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

Qian, Yun; Wong, Chi Chun; Lai, Shih-Kung; Chen, Huarong; He, Xingkang; Sun, Limei; Jing, Wu; Zhou, Jiancang; Yu, Jun; Liu, Weili; Zhou, Daoyang; Si, Jianmin

doi:10.1038/srep38587

Cited by 68 publications

(79 citation statements)

References 35 publications

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“…In mainland China, 63.9% of PLA cases were culture‐positive for K. pneumoniae. The increasing prevalence of K. pneumoniae in PLA can be attributed to the emergence of more virulent strains of K. pneumoniae , particularly the K1 serotype …”

Section: K Pneumoniae‐associated Diseases Of the Lower Gitmentioning

confidence: 99%

“…In mainland China, 63.9% of PLA cases were culture-positive for K. pneumoniae. 75 The increasing prevalence of K. pneumoniae in PLA can be attributed to the emergence of more virulent strains of K. pneumoniae, particularly the K1 serotype. [76][77][78] CRC CRC is one of the leading causes of morbidity and mortality with its annual incidence rate of approximately 1.4 million cases worldwide.…”

Section: K Pneumoniae-associated Diseases Of the Lower Gitmentioning

confidence: 99%

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Impact of Klebsiella pneumoniae in lower gastrointestinal tract diseases

Kaur

Vadivelu

Samudi

2018

J of Digest Diseases

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The 2016 Global Burden of Disease report by WHO revealed that diseases of the gastrointestinal tract (GIT) had one of the highest incidence rates worldwide. The plethora of factors that contribute to the development of GIT-related illnesses can be divided into genetic, environmental and lifestyle factors. Apart from that, the role that infectious agents play in the development of GIT diseases has piqued the interest of researchers worldwide. The human gut harbors approximately 10 bacteria in it with increasing concentration toward the lower GIT. Among the various microbiota that colonize the human gut, Gram-negative bacteria have been most notoriously linked to GIT-related diseases such as inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis and colorectal cancer (CRC). Some of the notable culprits that have been attributed to these diseases are Bacteroides fragilis, Fusobacterium nucleatum, Escherichia coli and Helicobacter pylori. However, studies in recent years are beginning to recognize a new player, Klebsiella pneumoniae (K. pneumoniae) in the causation and progression of GIT diseases. Once synonymous with infections and diseases of the upper respiratory tract, K. pneumoniae has now emerged as one of the pathogens commonly isolated from patients with GIT diseases. However, extensive studies attributing K. pneumoniae to GIT diseases, particularly that of CRC are scanty. Therefore, this review intends to shed light on the association of K. pneumoniae in gastrointestinal diseases such as Crohn's disease, ulcerative colitis as well as CRC.

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Section: K Pneumoniae‐associated Diseases Of the Lower Gitmentioning

confidence: 99%

Section: K Pneumoniae-associated Diseases Of the Lower Gitmentioning

confidence: 99%

Impact of Klebsiella pneumoniae in lower gastrointestinal tract diseases

Kaur

Vadivelu

Samudi

2018

J of Digest Diseases

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“…The past three decades have also seen the emergence of severe community-acquired hypervirulent Kp disease, usually manifesting as pyogenic liver abscess with accompanying bacteraemia, but also meningitis, brain abscess or opthalmitis 1,2 . Earliest reports of this syndrome emerged across parts of Asia including Taiwan, China, Hong-Kong, Singapore and South Korea [3][4][5][6] . More recently, reports have emerged from Europe, the United States, South America, the Middle East and Australia [7][8][9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Population genomics of hypervirulentKlebsiella pneumoniaeclonal group 23 reveals early emergence and rapid global dissemination

Wyres

Duchêne

Wick

et al. 2017

Preprint

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Since the mid-1980s there have been increasing reports of severe community-acquired pyogenic liver abscess, meningitis and bloodstream infections caused by hypervirulent Klebsiella pneumoniae, predominantly encompassing clonal group (CG) 23 serotype K1 strains. Common features of CG23 include a virulence plasmid associated with iron scavenging and hypermucoidy, and a chromosomal integrative and conjugative element (ICE) encoding the siderophore yersiniabactin and the genotoxin colibactin. Here we investigate the evolutionary history and genomic diversity of CG23 based on comparative analysis of 98 genomes. Contrary to previous reports with more limited samples, we show that CG23 comprises several deep branching sublineages dating back to the 1870s, many of which are associated with distinct chromosomal insertions of ICEs encoding yersiniabactin. We find that most liver abscess isolates (>80%) belong to a dominant sublineage, CG23-I, which emerged in the 1920s following acquisition of ICEKp10 (encoding colibactin in addition to yersiniabactin) and has undergone clonal expansion and global dissemination within the human population. The unique genomic feature of CG23-I is the production of colibactin, which has been reported previously as a promoter of gut colonisation and dissemination to the liver and brain in a mouse model of CG23 K. pneumoniae infection, and has been linked to colorectal cancer. We also identify an antibiotic-resistant subclade of CG23-I associated with sexually-transmitted infections in horses dating back to the 1980s. These data show that hypervirulent CG23 K. pneumoniae was circulating in humans for decades before the liver abscess epidemic was first recognised, and has the capacity to acquire and maintain AMR plasmids. These data provide a framework for future epidemiological and experimental studies of hypervirulent K. pneumoniae. To further support such studies we present an open access and completely sequenced human liver abscess isolate, SGH10, which is typical of the globally disseminated CG23-I sublineage.

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“…Thirty three percent and all of them were surgically drained, respectively [32,33]. They also alerted that about 10 % of the patients with Klebsiella pneumoniae-associated PLA had invasive liver abscess syndrome with distant metastasis infection, as compared to only one (0.2 %) of our cohort [16].…”

Section: Discussionmentioning

confidence: 53%

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

Morii¹,

Yamamoto²,

Nakamura³

et al. 2017

GHOA

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Background: Percutaneous catheter drainage (PCD) is currently the preferred therapeutic procedure of pyogenic liver abscesses (PLAs). However, multilocular poorly liquefied PLAs (MPLPs) are unsuitable for PCD. As reports on MPLPs are scarce, we aimed to explore possible therapeutic strategies for this serious type of PLA. Methods:The medical records of patients with PLA who were hospitalized at our institution between January 2011 to December 2015 were retrospectively reviewed. Demographic factors, biochemical, bacteriological, and imaging results, and treatment outcomes were evaluated.Results: Fourteen patients with MPLPs and 37 with drainable PLAs were identified and included in the study. Clinical characteristics were generally similar between the two groups. Klebsiella pneumoniae accounted for the majority of the culprit pathogens in MPLPs. Patients with MPLPs were managed medically without PCD. Despite this, treatment outcomes were not inferior compared to patients with drainable PLAs. Contrast-enhanced images revealed that the intricate septa of the MPLP maintained its blood perfusion. Most MPLPs did not liquefy over the treatment period. Conclusion:We should remember that MPLP is not rare. The septa may have delivered antibiotics adequately into the MPLPs, thus producing good treatment outcomes. Despite our findings, a high level of suspicion of treatment failure is crucial in these patients to ensure favorable treatment outcomes.

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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

Cited by 68 publications

References 35 publications

Impact of Klebsiella pneumoniae in lower gastrointestinal tract diseases

Impact of Klebsiella pneumoniae in lower gastrointestinal tract diseases

Population genomics of hypervirulentKlebsiella pneumoniaeclonal group 23 reveals early emergence and rapid global dissemination

Multilocular Pyogenic Liver Abscess with Poorly Liquefied Content: A Potential Therapeutic Concern

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