Klebsiella pneumoniae Liver Abscess: An Emerging Disease

Fazili, Tasaduq; Sharngoe, Calden; Endy, Timothy P.; Kiska, Deana; Javaid, Waleed; Polhemus, Mark E.

doi:10.1016/j.amjms.2015.12.018

Cited by 61 publications

(46 citation statements)

References 39 publications

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“…We observed that the crude annual incidence of PLA and KP-PLA increased significantly from 1994–2004 to 2004–2015, which could be due to larger number of inpatients and improved early diagnostic techniques. In short, PLA and KP-PLA are common health problems in mainland China, which consistent with the recent epidemiological trends observed in other countries and regions6121319202122232425.…”

Section: Discussionsupporting

confidence: 87%

“…In present study, we observed that the blood culture positive rate (33.3%) in KP-PLA was lower than previously reported 46–61.1% by other studies122031. We speculated that the collection time, the frequency of sampling, the amount of blood drawn for culture and number of bottles within 24 hours all might contribute to the relatively low positive rate.…”

Section: Discussioncontrasting

confidence: 62%

“…A definition of invasive liver abscess syndrome was proposed based on a systematic review, referring to KP-PLA with characteristic extrahepatic metastatic infection13. Recently, KP-PLA has been reported from North America, Europe and Oceania14151617181920, and was regarded as an emerging public health problem worldwide. Although KP-PLA occurs predominantly in Asian people or Asian descent, there are few reports about this disease in mainland China in spite of its large population.…”

mentioning

confidence: 99%

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A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015

Qian

Wong

Lai

et al. 2016

Sci Rep

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Pyogenic liver abscess (PLA) is a common intra-abdominal infection in adults. In this study, we aim to explore demographic and clinical characteristics of PLA focusing on Klebsiella pneumoniae (K. pneumoniae) induced PLA (KP-PLA) in mainland China. A retrospective review of medical records from all patients with KP-PLA admitted to a tertiary teaching hospital over a 21-year period (1994–2015) was performed. Among 296 PLA cases with confirmed culture-positive data, K. pneumoniae was revealed as the predominant pathogen (n = 189, 63.9%), followed by Escherichia coli (n = 39, 13.2%). Strikingly, KP-PLA patients had a higher incidence of metabolic disorders, such as diabetes mellitus (49.7% vs. 36.4%, P = 0.027; odds ratio (OR): 1.725; 95% confidence interval (CI): 1.061–2.805), hypertension (38.1% vs. 19.6%, P = 0.001; OR: 2.520; 95% CI: 1.439–4.413), and fatty liver (32.3% vs. 14.0%, P = 0.001; OR: 2.923; 95% CI: 1.564–5.462) than those with non-K. pneumoniae induced PLA (non-KP-PLA). Moreover, patients with KP-PLA had higher susceptibility to septic metastatic infection at distant sites compared to those with non-KP-PLA (10.6% vs. 3.7%, p = 0.038). Our results indicate that K. pneumoniae is the predominant pathogen of PLA in mainland China. KP-PLA is frequently diagnosed in patients with metabolic diseases and has a higher risk for septic metastatic infection.

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Section: Discussionsupporting

confidence: 87%

Section: Discussioncontrasting

confidence: 62%

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confidence: 99%

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A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015

Qian

Wong

Lai

et al. 2016

Sci Rep

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“…Since then, it has been increasing[4-6], becoming a disease of worldwide relevance[3] due to several factors: immunosuppressive therapies in oncological and transplant patients; increasingly aggressive management of hepatobiliary diseases; and the high diagnostic efficacy of ultrasound, computerized tomography (CT) and abdominal magnetic resonance imaging[6,7]. Mortality fluctuates between 8% and 31%[5,6], although it is decreasing thanks to early diagnosis, the use of more effective antibiotics, and percutaneous drainage (percutaneous puncture or puncture with a fine needle) with ultrasound or CT guidance[8-10]. …”

Section: Introductionmentioning

confidence: 99%

Areas of research and clinical approaches to the study of liver abscess

González‐Alcaide¹,

Peris²,

Ramos³

2017

WJG

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AIMTo analyze the research activity on liver abscess (LA) and identify the main topic clusters in the area.METHODSWe identified all documents using the medical subject heading “LA” indexed in the MEDLINE database between 2001 and 2015. We performed a descriptive bibliometric analysis, characterizing the evolution of scientific activity, the publication types of the documents, the document categories of clinical interest (case reports, clinical trials, evaluation studies, meta-analysis, observational studies, practice guidelines and validation studies) and the geographic distribution of the research. We also carried out an analysis of networks and research clusters in order to identify the main topic areas of research.RESULTSOur search yielded a total of 1278 documents, showing a stable scientific production over the study period and a marked multidisciplinary nature. The research was dominated by case reports (65.9% of the documents analyzed). In terms of geographic distribution, researchers from the United States led in the number of signatures (n = 229), followed by those from Taiwan (n = 185), India (n = 145), Japan (n = 144), South Korea (n = 100), and China (n = 84). With regard to amebic LA, the top-producing countries were India and Mexico (n = 69 each), followed by the United States (n = 29). In the case of pyogenic LA, Taiwanese researchers led scientific production (n = 71), followed by the United States (n = 39) and China (n = 29). The most active areas of research in the field are diagnosis via computerized tomography scan, differential diagnosis with regard to liver cancer, treatment with antimicrobial agents, and Klebsiella infections (including bacteremia).CONCLUSIONClinical case reports associated with diagnosis and treatment are the main topic of study, highlighting the importance of this document type in advancing knowledge.

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“…In contrast, the K1 and K2 serotypes are most often associated with bacteremia, liver abscess, and community-acquired pneumonia in Asia (3). However, reports of this new invasive syndrome have recently been on the rise in western countries (6,7). In addition to causing human disease, K. pneumoniae serotypes K1 and K2 have also been detected in contaminated animal milk (8).…”

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confidence: 99%

Development of a Colloidal Gold-Based Immunochromatographic Strip for Rapid Detection of Klebsiella pneumoniae Serotypes K1 and K2

et al. 2016

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eIn this study, a novel colloidal gold-based immunochromatographic strip (ICS) containing anti-Klebsiella pneumoniae capsular polysaccharide polyclonal antibodies was developed to specifically detect K. pneumoniae serotypes K1 and K2. Capsular polysaccharide K1 and K2 antigens were first used to produce polyclonal anti-K1 and anti-K2 antibodies. Reference strains with different serotypes, nontypeable K. pneumoniae strains, and other bacterial species were then used to assess the sensitivity and specificity of these test strips. The detection limit was found to be 10 5 CFU, and the ICSs were stable for 6 months when stored at room temperature. No false-positive or false-negative results were observed, and equivalent results were obtained compared to those of more conventional test methods, such as PCR or serum agglutination. In conclusion, the ICS developed here requires no technical expertise and allows for the specific, rapid, and simultaneous detection of K. pneumoniae serotypes K1 and K2.K lebsiella pneumoniae is a Gram-negative, rod-shaped bacterium that is found in the normal flora of the mouth, skin, and intestines. Recently, a new type of invasive infection caused by K. pneumoniae has emerged as a global disease (1). There are 77 different serotypes of the capsular polysaccharides (CPSs) of K. pneumoniae (2), with K2 and K21 being the most prevalent in western countries (3). Recently, by genotyping capsular polysaccharide genes, 79 capsular types were distinguished (4, 5). In contrast, the K1 and K2 serotypes are most often associated with bacteremia, liver abscess, and community-acquired pneumonia in Asia (3). However, reports of this new invasive syndrome have recently been on the rise in western countries (6, 7). In addition to causing human disease, K. pneumoniae serotypes K1 and K2 have also been detected in contaminated animal milk (8). Capsular serotypes have typically been identified by using either a capsular swelling test or countercurrent immunoelectrophoresis (3, 9). However, these conventional methods are time-consuming, require extensive materials and manpower, and often produce falsepositive or false-negative results that are caused by cross-reactions. Another option is PCR, but this analysis requires a long time for preparation, expensive equipment, and skilled technicians, and previous studies have recommended that rapid detection is ideal for early clinical diagnosis and treatment (1).To address these concerns, this study involved the development of a colloidal gold-based immunochromatographic strip (ICS) that contained anti-K. pneumoniae capsular polysaccharide polyclonal antibodies (pAbs) and was able to detect K. pneumoniae serotypes K1 and K2. This testing kit provides a sensitive, rapid, and simultaneous method to detect K. pneumoniae serotypes K1 and K2. MATERIALS AND METHODSBacterial strains. The various serotypes of K. pneumoniae that were used here were obtained from our previous studies in Taiwan and at the Serum Institute in Denmark. The panel of bacterial strains contained al...

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Klebsiella pneumoniae Liver Abscess: An Emerging Disease

Cited by 61 publications

References 39 publications

A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015

A retrospective study of pyogenic liver abscess focusing on Klebsiella pneumoniae as a primary pathogen in China from 1994 to 2015

Areas of research and clinical approaches to the study of liver abscess

Development of a Colloidal Gold-Based Immunochromatographic Strip for Rapid Detection of Klebsiella pneumoniae Serotypes K1 and K2

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