Pediatric hypervirulent Klebsiella pneumoniae septic arthritis

Abstract

Cases of infection with hypervirulent Klebsiella pneumoniae are gradually increasing in number, and cause life-threatening community-acquired infection even in immunocompetent patients. A 14-year-old boy developed septic hip arthritis due to hypervirulent K. pneumoniae (sequence type 23, serotype K1, magA positive). The patient initially seemed to have been successfully treated with antibiotics and surgical intervention, but septic arthritis developed into osteomyelitis of the femoral head and myositis, which required long-term antibiotic therapy and additional surgical intervention. This is the first pediatric case of hypervirulent K. pneumoniae septic hip arthritis. Treatment plans should mainly consist of antibiotic therapy and surgical intervention. Clinicians, even pediatricians, in developed countries should be aware of the increasing incidence of hypervirulent Klebsiella pneumoniae infection.

Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area

“…They showed a trend towards a higher mortality amongst ESBL-producing K. pneumoniae-infected patients in systemic infections. Also, in our series it can be hypothesized that the presence of 5 hypermucoviscous phenotype of K. pneumoniae determined by a positive string test (among 7 isolates tested), a hypervirulent strain circulating in some parts of the world, might have enhanced the severity of the observed osteomyelitis, as previously reported in a case reports [21][22][23][24].…”

Frequency of colonization with “hypervirulent” Klebsiella pneumoniae strains of newborns and infants with community-acquired and nosocomial klebsiella infection

“…В эксперименте на лабораторных животных показано, что инфекционный процесс при пероральном заражении «гипервирулентными штаммами» клебсиелл имеет последовательные стадии: колонизация кишечника, транслокация бактерий в кровоток, их репликация в печени с последующим развитием септических метастазов [17]. Данные о частоте колонизации у детей «гипервирулентными штаммами» клебсиелл отсутствуют, однако в литературе имеются описания единичных случаев заболевания в форме менингита, сепсиса новорожденных, кишечной инфекции у грудного ребенка и септического артрита у подростка [18][19][20].…”

PrimaryKlebsiella pneumoniaeOsteomyelitis with Bacteremia and Sepsis in a Patient with Cirrhosis

“…In recent years, new hypervirulent Kp strains (in particular, Kp serotypes K1 and K2) have been associated with life-threatening infections (bacteremia, liver abscess, and meningitis) with distant metastasis in younger immune-competent hosts [ 12 , 28 , 29 ]. The increased virulence is related to the presence of the capsular (K) antigen, producing a hyperviscous capsule leading to the growth of mucoid colonies on culture plates that resists phagocytosis [ 12 , 30 ].…”