Endogenous endophthalmitis caused by hypermucoviscous Klebsiella pneumoniae: An emerging disease in Southeast Asia and Beyond

Keynan, Yoav; Rubinstein, Ethan

doi:10.1007/s11908-008-0055-2

Cited by 7 publications

(10 citation statements)

References 22 publications

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“…It is remarkable that most of the cases of KLAS outside Asia have involved patients of Asian ethnicity including Filipinos [1, 8, 24-26]; the reasons for this are not known [2, 23]. Our patient was white.…”

Section: Discussionmentioning

confidence: 91%

“…Although half of the cases occur in otherwise healthy people with no underlying hepatobiliary problems, diabetic patients are more susceptible to K. pneumoniae infection because poor glycemic control plays an important role in phagocytic resistance against K. pneumoniae [1, 5, 6, 8, 12, 26-29]. …”

Section: Discussionmentioning

confidence: 99%

“…More than one-half of patients with KLAS have diabetes mellitus, whereas the remainder are otherwise healthy individuals [5, 12, 13]. Septic metastatic complications are frequent [8, 10, 14, 15]. …”

Section: Introductionmentioning

confidence: 99%

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Appearance of Klebsiella Pneumoniae Liver Abscess Syndrome in Argentina: Case Report and Review of Molecular Mechanisms of Pathogenesis

Vila¹

2011

TOMICROJ

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Klebsiella pneumoniae liver abscess syndrome (KLAS) is an emerging invasive infection caused by highly virulent community-acquired strains of K. pneumoniae displaying hypermucoviscosity. The salient features of this syndrome include the presence of bacteremia, primary monomicrobial liver abscess, and metastatic complications. A previously healthy Argentinean man presented with fever and found to have liver abscess caused by K. pneumoniae with metastatic seeding of gastric wall. Cultures from blood and liver abscess grew hypermucoviscous K1 K. pneumoniae with sequence type (ST) 23 by multilocus sequence typing (MLST), positive for rmpA (regulator of mucoid phenotype A), wzyKpK1 (capsular polymerase) and aerobactin genes. The hypermucoviscous phenotype of this K. pneumoniae isolate was readily identified by the "string test" (colonies formed a long string when touched with a loop). The patient responded favourably to percutaneous drainage of the abscess and antibiotics. This is the first documented report of KLAS described in Argentina, and may signal the emergence of this syndrome in South America.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Appearance of Klebsiella Pneumoniae Liver Abscess Syndrome in Argentina: Case Report and Review of Molecular Mechanisms of Pathogenesis

Vila¹

2011

TOMICROJ

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“…This locus may represent a novel pathogenicity island responsible for the hypervirulence seen with certain K. pneumoniae pathogenic strains . HMV+ K. pneumoniae are the most common cause of EE in Southeast Asia, with cases of EE caused by HMV+ K. pneumoniae on the rise in Western countries (Keynan and Rubinstein, 2008;Lederman and Crum, 2005). Our laboratory has previously shown that the HMV phenotype contributes to the pathogenesis of experimental K. pneumoniae endophthalmitis.…”

Section: Pathogenesismentioning

confidence: 92%

“…Capsule production is likely to impede clearance of K. pneumoniae from the bloodstream and from the eye. The HMV phenotype is enriched among highly virulent, invasive strains of K. pneumoniae, especially those causing EE (Fang et al, 2004;Fang et al, 2007;Fung et al, 2002;Karama et al, 2008;Keynan and Rubinstein, 2008;Lee et al, 2006). Strains that express this phenotype possess a thick, viscous capsule-associated mucopolysaccharide web (Wiskur et al, 2008).…”

Section: Pathogenesismentioning

confidence: 99%

Endophthalmitis

Phillip¹,

Michelle²

2012

Advances in Ophthalmology

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The microbiology of endophthalmitis: global trends and a local perspective

Keynan

Finkelman²,

Lagacé-Wiens

2012

Eur J Clin Microbiol Infect Dis

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Endophthalmitis is a rare but frequently devastating infection, caused by diverse organisms, including bacteria, viruses, fungi, and parasites. The causative agents of endophthalmitis vary according to the mechanism. The involvement of intraocular structures can result from exogenous spread from ocular trauma, infection of adjacent structures, or as a complication of intraocular surgery. Of the causes of exogenous endophthalmitis, post-operative endophthalmitis is the most frequently encountered; specifically, cataract surgery is the most frequent eye surgery and, thus, leads the list of surgery-associated endophthalmitis. Exogenous source is far more common than endogenous endophthalmitis, a disease that is caused by the hematogenous spread of organisms from a remote infectious site to the eye, leading to severe visual loss. Several large series estimate that endogenous endophthalmitis accounts for 2-15 % of all cases of endophthalmitis. Progressive vitritis is a hallmark for all forms of endophthalmitis, accompanied by intraocular inflammation, loss of vision, pain, and hypopyon. The common presentation consists of reduced vision, conjunctival injection, pain, and eyelid swelling. We reviewed the microbiology of endophthalmitis during a 9-year period in Winnipeg, Canada. Gram-positive bacteria with coagulase-negative staphylococci are the most common causative organisms, reflecting the association with surgical procedures.

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Endogenous endophthalmitis caused by hypermucoviscous Klebsiella pneumoniae: An emerging disease in Southeast Asia and Beyond

Cited by 7 publications

References 22 publications

Appearance of Klebsiella Pneumoniae Liver Abscess Syndrome in Argentina: Case Report and Review of Molecular Mechanisms of Pathogenesis

Appearance of Klebsiella Pneumoniae Liver Abscess Syndrome in Argentina: Case Report and Review of Molecular Mechanisms of Pathogenesis

Endophthalmitis

The microbiology of endophthalmitis: global trends and a local perspective

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