Infection Sources and Klebsiella pneumoniae Antibiotic Susceptibilities in Endogenous Klebsiella Endophthalmitis

Abstract

Endogenous endophthalmitis is an uncommon intraocular infection with potentially devastating consequences on vision. Klebsiella pneumoniae is highly prevalent in East Asian countries, with an increasing incidence recently worldwide. This retrospective study investigates infection sources and antibiotic susceptibilities of K. pneumoniae in patients with endogenous K. pneumoniae endophthalmitis (EKE) in Northern Taiwan. One hundred and fifty-seven patients with EKE were reviewed between January 1996 and April 2019. Pyogenic liver abscess (120/157, 76.4%) was the most common infection source, followed by pneumonia (13, 8.3%), urinary tract infection (7, 4.5%), and intravenous drug use (4, 2.5%). Bilateral involvement was identified in 12.1% (19/157) of patients, especially in patients with pyogenic liver abscess (16/120, 13.3%), pneumonia (2/13, 15.4%), and urinary tract infection (1/7, 14.3%). The antibiotic susceptibility rates were 98.1%, 92.5%, 97.5%, 96.8%, 100%, 99.3%, and 100% for amikacin, cefuroxime, ceftazidime, ceftriaxone, carbapenems, ciprofloxacin, and levofloxacin, respectively. Four extended-spectrum β-lactamase-producing multidrug-resistant (MDR) K. pneumoniae isolates were identified. In conclusion, pyogenic liver abscess was the major infection source in EKE. In addition, K. pneumoniae was still highly susceptible to ceftazidime and amikacin, and the MDR K. pneumoniae isolates were not common in EKE.

Case report: A case of acute postoperative endophthalmitis following penetrating keratoplasty due to carbapenem-resistant Klebsiella Pneumoniae and literature review

“…Klebsiella pneumoniae is a gram-negative bacterium and an important nosocomial pathogen that can cause several infections, especially in hospitalized or immunocompromised individuals, and is associated with high mortality rates, including bloodstream infections, pulmonary infections, liver abscess, ventriculitis, meningitis, ocular infection, and urinary tract infection, which show increasingly frequent acquisition of resistance to antibiotics ( 5 , 6 ). Klebsiella pneumoniae is highly prevalent in East Asian countries, and with an increasing incidence worldwide ( 7 ). Carbapenems are the first-line therapy for infections caused by multidrug-resistant Klebsiella pneumoniae , particularly extended-spectrum β-lactamase producers.…”

Identification of Microbial Species and Analysis of Antimicrobial Resistance Patterns in Acute Cholangitis Patients with Malignant and Benign Biliary Obstructions: A Comparative Study

“…However, the resistance and susceptibility of Klebsiella spp. to sulbactam and associated combinations remain a debate [44,45].…”

Epidemiology, antimicrobial resistance profile and management of Carbapenem-resistant Klebsiella pneumoniae among mothers with suspected sepsis in Ethiopia

“…Carbapenemaseand ESBL-producing K. pneumoniae are the most severe global public health threats identi ed on the WHO priority pathogen list due to their ability to transfer antimicrobial resistance genes [2,4,16,42].However, the impact of K. pneumoniae on maternal and neonatal health in developing countries, including Ethiopia, has not yet been well established [43]. Overall, maternal sepsis has a disproportionate effect on neonates and pregnant women, suggesting that research on maternal sepsis caused by ESBL-producing K. pneumoniae and CRKP is essential [3,6,9,38,44,46].…”