A 5‐Year Study of the Seroepidemiology of<i>Klebsiella pneumoniae:</i>High Prevalence of Capsular Serotype K1 in Taiwan and Implication for Vaccine Efficacy

In this study, the relative roles of Toll-like receptor (TLR)2 and TLR4 were investigated independently and together. Moreover, we studied the role of haematopoietic compartment in anti-Klebsiella host defence.We infected TLR2 and TLR4 single-, and TLR264 double knockout (KO) animals with different doses of Klebsiella pneumoniae. In addition, bone marrow chimeric mice were created and infected.TLR4 played a more prominent role in antibacterial defence than TLR2, considering that only TLR4 KO mice demonstrated enhanced bacterial growth in lungs and spleen 24 h after infection with 3610 3 colony-forming units of Klebsiella compared with wild-type (WT) mice. In late-stage infection or after exposure to a higher infectious dose, bacterial counts in lungs of TLR2 KO animals were elevated compared with WT mice and TLR264 KO animals were more susceptible to infection than TLR4 KO mice. TLR signalling in cells of haematopoietic origin is of primary importance in host defence against K. pneumoniae. These data suggest that: 1) TLR4 drives the antibacterial host response after induction of pneumonia with relatively low Klebsiella doses; 2) TLR2 becomes involved at a later phase of the infection and/or upon exposure to higher bacterial burdens; and 3) haematopoietic TLR2 and TLR4 are important for an adequate host response during Klebsiella pneumonia.

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“…Capsular serotypes 1 and 2 are the most common and the most virulent Klebsiella serotypes [2,23,24].…”

Section: Respiratory Infections Cw Wieland Et Almentioning

confidence: 99%

Host defence duringKlebsiellapneumonia relies on haematopoietic-expressed Toll-like receptors 4 and 2

Wieland¹,

Lieshout²,

Hoogendijk³

et al. 2010

Eur Respir J

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“…As with other capsule-based vaccines, e.g., 23-valent pneumococcus vaccine, the efficacy of similar K. pneumoniae vaccines will depend on the distribution of capsule or "K" serotypes (5,6). The capsular distribution for K. pneumoniae K types is known to differ worldwide (3,9,16,19,29), but an acceptable explanation for this phenomenon has yet to be found.…”

mentioning

confidence: 99%

Seroepidemiology ofKlebsiella pneumoniaein an Australian Tertiary Hospital and Its Implications for Vaccine Development

et al. 2006

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The aim of this study was to determine the diversity of Klebsiella pneumoniae capsular serotypes in an Australian setting. Consecutive (n ‫؍‬ 293) nonrepetitive isolates of K. pneumoniae from a large teaching hospital laboratory were analyzed. The majority of isolates were from urinary specimens (60.8%); the next most common source was sputum (14.3%), followed by blood (14%). Serotyping revealed a wide range of capsule types. K54 (17.1%), K28 (4.1%), and K17 (3.1%) were the most common, and K54 isolates displayed a high degree of clonality, suggesting a common, nosocomial source. In vitro, one K54 isolate was more adherent to urinary catheters and HEp-2 cells than four other tested isolates; it was slightly more resistant to chlorhexidine but was more susceptible to drying than heavily encapsulated strains. This is the first seroprevalence survey of K. pneumoniae to be performed on Australian isolates, and the high level of diversity of serotypes suggests that capsule-based immunoprophylaxis might not be useful for Australia. In addition there are significant differences in the predominance of specific serotypes compared to the results of surveys performed overseas, which has important implications for capsule-based immunoprophylaxis aimed at a global market.

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“…Capsule polysaccharides and lipopolysaccharides, such as K1 and K2, are the most virulent serotypes and important virulence factors of K. pneumoniae. [17,18,20,22] Our previous studies showed that patients with hepatic dysfunction had significant associations with V. vulnificus infections; however, V. vulnificus can also produce severe sepsis in diabetic patients with or without other chronic illnesses. [14] Necrotizing fasciitis caused by K. pneumoniae is extremely rare in the western hemisphere, but necrotizing fasciitis caused by K. pneumoniae has been increasingly reported in the past decade, with fatality rates approaching 50%.…”

Section: Discussionmentioning

confidence: 99%

“…We considered that capsule polysaccharides and lipopolysaccharides of K. pneumoniae can cause more immunologic defect and severe infections in the hyperglycemic status than that Metastatic infections with K. pneumoniae necrotizing fasciitis, which may be a consequence of transient bacteremia, have been reported. [18][19][20][21][22][23][24][25][26] Ho et al [19] and Hu et al [24] have reported that patients with K. pneumoniae necrotizing fasciitis have concurrent liver abscesses. Dalal [26] reported that patients with K. pneumoniae necrotizing fasciitis have associated lung abscesses.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients

Hsu¹,

Shen²,

Yang³

et al. 2015

Biomed J

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Background: Vibrio vulnificus related necrotizing fasciitis is a fatal, rapidly progressive soft-tissue infection. Necrotizing fasciitis caused by Klebsiella pneumoniae is rare, which is indistinguishable from V. vulnificus infection in the emergency room. The purpose of this study was to compare the clinical characteristics and outcome between these two pathogens in diabetic patients. Methods:Thirty diabetic patients were retrospectively reviewed over an 8-year period. Necrotizing fasciitis caused by V. vulnificus was found in 19 patients and by K. pneumoniae in 11 patients. The demographic, clinical, and laboratory characteristics, and the outcome between diabetic patients with V. vulnificus and K. pneumoniae infections were compared. Results:Two patients in the V. vulnificus group (10.5%) and three patients in the K. pneumoniae group (27.3%) died. Fourteen patients in the V. vulnificus group (73.6%) had a history of exposure to seawater or raw seafood, and eight patients in the K. pneumoniae group (72.8%) had abrasions or chronic ulcers over the site of infection. We found that the time interval between onset of illness and presentation to the hospital was significantly shorter in the V. vulnificus group than in the K. pneumoniae group (2.47 days vs. 5.45 days, p < 0.001). Conclusions:The exposure history and the time from exposure to hospital presentation with severe sepsis syndromes should alert clinicians to distinguish between necrotizing soft-tissue infections with V. vulnificus (contact with seawater or raw seafood) and K. pneumoniae (abrasions or chronic ulcers) in diabetic patients. Infection with V. vulnificus progresses more rapidly than infection with K. pneumoniae during the initial clinical course. (Biomed J 2015;38:136-142) Key words: klebsiella pneumonia, necrotizing fasciitis, Vibrio vulnificus At a Glance Commentary Scientific background of the subjectThe purpose of this study was to compare the specific characteristics and clinical outcomes between V. vulnificus and K. pneumoniae necrotizing fasciitis.

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A 5‐Year Study of the Seroepidemiology ofKlebsiella pneumoniae:High Prevalence of Capsular Serotype K1 in Taiwan and Implication for Vaccine Efficacy

Cited by 87 publications

References 12 publications

Host defence duringKlebsiellapneumonia relies on haematopoietic-expressed Toll-like receptors 4 and 2

Host defence duringKlebsiellapneumonia relies on haematopoietic-expressed Toll-like receptors 4 and 2

Seroepidemiology ofKlebsiella pneumoniaein an Australian Tertiary Hospital and Its Implications for Vaccine Development

Necrotizing fasciitis and sepsis caused by Vibrio vulnificus and Klebsiella pneumoniae in diabetic patients

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