A case report of pyogenic liver abscess caused by hypervirulent <i>Klebsiella pneumoniae</i> diagnosed by metagenomic next-generation sequencing

Xie, Jiafeng; Zhu, Zhiqiang

doi:10.1177/03000605211032793

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…16 Metagenomic next-generation sequencing (mNGS) has also been applied to detect pathogenic microorganisms of PLA in the laboratory and in clinical settings. 17,18 Compared to traditional microbial culture, mNGS possesses advantages in a broad spectrum of pathogen detection, shortening turnaround time, and metagenomic analyses of antibiotic resistance prediction could be employed for better treatment and prognosis. 19,20 Although cases of mNGS applied in the emergency department 17,21 were reported, cohort studies are needed to explore its diagnostic performance.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Diagnostic Performance of mNGS in Detecting Intra-Abdominal Infections of the Emergency Department Patients

Zheng¹,

Kang²,

Wang³

et al. 2023

IDR

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Intra-abdominal infections (IAI) are gradually becoming common in the emergency department, though the incidence is low and the prognosis is fair, as the symptoms are similar to other intra-abdominal diseases, rapid and accurate diagnosis of the causative agents is essential for clinical management. This study aimed to evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS) in detecting IAI in the emergency department. Patients and Methods: This was a retrospective, single-centered study including patients admitted to the emergency department from January 1st, 2021 to August 31st, 2022 with diagnosis of IAI. The comparison between mNGS and microbial culture using paracentesis fluid samples was performed to evaluate the diagnostic performance of mNGS for IAI. Meanwhile, paracentesis fluid and peripheral blood mNGS were compared to explore the sample specificity. Further, the microbial community structure of the patients with pyogenic liver abscesses (PLA) was analyzed. Results: Thirty-four IAI patients including 23 with pyogenic liver abscesses (PLA), 3 with parapancreatic abscesses, and 8 with other IAI were included in this study. Compared with the conventional microbial culture of paracentesis fluid, mNGS using paracentesis fluid detected more positive cases of IAI (93.75% vs 81.25%), and identified more species of pathogens, especially in obligate anaerobes and viral pathogens. Peripheral blood mNGS presented a relatively high consistency with the paracentesis fluid mNGS (91% mutual positive). The microbial community structure of PLA patients with diabetes is less diverse than that of those without diabetes. Patients with diabetes are at high risk of PLA caused by Klebsiella pneumonia. Conclusion: mNGS has advantages in detecting IAI in the emergency department, and peripheral blood mNGS can be a non-invasive choice for early diagnosis.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the Diagnostic Performance of mNGS in Detecting Intra-Abdominal Infections of the Emergency Department Patients

Zheng¹,

Kang²,

Wang³

et al. 2023

IDR

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“…[13,14] The generally accepted theory is that high glucose levels reduce the adhesion, chemotaxis, phagocytosis of neutrophils, and increase the aggressiveness of Klebsiella pneumoniae. [15] The most common bacterial infection of PLA originates from the biliary tract, and some cryptogenic liver abscesses with unknown infection source were reclassified as enteric after intestinal examination, even were associated with intestinal tumors. [16] Unfortunately, the patient had no intestinal infection symptom when he was admitted to hospital for the first time due to liver abscess, which was classified as cryptogenic liver abscess without complete colonoscopy, thus missing the opportunity for early screening of intestinal tumors.…”

Section: Discussionmentioning

confidence: 99%

Occult colon cancer with liver abscess and pancreatitis as the first manifestations: A case report

2023

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Introduction: Klebsiella pneumoniae-induced liver abscess (KP-PLA) is a common type of pyogenic liver abscess, severe acute pancreatitis (SAP) has high mortality, and poor prognosis in advanced colon cancer. There have been no report of SAP complicated with colon cancer after KP-PLA as so far. In this study, we reported a case of SAP secondary to KP-PLA with colon cancer for the first time, so as to provide reference for clinical diagnosis and treatment of these diseases.Patient concerns and diagnosis: A 64-year-old woman with a history of diabetes visited our hospital with abdominal pain for 5 + days. He was diagnosed with KP-PLA a month ago, which had not healed when he was admitted. He was diagnosed with SAP, and histological examination of colonic biopsy confirmed the diagnosis of moderately differentiated adenocarcinoma.Interventions and outcomes: He was treated with intravenous antibiotics and underwent modified endoscopic mucosal resection under colonoscopy. We conducted a 2-month follow-up, and there was no recurrence of liver abscess and pancreatitis. Conclusion:Screening for intestinal tumors is necessary in patients with cryptogenic liver abscess, especially KP-PLA with diabetes.

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“…Several viruses (including arboviruses) have been identified as aetiological agents of human disease, by using the mNGS approach (Grard et al 2012;Huang et al 2021;Phan et al 2018;Piantadosi et al 2021;Quintão et al 2022;Reyes et al 2021;Tang & Chiu 2010;Xie & Zhu 2021;Yozwiak et al 2012), including the pandemic SARS-CoV-2 (Wu et al 2020). This approach can also be used for the rapid identification of new vector species, the feeding sources and the screening for arboviruses, allowing the surveillance of potential emerging viruses and the prevention and control of VBDs (Batovska et al 2018).…”

Section: Metagenomic Ngs For the Identification And Discovery Of New ...mentioning

confidence: 99%

Evolution and emergence of mosquito-borne viruses of medical importance: towards a routine metagenomic surveillance approach

et al. 2023

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During the last two decades, the world has witnessed the emergence and re-emergence of arthropod-borne viruses, better known as arboviruses. The close contact between sylvatic, rural and peri-urban vector species and humans has been mainly determined by the environment-modifying human activity. The resulting interactions have led to multiple dead-end host infections and have allowed sylvatic arboviruses to eventually adapt to new vectors and hosts, contributing to the establishment of urban transmission cycles of some viruses with enormous epidemiologic impact. The metagenomic next-generation sequencing (NGS) approach has allowed obtaining unbiased sequence information of millions of DNA and RNA molecules from clinical and environmental samples. Robust bioinformatics tools have enabled the assembly of individual sequence reads into contigs and scaffolds partially or completely representing the genomes of the microorganisms and viruses being present in biological samples of clinical relevance. In this review, we describe the different ecological scenarios for the emergence of viral diseases, the virus adaptation process required for the establishment of a new transmission cycle and the usefulness of NGS and computational methods for the discovery and routine genomic surveillance of mosquito-borne viruses in their ecosystems.

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A case report of pyogenic liver abscess caused by hypervirulent Klebsiella pneumoniae diagnosed by metagenomic next-generation sequencing

Cited by 5 publications

References 17 publications

Evaluation of the Diagnostic Performance of mNGS in Detecting Intra-Abdominal Infections of the Emergency Department Patients

Evaluation of the Diagnostic Performance of mNGS in Detecting Intra-Abdominal Infections of the Emergency Department Patients

Occult colon cancer with liver abscess and pancreatitis as the first manifestations: A case report

Evolution and emergence of mosquito-borne viruses of medical importance: towards a routine metagenomic surveillance approach

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