{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:29:18Z","timestamp":1789961358927,"version":"4.0.1"},"reference-count":64,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T00:00:00Z","timestamp":1619049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Universidad Central de Chile","award":["CIP2019007"],"award-info":[{"award-number":["CIP2019007"]}]},{"name":"Fondecyt","award":["1180673"],"award-info":[{"award-number":["1180673"]}]},{"DOI":"10.13039\/100000006","name":"Office of Naval Research","doi-asserted-by":"publisher","award":["N62909-18-1-2180"],"award-info":[{"award-number":["N62909-18-1-2180"]}],"id":[{"id":"10.13039\/100000006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background: The extended-spectrum beta-lactamase (ESBL) Klebsiella pneumoniae is one of the leading causes of health-associated infections (HAIs), whose antibiotic treatments have been severely reduced. Moreover, HAI bacteria may harbor pathogenic factors such as siderophores, enzymes, or capsules, which increase the virulence of these strains. Thus, new therapies, such as antimicrobial photodynamic inactivation (aPDI), are needed. Method: A collection of 118 clinical isolates of K. pneumoniae was characterized by susceptibility and virulence through the determination of the minimum inhibitory concentration (MIC) of amikacin (Amk), cefotaxime (Cfx), ceftazidime (Cfz), imipenem (Imp), meropenem (Mer), and piperacillin\u2013tazobactam (Pip\u2013Taz); and, by PCR, the frequency of the virulence genes K2, magA, rmpA, entB, ybtS, and allS. Susceptibility to innate immunity, such as human serum, macrophages, and polymorphonuclear cells, was tested. All the strains were tested for sensitivity to the photosensitizer PSIR-3 (4 \u00b5g\/mL) in a 17 \u00b5W\/cm2 for 30 min aPDI. Results: A significantly higher frequency of virulence genes in ESBL than non-ESBL bacteria was observed. The isolates of the genotype K2+, ybtS+, and allS+ display enhanced virulence, since they showed higher resistance to human serum, as well as to phagocytosis. All strains are susceptible to the aPDI with PSIR-3 decreasing viability in 3log10. The combined treatment with Cfx improved the aPDI to 6log10 for the ESBL strains. The combined treatment is synergistic, as it showed a fractional inhibitory concentration (FIC) index value of 0.15. Conclusions: The aPDI effectively inhibits clinical isolates of K. pneumoniae, including the riskier strains of ESBL-producing bacteria and the K2+, ybtS+, and allS+ genotype. The aPDI with PSIR-3 is synergistic with Cfx.<\/jats:p>","DOI":"10.3390\/pharmaceutics13050603","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T13:59:14Z","timestamp":1619099954000},"page":"603","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effective Photodynamic Therapy with Ir(III) for Virulent Clinical Isolates of Extended-Spectrum Beta-Lactamase Klebsiella pneumoniae"],"prefix":"10.3390","volume":"13","author":[{"given":"Constanza","family":"N\u00fa\u00f1ez","sequence":"first","affiliation":[{"name":"Laboratorio de Microbiolog\u00eda Celular, Instituto de Investigaci\u00f3n y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330546, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annegrett","family":"Palavecino","sequence":"additional","affiliation":[{"name":"Laboratorio de Microbiolog\u00eda Celular, Instituto de Investigaci\u00f3n y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330546, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n A.","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Laboratorio de Qu\u00edmica Aplicada, Instituto de Investigaci\u00f3n y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330546, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Dreyse","sequence":"additional","affiliation":[{"name":"Departamento de Qu\u00edmica, Universidad T\u00e9cnica Federico Santa Mar\u00eda, Av. Espa\u00f1a 1680, Casilla 2390123, Valpara\u00edso 2390123, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4581-7327","authenticated-orcid":false,"given":"Christian Erick","family":"Palavecino","sequence":"additional","affiliation":[{"name":"Laboratorio de Microbiolog\u00eda Celular, Instituto de Investigaci\u00f3n y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330546, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,22]]},"reference":[{"key":"ref_1","first-page":"190","article-title":"Antimicrobial resistance and virulence factors of Klebsiella pneumoniae affecting 30 day mortality in patients with bloodstream infection","volume":"74","author":"Kim","year":"2019","journal-title":"J. Antimicrob. 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