Community-acquired Klebsiella pneumoniae liver abscess: an emerging infection in Ireland and Europe

Moore, Roger A.; O'Shea, Dàire; Geoghegan, Tony; Mallon, Paddy; Sheehan, Gerard

doi:10.1007/s15010-013-0408-0

Cited by 84 publications

(63 citation statements)

References 24 publications

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“…The mortality rate associated with HvKP has been significantly rising up to 31z (2). HvKP infections appeared to be more widespread in Asian countries like Taiwan (3,4), Japan (5), and Korea (6) but rare cases in Western Europe (7) and North America (8) have also been reported. In mainland China, very limited data are available regarding the prevalence and characteristics of HvKP isolated from community-acquired infection cases.…”

Section: Introductionmentioning

confidence: 99%

Multilocus Sequence Types and Virulence Determinants of Hypermucoviscosity-Positive <i>Klebsiella pneumoniae</i> Isolated from Community-Acquired Infection Cases in Harbin, North China

et al. 2016

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SUMMARY:We investigated the molecular epidemiologic characteristics and virulence of hypermucoviscosity-positive Klebsiella pneumoniae in mainland China. We detected 16 hypermucoviscositypositive strains in 65 total clinical isolates (24.62z). We found that 68.75z (11/16) of the positive strains had K2 genotype and carried the rmpA and iucA genes. Multilocus sequence typing revealed 5 sequence types (STs):, whereas the remaining 4 isolates were defined as other STs. The order of the median lethal dose values for the ST types was ST23 (2.19 × 10 3 CFU/mouse) ＜ ST86 (1.70 × 10 4 CFU/mouse) ＜ ST65 (5.05 × 10 7 CFU/mouse) ＜ the other STs (1.90 × 10 8 CFU/mouse). In conclusion, the K2 with ST65 carrying rmpA and iucA was the most predominant among the hypermucoviscosity-positive K. pneumoniae strains obtained from communityacquired infection cases in Harbin, North China. Sequence types are a valuable tool to predict the risk of K. pneumoniae infection.

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Section: Introductionmentioning

confidence: 99%

Multilocus Sequence Types and Virulence Determinants of Hypermucoviscosity-Positive <i>Klebsiella pneumoniae</i> Isolated from Community-Acquired Infection Cases in Harbin, North China

et al. 2016

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“…5 The emerging serotype K1 K. pneumoniae with multilocus sequence type 23 has been strongly associated with the virulence of liver abscess and invasive syndrome. 6,7 ALA has not been a topic of focus, but it is a potentially life-threatening complication by infection with the protozoan parasite Entamoeba histolytica. 8 ALA is widely distributed throughout the tropics and subtropics, causing up to 40 million infections annually.…”

Section: Introductionmentioning

confidence: 99%

Burden of Liver Abscess and Survival Risk Score in Thailand: A Population-Based Study

Poovorawan¹,

Pan-ngum²,

Soonthornworasiri³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. In Thailand, the burden of liver abscess, a life-threatening infectious disease, has not been thoroughly evaluated. We developed a predictive scoring system to estimate survival of patients with liver abscess using information from the 2008-2013 Nationwide Hospital Admission Data to evaluate the burden of liver abscess in Thailand. All patients with primary diagnosis of pyogenic liver abscess (PLA) and amoebic liver abscess (ALA) were included. Epidemiological data, baseline characteristics, hospital course, and survival were analyzed. Overall, 11,296 admissions comprising 8,423 patients from 844 hospitals across Thailand were eligible for analysis. The mean age was 52 ± 17 years and 66.1% of patients were male. ALA was significantly prevalent in southern and western border regions of Thailand, and PLA occurred nationwide. The highest incidence of liver abscess occurred in the rainy season (June-November, P < 0.01). The median length of hospital stay was 8 days (interquartile range = 4-13 days), and mean direct cost of hospitalization was 846 ± 1,574 USD. The overall inhospital mortality rate was 2.8%. Incidence of ALA decreased over the 5-year study period, whereas PLA incidence increased (P < 0.01). Using multivariable Cox regression methods with stepwise variable selection, we developed a final model with five highly significant baseline parameters associated with increased 60-day mortality: older age, PLA, underlying chronic kidney disease, cirrhosis, and human immunodeficiency virus infection. Range of estimated probability of 60-day survival was 95-16% at cumulative risk score 0-13. This simplified score is practical, and may help clinicians prioritize patients requiring more intensive care.

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“…In addition, many researchers have also noted distinctive metastatic complications of KPLA, especially endophthalmitis and meningitis, which cause significant morbidity and mortality (14)(15)(16). Even though there is a relatively lower incidence in Western countries, emerging cases in North America (17) and Europe (18) have been identified in recent years. Capsular serotype K1 of K. pneumoniae is thought to be the major virulence determinant responsible for KPLA and this invasive syndrome (7).…”

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confidence: 99%

TREM-1 Promotes Survival during Klebsiella pneumoniae Liver Abscess in Mice

Lin

Tseng²,

Yeh

et al. 2014

Infect Immun

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g Klebsiella pneumoniae liver abscess (KPLA) is prevalent in East Asia. Liver abscess can develop after translocation of K. pneumoniae from a patient's bowel into the liver via the portal circulation. TREM-1 (triggering receptor expressed on myeloid cells 1) amplifies inflammatory signaling during infection, but its role in KPLA is poorly understood. We used an animal study to characterize the role of TREM-1 in KPLA. We compared survival rates, bacterial burdens in tissues, inflammatory cytokine levels, and histology findings between wild-type and Trem-1 knockout (KO) mice after oral inoculation of capsular type K1 K. pneumoniae. Translocation of K. pneumoniae to mesenteric lymph nodes and liver was examined, and intestinal permeability, antimicrobial peptide expression, and the clearance of K. pneumoniae in the small intestine were determined. In the absence of TREM-1, KPLA model mice showed increased K. pneumoniae dissemination, enhanced liver and systemic inflammation, and reduced survival. Impaired bacterial clearance in the small intestine causes enhanced K. pneumoniae translocation, which renders Trem-1 KO mice more susceptible to K. pneumoniae oral infection. In conclusion, TREM-1-mediated bacterial clearance in the small intestine is an important immune response against K. pneumoniae. TREM-1 deficiency enhances K. pneumoniae translocation in the small intestine and increases mortality rates in mice with KPLA.

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Community-acquired Klebsiella pneumoniae liver abscess: an emerging infection in Ireland and Europe

Abstract: Klebsiella pneumoniae invasive liver abscess syndrome is now emerging in Europe and notably is not restricted to individuals of Asian descent.

Cited by 84 publications

References 24 publications

Multilocus Sequence Types and Virulence Determinants of Hypermucoviscosity-Positive <i>Klebsiella pneumoniae</i> Isolated from Community-Acquired Infection Cases in Harbin, North China

Multilocus Sequence Types and Virulence Determinants of Hypermucoviscosity-Positive <i>Klebsiella pneumoniae</i> Isolated from Community-Acquired Infection Cases in Harbin, North China

Burden of Liver Abscess and Survival Risk Score in Thailand: A Population-Based Study

TREM-1 Promotes Survival during Klebsiella pneumoniae Liver Abscess in Mice

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