Bacteremic community-acquired pneumonia due to Klebsiella pneumoniae: Clinical and microbiological characteristics in Taiwan, 2001-2008

Lin, Yi Tsung; Jeng, Yuan Yu; Chen, Te Li; Fung, Chang Phone

doi:10.1186/1471-2334-10-307

Cited by 124 publications

(125 citation statements)

References 23 publications

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“…Reports estimate that K. pneumoniae CAPs comprise 22 to 32% of cases requiring admission to the ICU, with mortality rates in these ICU patients ranging from 45 to 72% (61,63,64). In Asia, one report cites K. pneumoniae CAPs as the most frequent causative agent of CAPs that required mechanical ventilation, and another report estimated a mortality rate of 55% in hospitalized patients (65,66). Cases of K. pneumoniae CAPs usually present with symptoms typical of acute pneumonias, including cough, fever, leukocytosis, and chest pain.…”

Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

See 1 more Smart Citation

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,364

1,345

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SUMMARYKlebsiella pneumoniaecauses a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Historically,K. pneumoniaehas caused serious infection primarily in immunocompromised individuals, but the recent emergence and spread of hypervirulent strains have broadened the number of people susceptible to infections to include those who are healthy and immunosufficient. Furthermore,K. pneumoniaestrains have become increasingly resistant to antibiotics, rendering infection by these strains very challenging to treat. The emergence of hypervirulent and antibiotic-resistant strains has driven a number of recent studies. Work has described the worldwide spread of one drug-resistant strain and a host defense axis, interleukin-17 (IL-17), that is important for controlling infection. Four factors, capsule, lipopolysaccharide, fimbriae, and siderophores, have been well studied and are important for virulence in at least one infection model. Several other factors have been less well characterized but are also important in at least one infection model. However, there is a significant amount of heterogeneity inK. pneumoniaestrains, and not every factor plays the same critical role in all virulentKlebsiellastrains. Recent studies have identified additionalK. pneumoniaevirulence factors and led to more insights about factors important for the growth of this pathogen at a variety of tissue sites. Many of these genes encode proteins that function in metabolism and the regulation of transcription. However, much work is left to be done in characterizing these newly discovered factors, understanding how infections differ between healthy and immunocompromised patients, and identifying attractive bacterial or host targets for treating these infections.

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Section: Infections Caused By K Pneumoniaementioning

confidence: 99%

“…lated from clinical samples (225). Based on the most frequently isolated serotypes collected from patients and results from mouse experiments, K1 and K2 strains are generally more virulent than strains of other serotypes (65,226,227). K2 strains are the most prevalent type of K. pneumoniae strain isolated clinically, followed by K1 strains.…”

Section: Capsulementioning

confidence: 99%

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Paczosa

Mecsas

2016

Microbiol Mol Biol Rev

1,364

1,345

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“…The site of infections in these studies was mostly intra-abdominal, especially as a liver abscess (5,8). Few studies have focused on respiratory tract infections and investigated the relationship between clinical findings and microbiological factors, including genetic characteristics (9,10).…”

mentioning

confidence: 99%

Molecular Epidemiological Characteristics of Klebsiella pneumoniae Associated with Bacteremia among Patients with Pneumonia

et al. 2015

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e Some important virulence factors have been elucidated in Klebsiella pneumoniae infections. We investigated the relationship between virulence factors and multilocus sequence types (STs) and assessed the risk factors for bacteremia in patients with pneumonia due to K. pneumoniae. From April 2004 through April 2012, a total of 120 K. pneumoniae isolates from patients with pneumonia (23 with bacteremia and 97 without bacteremia) were collected from 10 medical institutions in Japan. Additionally, 10 strains of K. pneumoniae serotype K2 that were isolated >30 years ago were included in this study. These isolates were characterized using multilocus sequence typing (MLST), and the characteristics of their virulence factors, such as hypermucoviscosity phenotype and RmpA and aerobactin production between patients with and without bacteremia, were examined. MLST analysis was performed on the 120 isolates from patients with pneumonia, and some sequence type groups were defined as genetic lineages (GLs). GL65 was more prevalent among patients with bacteremia (21.7%) than in those without bacteremia (7.2%). The majority of the strains with serotype K2 were classified into GL14 or GL65, and rmpA and the gene for aerobactin were present in all GL65-K2 strains but absent in all GL14-K2 strains. In a multivariate analysis, the independent risk factors for bacteremia included GL65 ( K lebsiella pneumoniae is a member of the family Enterobacteriaceae and is one of the most common pathogens causing pneumonia, abscess, bacteremia, and urinary tract infections (1, 2).Over several decades, some virulence factors of K. pneumoniae, including a capsular serotype, the presence of mucoviscosity-associated gene A (magA), and a regulator of mucoid phenotype A (rmpA) gene, have been identified. The strains of serotypes K1 and K2 were found to be virulent in a mouse model (3), and the magA and rmpA genes were found to be associated with hypermucoviscosity (HV), which has an antiphagocytic effect against macrophages and neutrophils (4-6).Clinically, K. pneumoniae was identified as an independent risk factor for mortality in severe community-acquired pneumonia (7). Some studies assessed the relationship between clinical findings and microbiological factors, such as capsular serotype and the presence or absence of rmpA and magA. The site of infections in these studies was mostly intra-abdominal, especially as a liver abscess (5,8). Few studies have focused on respiratory tract infections and investigated the relationship between clinical findings and microbiological factors, including genetic characteristics (9, 10).It is well-known that multilocus sequence typing (MLST), a nucleotide sequence-based genotyping method, is used to characterize genetic relationships among bacterial isolates and to identify and track the global spread of drug-resistant strains (11,12). In order to predict and evaluate bacterial pathogenicity, it is important to first determine the genetic background of the bacteria causing severe infections. Recently, using MLST, s...

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“…In the United States, nearly 100,000 deaths are attributed to pneumonia and sepsis per year, making these the fifth leading causes of death (2). The Gramnegative bacterium Klebsiella (K.) pneumoniae is a common causative pathogen in pneumonia (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Kinase Activity Profiling of Gram-Negative Pneumonia

Hoogendijk

Diks

Peppelenbosch

et al. 2011

Mol Med

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Pneumonia is a severe disease with high morbidity and mortality. A major causative pathogen is the Gram-negative bacterium Klebsiella (K.) pneumoniae. Kinases play an integral role in the transduction of intracellular signaling cascades and regulate a diverse array of biological processes essential to immune cells. The current study explored signal transduction events during murine Gram-negative pneumonia using a systems biology approach. Kinase activity arrays enable the analysis of 1,024 consensus sequences of protein kinase substrates. Using a kinase activity array on whole lung lysates, cellular kinase activities were determined in a mouse model of K. pneumoniae pneumonia. Notable kinase activities also were validated with phospho-specific Western blots. On the basis of the profiling data, mitogen-activated protein kinase (MAPK) signaling via p42 mitogen-activated protein kinase (p42) and p38 mitogen-activated protein kinase (p38) and transforming growth factor β (TGFβ) activity were reduced during infection, whereas v-src sarcoma (Schmidt-Ruppin A-2) viral oncogene homolog (avian) (SRC) activity generally was enhanced. AKT signaling was represented in both metabolic and inflammatory (mitogen-activated protein kinase kinase 2 [MKK], apoptosis signal-regulating kinase/mitogen-activated protein kinase kinase kinase 5 [ASK] and v-raf murine sarcoma viral oncogene homolog B1 [b-RAF]) context. This study reaffirms the importance of classic inflammation pathways, such as MAPK and TGFβ signaling and reveals less known involvement of glycogen synthase kinase 3β (GSK-3β), AKT and SRC signaling cassettes in pneumonia.

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Bacteremic community-acquired pneumonia due to Klebsiella pneumoniae: Clinical and microbiological characteristics in Taiwan, 2001-2008

Cited by 124 publications

References 23 publications

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Klebsiella pneumoniae: Going on the Offense with a Strong Defense

Molecular Epidemiological Characteristics of Klebsiella pneumoniae Associated with Bacteremia among Patients with Pneumonia

Kinase Activity Profiling of Gram-Negative Pneumonia

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