Clinical characteristics of post-neurosurgical Klebsiella pneumoniae meningitis in adults and a clinical comparison to the spontaneous form in a Taiwanese population

Postoperative Meningitis and Epidural Abscess due to Extended-spectrum β-Lactamase-producing <i>Klebsiella pneumoniae</i>: A Case Report and a Review of the Literature

“…We searched the English literature using PubMed and have summarized the features of these cases (2,4,(6)(7)(8) in Table 2. Based on the patient information we obtained, five cases were posttrauma and/or postoperative.…”

“…However, our case supports that a pre-existing external ventricular drain and existing artificial dura mater might be risk factors for ESBL K. pneumoniae invasion. The Infectious Diseases Society of America (IDSA) guideline recommends meropenem for the treatment of meningitis caused by ESBL-producing GNB (16), and four of the previous cases were treated with carbapenems (2,4,7). It is widely known that meropenem penetrates into the cerebrospinal fluid when there is meningeal inflammation (17).…”

“…Some studies (1)(2)(3)(4) from Taiwan have reported K. pneumoniae meningitis cases as community-acquired or nosocomial infection. In other countries, K. pneumoniae meningitis is almost always seen in nosocomial or postsurgical patients (5).…”

“…In other countries, K. pneumoniae meningitis is almost always seen in nosocomial or postsurgical patients (5). Although some cases (2,4,(6)(7)(8) have been reported, extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae meningitis is very rare. We herein report a case of meningitis and epidural abscess with artificial dura mater caused by ESBL-producing K. pneumoniae and also provide a review of the existing literature.…”

Klebsiella pneumoniaeand the pyogenic liver abscess: implications and association of the presence ofrpmAgenes and expression of hypermucoviscosity

“…This pathogen produces a wide range of infections including, pneumonia, bacteremia, urinary tract infection, meningitis, intraabdominal infections, and communityacquired pyogenic liver abscess (PLA). [1][2][3][4][5] Several virulence factors have been characterized clearly demonstrating their contribution to K. pneumoniae pathogenesis. The major virulence factors so far described are: a) the capsular polysaccharide (CPS), which confers the bacteria the ability to evade phagocytosis by immune cells and impedes bacterial killing by bactericidal complement serum; 6 b) the LPS O-antigen, prevents complement protein deposition and complement-associated serum lytic activity; 7 c) several pili or fimbrial adherence factors required for epithelial cell attachment and host colonization such as type 1 and type 3 pili, K. pneumoniae fimbriae 28 (KPF-28), the non-fimbrial adhesin CF29K, and the E. coli common pilus (ECP) have been described; 2,8 d) enterobactin and aerobactin siderophores, are required for a pathogen to establish infection when entering the hosts and enhance iron uptake by K. pneumoniae, 9 e) mucosity, a phenotype associated with a muco-polysaccharide network associated outside the capsule can facilitate mucosal colonization by K. pneumoniae and protects it from the interaction with anticapsule-specific antibodies to evade phagocytosis.…”