Hamadan University of Medical Sciences Avicenna Journal of Clinical Microbiology and Infection 2383-0298 12 4 2025 11 22 Molecular Profiling of Antibiotic Resistance and Virulence in Multidrug-Resistant Uropathogenic Klebsiella pneumoniae 180 187 10.34172/ajcmi.3738 EN Anandha Krishnan Rajaram Heamchandsaravanan https://orcid.org/0000-0003-3369-2587 Ishrath Razia Riaz Maheswari Paulraj Divyapriya Dhayalan Ragala Venkata Nandha Prabu Dhandapani https://orcid.org/0000-0003-2866-4338 Journal Article 10.34172/ajcmi.3738 2025 08 03 2025 10 08 Background: Urinary tract infections (UTIs) constitute a serious public health concern, with Klebsiella pneumoniae being a prevalent cause worldwide. This bacterium is recognized for elevated recurrence rates and significant antibiotic resistance. The complex virulence mechanisms of K. pneumoniae contribute to its persistence within the host. Nevertheless, it is still unknown how particular virulence genes and antibiotic resistance relate to uropathogenic K. pneumoniae. This study examined the relationship between pathways of virulence and antibiotic resistance in the isolates of uropathogenic K. pneumoniae. Methods: Overall, 207 uropathogenic K. pneumoniae isolates were analyzed for antibiotic susceptibility. Then, polymerase chain reaction (PCR) was used to identify resistance (blaSHV, blaTEM, blaNDM, blaCTX-M, blaKPC, and blaOXA) and virulence (Ompk35, Ompk36, Mdtk, AcrAB, TolC, mrkD, allS, ybtS, entB, kfu, and iutA) genes. Eventually, enterobacterial repetitive intergenic consensus (ERIC)-PCR was utilized to assess the genetic diversity of the strains. Results: All multidrug-resistant strains (100%) carried the Mdtk and AcrAB efflux pump genes. Virulence genes (e.g., mrkD and entB) were common across the isolates. Several genes were shown to be prevalent in β-lactam resistance, including blaSHV (95.8%), blaCTX-M (70.8%), blaNDM (62.5%), blaTEM (41.7%), and blaOXA (33%). Finally, ERIC-PCR produced distinct banding profiles between 50 and 1500 base pairs, with each isolate demonstrating between one and eight bands. Conclusion: Our findings emphasize the connection between K. pneumoniae virulence genotypes and antibiotic resistance. Understanding these associations is crucial for managing and preventing K. pneumoniae-related UTIs effectively.