Hypermucoviscous (HV) isolates of Klebsiella pneumoniae have been linked to virulence potential in experimental infections. We examined 33 isolates of K. pneumoniae from patients with bacteraemia for the HV phenotype on agar culture, and determined their virulence potential by screening for capsular (K) serotype by polymerase chain reaction and the presence of seven virulence factor genes. Fourteen (42·4%) isolates expressed the HV phenotype and 11 of these were serotype K1 or K2; these serotypes were not identified in HV-negative isolates. The genes rmpA, rmpA2, aerobactin, wabG and allS were significantly more frequent in HV than non-HV isolates. Multilocus sequence typing identified 21 sequence types (ST), eight of which were found in HV-positive isolates and the clonal relatedness of isolates of the most frequent types (ST23 and ST11) from different hospitals was confirmed by pulsed-field gel electrophoresis. The HV phenotype was more associated with community-acquired infection with a lower frequency of fatal underlying illness, but with significantly more focal infections, notably liver abscesses. Clinicians should be aware of such clinical impacts of the HV phenotype.

This study aimed to assess intensive care unit (ICU) nurses' experiences caring for delirious patients and the empirical evaluation of the clinical feasibility of the confusion assessment method (CAM) for ICU (CAM-ICU). In Korea, neither regular assessment of early-stage delirium nor preventive interventions are carried out properly in the ICU. This study was conducted using a qualitative research design with focus group interviews. Nurses received training about the CAM-ICU, and used it to assess surgical ICU patients for the presence of delirium during a 5-month period. None of the nurses had heard of the CAM-ICU before the study, and many complained that it was very challenging to use. One positive outcome of the CAM-ICU trial was that the clinical interest in delirium increased. The CAM-ICU could be used to facilitate communication once the instrument becomes well-known among health care professionals.