Mrk D and fim H Biofilm Genes Detection and Antibiotic Susceptibility: A Study on Uropathogenic Biofilm Producing Klebsiella pneumoniae in Sana'a City, Yemen

Background Urinary tract infections (UTIs) caused by antibiotic-resistant strains of Klebsiella pneumoniae ( K. pneumoniae ) are one of the most important causes of morbidity and health care spending affecting people in Yemen, including young women, children, and the elderly. Biofilm formation has become a major factor among those uropathogenic strains. Objectives This study aimed to investigate the biofilm-forming ability of K. pneumoniae isolated from patients with UTIs, to determine the antibiotic susceptibility of those biofilm producers, and to assess the association between fimbrial virulence genes ( fimH and mrkD ) and biofilm strength. Methods The standard procedures for identifying and isolating bacteria from UTIs were used. The ability of the isolated K. pneumoniae to form biofilms was examined using tissue culture plates. The Kirby-Bauer disc diffusion method was used to determine the antibiogram susceptibility pattern of uropathogens. The fimbriae virulence genes ( fimH and mrkD ) for the biofilm-producing K. pneumoniae were found using conventional PCR. Results From UTI patients, 79(32.8%) of K. pneumoniae were isolated. 39 UTI patients (49.4%) had K. pneumoniae that did not produce a biofilm, although 40 (50.6%) of the bacteria are capable of doing so. Among those biofilm-forming strains, 19 (47.7%) were able to produce strong biofilms, while 21 (52.5%) produced moderate biofilms. PDR (5%), on the other hand, had the lowest percentage of antibiotic resistance, whereas XDR (47.5%) and MDR (32.5%) had the greatest percentages. The mrkD gene was detected in 40 (100%) of the biofilm-forming K. pneumoniae , and fimH had a significant association with strong biofilm (p = 0.031). Conclusion The presence of fimbriae virulence genes ( mrkD and fimH ) was significantly correlated with multi-drug resistance (MRD) biofilm-producing K. pneumoniae isolated from UTI patients.