{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:48:36Z","timestamp":1791852516296,"version":"4.3.4"},"reference-count":83,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UKRI MRC","award":["MR\/M01360X\/1"],"award-info":[{"award-number":["MR\/M01360X\/1"]}]},{"name":"UKRI MRC","award":["MR\/N010469\/1"],"award-info":[{"award-number":["MR\/N010469\/1"]}]},{"name":"UKRI MRC","award":["MR\/R025576\/1"],"award-info":[{"award-number":["MR\/R025576\/1"]}]},{"name":"UKRI MRC","award":["MR\/R020973\/1"],"award-info":[{"award-number":["MR\/R020973\/1"]}]},{"name":"UKRI MRC","award":["MR\/X005895\/1"],"award-info":[{"award-number":["MR\/X005895\/1"]}]},{"name":"UKRI MRC","award":["EP\/Y018842\/1"],"award-info":[{"award-number":["EP\/Y018842\/1"]}]},{"name":"EPSRC","award":["MR\/M01360X\/1"],"award-info":[{"award-number":["MR\/M01360X\/1"]}]},{"name":"EPSRC","award":["MR\/N010469\/1"],"award-info":[{"award-number":["MR\/N010469\/1"]}]},{"name":"EPSRC","award":["MR\/R025576\/1"],"award-info":[{"award-number":["MR\/R025576\/1"]}]},{"name":"EPSRC","award":["MR\/R020973\/1"],"award-info":[{"award-number":["MR\/R020973\/1"]}]},{"name":"EPSRC","award":["MR\/X005895\/1"],"award-info":[{"award-number":["MR\/X005895\/1"]}]},{"name":"EPSRC","award":["EP\/Y018842\/1"],"award-info":[{"award-number":["EP\/Y018842\/1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The emergence of hypervirulent and carbapenem-resistant hypermucoviscous Klebsiella pneumoniae strains presents a significant public health challenge due to their increased virulence and resistance to multiple antibiotics. This study evaluates the antibiotic susceptibility patterns and virulence profiles of classical and hypervirulent K. pneumoniae strains isolated from various clinical samples. A total of 500 clinical samples were collected from patients at the Mardan Medical Complex and Ayub Medical Complex in KPK between July 2022 and June 2024. Among these, 64 K. pneumoniae strains were isolated and subsequently subjected to antimicrobial susceptibility testing (AST) and phenotypic virulence detection. Among the 64 isolates, 21 (32.8%) exhibited hypermucoviscosity, a characteristic associated with increased pathogenicity. Hemagglutination was observed in 35 (54.1%) of the isolates, indicating the presence of surface adhesins that facilitate bacterial adherence to host tissues. A high prevalence of biofilm formation was noted, with 54 (84%) isolates capable of forming biofilms, which are known to protect bacteria from antibiotics and the host immune response. Most isolates (59\/64, 92.1%) were resistant against ampicillin, highlighting its limited efficacy against these strains. Conversely, the lowest resistance was observed for tigecycline, with only 15% (10\/64) of the isolates showing resistance, indicating its potential utility as a treatment option. The study also found that 38 (59.3%) of the isolates were extended-spectrum beta-lactamase (ESBL) producers, 42 (65.6%) were multidrug-resistant (MDR), 32 (50%) were extensively drug-resistant (XDR), and 13 (20.3%) were resistant to carbapenems. The genetic study revealed biofilm producer and enhancer genes (mrkD, pgaABCD, fimH, treC, wzc, pilQ, and luxS) mainly in the hypervirulent strains. These hypervirulent strains also show a high number of resistance genes. The findings of this study underscore the critical need for the active surveillance of antimicrobial resistance and virulence determinants in K. pneumoniae. The coexistence of high levels of antibiotic resistance and virulence factors in these isolates poses a severe threat to public health, as it can lead to difficult-to-treat infections and increased morbidity and mortality.<\/jats:p>","DOI":"10.3390\/pathogens14010079","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T11:32:29Z","timestamp":1736940749000},"page":"79","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Antibiotic Susceptibility Patterns and Virulence Profiles of Classical and Hypervirulent Klebsiella pneumoniae Strains Isolated from Clinical Samples in Khyber Pakhtunkhwa, Pakistan"],"prefix":"10.3390","volume":"14","author":[{"family":"Azra","sequence":"first","affiliation":[{"name":"Institute of Pathology and Diagnostic Medicines, IPDM, Khyber Medical University Peshawar, Peshawar 25000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taj Ali","family":"Khan","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Diagnostic Medicines, IPDM, Khyber Medical University Peshawar, Peshawar 25000, Pakistan"},{"name":"Emerging Pathogens Institute, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0806-6907","authenticated-orcid":false,"given":"Ihtisham","family":"Ul Haq","sequence":"additional","affiliation":[{"name":"Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, 44-100 Gliwice, Poland"},{"name":"Joint Doctoral School, Silesian University of Technology, 44-100 Gliwice, Poland"},{"name":"Postgraduate Program in Technological Innovation, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woranich","family":"Hinthong","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Campino","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"},{"name":"Faculty of Epidemiology and Population Health, School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisha","family":"Gohar","sequence":"additional","affiliation":[{"name":"Microbiology Department, Bacha Khan Medical College Mardan, Mardan 23200, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8402-0249","authenticated-orcid":false,"given":"Noman","family":"Khan","sequence":"additional","affiliation":[{"name":"Al Rasheed Hospital & Kidney Center, Opposite Gilani Mart, Maneshra Road, Abbottabad 22020, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Kashif","sequence":"additional","affiliation":[{"name":"Public Health Reference Laboratory, Khyber Medical University Peshawar, Peshawar 25000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihsan","family":"Ullah","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Diagnostic Medicines, IPDM, Khyber Medical University Peshawar, Peshawar 25000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8985-9265","authenticated-orcid":false,"given":"Taane G.","family":"Clark","sequence":"additional","affiliation":[{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1128\/CMR.11.4.589","article-title":"Klebsiella spp. as nosocomial pathogens: Epidemiology, taxonomy, typing methods, and pathogenicity factors","volume":"11","author":"Podschun","year":"1998","journal-title":"Clin. 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