Genomic Heterogeneity in<i>Klebsiella pneumoniae</i>Strains Is Associated with Primary Pyogenic Liver Abscess and Metastatic Infection

Ma, Li-Chen; Fang, Chi-Tai; Lee, Cha-Ze; Shun, Chia‐Tung; Wang, Jann-Tay

doi:10.1086/430619

Cited by 158 publications

(128 citation statements)

References 45 publications

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“…The assay was evaluated after 24 and 48 hours of incubation, and was performed twice for each isolate. PCR was carried out to assess the presence of yersiniabactin (irp2-1) and Klebsiella ferric iron uptake gene cluster (kfuB) [26,27]. Yeast cell coagglutination in the presence or absence of 1.0% D-mannose was used to detect type 1 fi mbria [28,29].…”

Section: Virulence Associated Traitsmentioning

confidence: 99%

Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital

Melegh

Schneider

Horváth

et al. 2015

Acta Microbiologica et Immunologica Hungarica

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We investigated the molecular epidemiology of extended spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae isolates derived from the teaching hospitals of University of Pécs, Pécs, Hungary in the time period [2004][2005][2006][2007][2008]. Molecular typing, antimicrobial susceptibility testing, detection of common β-lactamase genes (bla CTX-M , bla TEM and bla SHV ) and virulence associated traits (hypermucoviscosity, magA, k2a, rmpA, siderophores, type 1 and 3 fi mbria, biofi lm formation, serum resistance) were performed for 102 isolates. The results showed the presence of three major ciprofl oxacin resistant CTX-M-15 producing clones (ST15 n = 69, ST101 n = 10, and ST147 n = 9), of which ST15 was predominant and universally widespread. Considering distribution in time and place, ST101 and ST147 were detected at fewer inpatient units and within a narrower time frame, as compared to ST15. Beside major clones, eleven minor clones were identifi ed, and were shown to harbour the following β-lactamase genes: six clones carried bla CTX-M , four clones harboured bla SHV-5 and one clone possessed both bla CTX-M and ESBL type bla SHV . Among the SHV-5 producing K. pneumoniae clones a novel sequence type was found, namely ST1193, which harboured a unique infB allele. Different virulence factor content and peculiar antimicrobial susceptibility profi le were characteristic for each clone. In contrast to major clone isolates, which showed high level resistance to ciprofl oxacin, minor clone *Corresponding author; E-mail: melegh.szilvia@pte.hu 234 MELEGH et al.Acta Microbiologica et Immunologica Hungarica 62, 2015 isolates displayed signifi cantly lower MIC values for ciprofl oxacin suggesting a role for fl uoroquinolones in the dissemination of the major K. pneumoniae clones. This is the fi rst description of the CTX-M-15 producing K. pneumoniae clone ST101 in Hungary.

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Section: Virulence Associated Traitsmentioning

confidence: 99%

Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital

Melegh

Schneider

Horváth

et al. 2015

Acta Microbiologica et Immunologica Hungarica

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“…Recent studies have shown that the mucoviscosity-associated gene A (magA) and regulator of mucoid phenotype A (rmpA) are associated with this syndrome [9,[12][13][14]17]. However, we could not ascertain which phenotype and genotype produced invasive K. pneumoniae syndrome in our case.…”

Section: Discussionmentioning

confidence: 66%

“…pneumoniae has been reported to be the most common pathogen causing liver abscess in Korea [6,7]. The incidence of K. pneumoniae infection increases in immunocompromised conditions, such as diabetes mellitus, alcoholism, malignancy, hepatobiliary disease, chronic obstructive pulmonary disease, glucocorticoid therapy and renal failure [6][7][8][9][10][11][12][13][14]. In our case, the In a few cases, K. pneumoniae liver abscess has been associated with metastatic infection at other sites [7,8,[10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Some investigators have reported that a minority of patients with Klebsiella liver abscess, and mostly from Taiwan, develop metastatic infection as manifested by endophthalmitis, uveitis, pneumonia, pulmonary abscess, pulmonary emboli, pulmonary abscess, pleural empyema, peritonitis, subcutaneous abscess, deep neck infection involving the mediastinum, splenic abscess, brain abscess, purulent meningitis, epidural abscess, renal abscess, prostate abscess, osteomyelitis, pyogenic arthritis and psoas abscess [7,8,[10][11][12][13][14][15][16][17][18]. This disease entity is called invasive liver abscess syndrome, which is caused by the hypervirulent K.…”

Section: Discussionmentioning

confidence: 99%

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Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

et al. 2011

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Emphysematous prostatitis combined with a liver ab scess caused by Klebsiella pneumoniae Emphysematous prostatitis is a rare condition that is characterized by gas and abscess accumulation in the prostate. This uncommon but serious disease requires special attention because of its nonspecific presentation such as dysuria, frequency, urgency, fever, acute urinary retension and/or perineal pain. We report here on a case of emphysematous prostatitis that was combined with a liver abscess caused by Klebsiella pneumoniae. A 55yearold man was admitted due to a 3day history of urinary retention with a febrile sensation. He had histories of liver cirrhosis and uncontrolled diabetes mellitus. After blood and urine cultures, levofloxacin 500 mg was started intravenously. On the third hospital day, he displayed septic shock.The kidneysureters bladder (KUB) Xray showed pockets of airaccumulation in the lower pelvic cavity, and abdominopelvic computed tomography (CT) with contrast enhancement taken on the third day showed a 5cm liver abscess with an emphysematous prostate. Intravenous antibiotics was changed to metronidazole 500 mg q.i.d. and cefotaxime 2 g t.i.d. On the sixth day, transurethral resection and drainage were performed under spinal anesthesia. However, the postoperative bleeding continued and hypovolemic shock persisted, which then provoked multiorgan failure. The patient died on the 11th hospital day. K. pneumoniae was cultured from the liver abscess aspirate, blood and prostatic tissue, and the bacteria were sensitive to both levofloxacin and cefotaxime. Emphysematous prostatitis is a difficult to diagnose because of its rarity and nonspecific symptoms. A delayed diagnosis can cause high mortality and morbidity, so making a prompt clinical diagnosis of this condition is essential. Appropriate antibiotics with early adequate incision and drainage are also needed.

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“…As we all know, K. pneumoniae is one of the most common and clinically important pathogens worldwide, causing abscess (especially liver abscess) (7,8), and then invades into blood causing multi-sites infection. It can also cause an endogenous infection in diabetes mellitus patients (9-11) as well as cancer patients (12).…”

Section: Discussionmentioning

confidence: 99%

Multi-Sites Infection Caused by Klebsiella pneumoniae After Hemopoietic Stem Cell Transplantation

Huang

Zhang

2017

Jundishapur J Microbiol

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Introduction: Leukemia patients can easily become hypoimmunity after hemopoietic stem cell transplantation, endogenous infection often happens in these patients. Meanwhile, Klebsiella pneumoniae is often isolated from various specimens in inpatient. It can lead to infections in the whole body, especially in those immunosuppressed patients. Case Presentation: A 22-year-old girl with complete remission after chemotherapy for her acute lymphoblastic leukemia was presented to the 2nd affiliated hospital of Zhejiang University for hemopoietic stem cell transplantation. She got a good check-up, however, her spirit was a little bad. Her primitive lymphocyte (0.06%) and total lymphocyte (27.05%) in the peripheral blood were in the normal range. She received a 224 mL stem cell transfusion including mononuclear cell (4.87 × 10 8 /kg) CD34+ (0.6%) as well as reached the transplantation threshold of CD34+ cell (3 × 10 6 /kg). Nine days after transplantation, there were no severe side effects except a little bit of vomit. However, the symptom of diarrhea appeared first. K. pneumoniae was isolated from the stool, then invaded into the blood, and caused sepsis. It disseminated and caused multi-sites infection. Conclusions: It should be kept in mind that K. pneumoniae can translocate across the intestinal epithelium. It is important to pay attention to the bacterium isolated from the intestine in immunosuppressed patients.

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Genomic Heterogeneity inKlebsiella pneumoniaeStrains Is Associated with Primary Pyogenic Liver Abscess and Metastatic Infection

Cited by 158 publications

References 45 publications

Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital

Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital

Emphysematous prostatitis combined with a liver abscess caused byKlebsiella pneumoniae

Multi-Sites Infection Caused by Klebsiella pneumoniae After Hemopoietic Stem Cell Transplantation

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