Klebsiella pneumoniaeBacteremia and Capsular Serotypes, Taiwan

Liao, Chun-Hsing; Huang, Yu-Tsung; Lai, Chih‐Cheng; Chang, Chung-Yi; Chu, Fang-Yeh; Hsu, Meng-Shiuan; Hsu, Hsin-Sui; Hseuh, Po-Ren

doi:10.3201/eid/1706.100811

Cited by 20 publications

(13 citation statements)

References 15 publications

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“…There have been a few reports with detailed surveillance data on the distribution of capsular serotypes among K. pneumoniae isolates derived from patients with invasive infections across Japan [39]. Our study showed hypervirulent K1 K. pneumoniae is frequently the cause of BSI but is not associated with mortality; similar results have been found in Taiwan and China [40, 41]. It is reported that ESBL-producing isolates are associated with higher mortality rates [42].…”

Section: Discussionsupporting

confidence: 83%

Clinical characteristics in blood stream infections caused by Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae: a comparative study, Japan, 2014–2017

et al. 2019

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BackgroundKlebsiella variicola and K. quasipneumoniae are new species distinguishable from K. pneumoniae but they are often misidentified as K. pneumoniae in clinical settings. Several reports have demonstrated the possibility that the virulence factors and clinical features differ among these three phylogroups. In this study, we aimed to clarify whether there were differences in clinical and bacterial features between the three phylogroups isolated from patients with bloodstream infections (BSIs) in Japan.MethodsIsolates from all patients with BSIs caused by K. pneumoniae admitted to two hospitals between 2014 and 2017 (n = 119) were included in the study. Bacterial species were identified via sequence analysis, and their virulence factors and serotypes were analyzed via multiplex PCR results. Clinical data were retrieved from medical records.ResultsOf the 119 isolates, 21 (17.7%) were identified as K. variicola and 11 (9.2%) as K. quasipneumoniae; K1 serotype was found in 16 (13.4%), and K2 serotype in 13 (10.9%). Significant differences in the prevalence of rmpA, iutA, ybtS, entB and kfu (p < 0.001), and allS genes (p < 0.05) were found between the three phylogroups. However, there were no significant differences in clinical features, including the 30-day mortality rate, between the three organisms, although K. variicola was more frequently detected in patients over 80 years old compared with other Klebsiella species (p < 0.005), and K. quasipneumoniae more frequently occurred in patients with malignancy (p < 0.05).ConclusionsOur findings demonstrated the differences in bacterial pathogenicity and clinical features among these three phylogroups. Further epidemiological studies into BSI caused by Klebsiella species are warranted.

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Section: Discussionsupporting

confidence: 83%

Clinical characteristics in blood stream infections caused by Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae: a comparative study, Japan, 2014–2017

et al. 2019

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“…Although most K. pneumoniae strains with the hypermucoviscous phenotype harbored magA , some magA -negative strains harboring the rmpA gene also exhibited this phenotype 32. In the present study, the overall frequency of the hypermucoviscous phenotype was 25.2%, which was similar to those found in other studies33 but higher than those found in other investigations conducted in European countries 34. Interestingly, the identification of virulence genes performed in our study showed that rmpA (10.6%) and magA (6.9%) were present in the hypermucoviscous isolates.…”

Section: Discussionsupporting

confidence: 90%

High rate of multiresistant Klebsiella pneumoniae from human and animal origin

Yang

Deng

Liao

et al. 2019

IDR

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Purpose The main objectives of the present study were to detect the antimicrobial susceptibility and molecular characteristics of Klebsiella pneumoniae isolated from different hosts and to investigate the possibility of K. pneumoniae transmission between animals and humans. Materials and methods A total of 189 nonduplicate K. pneumoniae isolates were collected from hospitals and four species of animals in Henan Province, China. The disk diffusion method was used for antimicrobial susceptibility testing, and resistance and virulence genes were screened by polymerase chain reaction (PCR). The molecular types were identified through multilocus sequence typing (MLST), and the hypermucoviscous (HMV) phenotype was identified using the “string-forming test”. Pearson’s parameters were used to determine the potential link among the molecular types and resistance and virulence genes of all K. pneumoniae strains. Results The resistance rates of the 189 K. pneumoniae isolates against 15 antibiotics ranged from 11.6% to 77.8%. The highest multidrug resistance rate was detected in the pig strains (93.6%), followed by the human strains (90.4%), chicken strains (88.9%), cow strains (52.0%) and sheep strains (50.0%). Forty-eight (25.4%) K. pneumoniae strains presented the HMV phenotype. entB, ﬁmH-1 and mrkD were the most prevalent of the detected virulence genes, and magA and rmpA were the least prevalent genes in all the isolates. The MLST analysis revealed 24 unique sequence types (STs) among from the 189 isolates. ST11, ST235 and ST258 were common STs among the five isolates of host origin. ST258 exhibited significantly positive correlations with blaNDM, magA and the HMV phenotype and a negative correlation with qnrB . Conclusion K. pneumoniae strains from different hosts, including humans and animals, have common molecular types and similar phenotypes, and these strains can potentially be transmitted between humans and animals.

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“…Homology over the entire capsule locus is therefore highest (99% identity) to that of the recently fully sequenced strains CG43 (Accession CP006648), KCTC 2242 (CP002910), and Kp52.145 (FO834906), and also to the partially sequenced capsule biosynthetic loci of VGH525 (Accession AB371296) and Chedid (D21242). The central region of the capsule loci encodes for the antigenic diversity of capsules, which has previously supported the use of PCR as a methodology to identify capsule serotype [40], [41].…”

Section: Resultsmentioning

confidence: 85%

Correlation of Klebsiella pneumoniae Comparative Genetic Analyses with Virulence Profiles in a Murine Respiratory Disease Model

et al. 2014

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Klebsiella pneumoniae is a bacterial pathogen of worldwide importance and a significant contributor to multiple disease presentations associated with both nosocomial and community acquired disease. ATCC 43816 is a well-studied K. pneumoniae strain which is capable of causing an acute respiratory disease in surrogate animal models. In this study, we performed sequencing of the ATCC 43816 genome to support future efforts characterizing genetic elements required for disease. Furthermore, we performed comparative genetic analyses to the previously sequenced genomes from NTUH-K2044 and MGH 78578 to gain an understanding of the conservation of known virulence determinants amongst the three strains. We found that ATCC 43816 and NTUH-K2044 both possess the known virulence determinant for yersiniabactin, as well as a Type 4 secretion system (T4SS), CRISPR system, and an acetonin catabolism locus, all absent from MGH 78578. While both NTUH-K2044 and MGH 78578 are clinical isolates, little is known about the disease potential of these strains in cell culture and animal models. Thus, we also performed functional analyses in the murine macrophage cell lines RAW264.7 and J774A.1 and found that MGH 78578 (K52 serotype) was internalized at higher levels than ATCC 43816 (K2) and NTUH-K2044 (K1), consistent with previous characterization of the antiphagocytic properties of K1 and K2 serotype capsules. We also examined the three K. pneumoniae strains in a novel BALB/c respiratory disease model and found that ATCC 43816 and NTUH-K2044 are highly virulent (LD50<100 CFU) while MGH 78578 is relatively avirulent.

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Klebsiella pneumoniaeBacteremia and Capsular Serotypes, Taiwan

Cited by 20 publications

References 15 publications

Clinical characteristics in blood stream infections caused by Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae: a comparative study, Japan, 2014–2017

Clinical characteristics in blood stream infections caused by Klebsiella pneumoniae, Klebsiella variicola, and Klebsiella quasipneumoniae: a comparative study, Japan, 2014–2017

<p>High rate of multiresistant <em>Klebsiella pneumoniae</em> from human and animal origin</p>

Correlation of Klebsiella pneumoniae Comparative Genetic Analyses with Virulence Profiles in a Murine Respiratory Disease Model

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