamdach","sequence":"additional","affiliation":[{"name":"Department of Microbiology Kadisha Medical Laboratories Tripoli Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisrine","family":"Bissar","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Technology, Faculty of Health Sciences Beirut Arab University Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2019.041"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13353-024-00893-w"},{"key":"e_1_2_11_4_1","volume-title":"StatPearls. Treasure Island (FL)","author":"Ashurst J. V.","year":"2025"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.18502\/ijph.v50i5.6118"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.738223"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-024-00215-7"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12122548"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000309"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2016.10.009"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S396609"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.561741"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2026.108305"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlad074"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2021.104743"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2018.03198"},{"key":"e_1_2_11_17_1","first-page":"1802115","volume-title":"Canadian Journal of Infectious Diseases and Medical Microbiology","author":"Gao X.","year":"2024"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.877995"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10071-24957"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2023.2234082"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph18050724"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43856-025-01112-1"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-20474-0"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mlf2.70029"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.01964.x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12020234"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2016.1244611"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-31086-w"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12866-021-02413-w"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2024.1324895"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1238482"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2020.1809322"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.22092\/ari.2022.357626.2076"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13568-021-01282-w"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-92549-w"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.04121-22"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-46221-w"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-46221-w"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1179\/2047773215Y.0000000030"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.14202\/vetworld.2022.2172-2179"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12071143"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2024.116595"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2024.116595"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms12122469"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1556\/030.2022.01908"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/jam.13533"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.3390\/vetsci12070628"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2019.103647"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2018.00021"}],"container-title":["MicrobiologyOpen"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mbo3.70336","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mbo3.70336","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mbo3.70336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:53:02Z","timestamp":1782467582000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mbo3.70336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/mbo3.70336"],"URL":"https:\/\/doi.org\/10.1002\/mbo3.70336","archive":["Portico"],"relation":{},"ISSN":["2045-8827","2045-8827"],"issn-type":[{"value":"2045-8827","type":"print"},{"value":"2045-8827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-01-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70336"}}