Community-acquired liver abscess caused by capsular genotype K2-ST375 hypervirulent Klebsiella pneumoniae isolates

Hoashi, Kosuke; Harada, Sohei; Ishii, Yoshikazu; Aoki, Kotaro; Ishikawa, Shin; Oshiro, Yusuke; Shinzato, Takashi

doi:10.1016/j.idcr.2019.e00577

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…In Taiwan, a hypervirulent K. pneumoniae (hvKP) variant was detected in 1986 for the first time, and these strains are increasingly being reported in Argentina, Korea, Australia, USA, and Scandinavia [1,2,[4][5][6][7][8]10]. HvKP may result in an invasive clinical syndrome, which is defined as a community-acquired liver abscess with or without extrahepatic complications like necrotizing fasciitis or endophthalmitis [9,13,14]. Furthermore, hvKP's infection has the ability to spread metastatically [9,15].…”

Section: Introductionmentioning

confidence: 99%

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

Davoudabadi

Goudarzi

et al. 2022

AMicr

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In this study, we focused on the emergence of extensively drug-resistant (XDR), pandrug-resistant (PDR), and hypervirulent Klebsiella pneumoniae (hvKP) in Iran. During 2018 to 2020 a total of 52 K. pneumoniae isolates were collected from different clinical specimens. The hvKP isolates were identified by PCR amplification of virulence and capsular serotype-specific genes. Hypermucoviscous K. pneumoniae (hmKP) were identified by string test. Carbapenem-resistant hvKP (CR-hvKP), multidrug-resistant hvKP (MDR-hvKP), extensively drug-resistant hvKP (XDR-hvKP), and pandrug-resistant hvKP (PDR-hvKP) were determined by disc diffusion method, Carba-NP test and PCR method. XDR-hvKP isolates were typed by multilocus sequence typing (MLST). Among all K. pneumoniae isolates 14 (26.9%) were identified as hvKP and 78.6% (11/14) of them were hmKP however, none of the classic K. pneumoniae (cKP) isolates were hmKP. The predominant capsular serotype of hvKP was K2 (42.85%) followed by K1 (35.71%). The prevalence of MDR-hvKP, XDR-hvKP and PDR-hvKP isolates were 6 (42.9%), 5 (35.7%) and 1 (7.1%), respectively. ESBL production was found in 85.7% of hvKP isolates and most of them carried bla TEM gene (78.6%) and 6 isolates (42.9%) were CR-hvKP. Among hvKP isolates, 1 (7.1%), 2 (14.3%), 3 (21.4%), 8 (28.6%), and 11 (78.6%) carried bla NDM-6, bla OXA-48, bla CTX-M, bla SHV, and bla TEM genes, respectively. According to MLST analysis, 2, 1, 1, and 1 XDR-hvKP isolates belonged to ST15, ST377, ST442, and ST147, respectively. The occurrence of such isolates is deeply concerning due to the combination of hypervirulence and extensively drug-resistance or pandrug-resistance.

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Section: Introductionmentioning

confidence: 99%

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

Davoudabadi

Goudarzi

et al. 2022

AMicr

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“…In addition, K1-ST23 has been recognized as the most prevalent HV-KP isolate from liver abscess, 4 and all reported cases of K2-ST375 infection showed the presence of liver abscess. [15][16][17] Therefore, these two strains may be more likely to cause lung abscess in addition to liver abscess and should receive attention as causative pathogens of lung abscess, although current data are limited.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Importantly, three of the five reported cases of K. pneumoniae K2-ST375 infection (60%), including the case described here, are from Okinawa Prefecture in Japan. [15][16][17] A nationwide molecular epidemiological study that did not include Okinawa Prefecture also reported that K2-ST375 was not isolated in the main islands of Japan. 13 Our patient was from Miyako Island, Okinawa, located near Taiwan-380 km west of Taiwan and situated on the same latitude-where HV-KP-induced lung abscess was first reported.…”

Section: Dovepressmentioning

confidence: 99%

<p>Case Report of Primary Lung Abscesses Due to Hypervirulent <em>Klebsiella pneumoniae</em> (Serotype K2, Sequence Type 375): an Emerging Isolate in Okinawa, Japan</p>

Hirai

Sakanashi

Momose

et al. 2020

IDR

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Hypervirulent Klebsiella pneumoniae (HV-KP) is typically associated with community-acquired liver abscess and bacteremia with metastatic infection; however, primary lung abscess (PLA) caused by HV-KP is rare, with only one such case report to date. A 69year-old man with a history of diabetes mellitus (DM) was admitted to hospital complaining of slight bloody sputum. Chest imaging showed multiple consolidations with cavities in both lung fields. A culture of bronchoalveolar lavage fluid confirmed the presence of K. pneumoniae. Genetic analyses identified the isolate as serotype K2 and sequence type 375 (K2-ST375), and that it harbored the rmpA gene. The patient was an Asian middle-aged male with DM, all of which are risk factors for HV-KP infection. Although complicating DM and the presence of the rmpA gene are more likely to induce disseminated infection, metastatic infections were not found in this patient. The clinical and microbiological characteristics of our patient were different from those of a previous reported case, although in both cases the patient was from Asia and had DM. Therefore, DM appears to be one of the predisposing factors for HV-KP lung abscesses and physicians should pay attention to emerging HV-KP lung abscess infection, particularly in Asian countries. Previous studies have also revealed that K2-ST375 is one of the major clones causing HV-KP infection, and that it is mainly isolated from patients with liver abscess. Interestingly, including the present case, most of the infectious cases caused by K2-ST375 have been reported from Okinawa Prefecture in Japan. Therefore, the trend of the K2-ST375 strain should be carefully monitored, particularly in Okinawa, Japan. The serotype of HV-KP that causes PLA is still unknown and further study is needed to elucidate the etiology of PLA due to HV-KP and the relationship between the strain K2-ST375 and PLA.

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“…To construct the phylogenetic tree for the collection under study, we first mapped the short-reads against the genome of the reference strain of K. pneumoniae Ecl8, a ST375/K2 hypervirulent clone of epidemiological significance causing severe community-acquired infections [ 36 ] (accession number: PRJEB401) [ 37 ] with the Snippy pipeline ( https://github.com/tseemann/snippy ) with default parameters. We then computed the pair-wise SNP distance between the strains and reconstructed the neighbor-joining phylogenetic tree using the ape (v5.7.1) package in R [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

The emergence of highly resistant and hypervirulent Klebsiella pneumoniae CC14 clone in a tertiary hospital over 8 years

Hala,

Malaikah,

Huang

et al. 2024

Genome Med

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Background Klebsiella pneumoniae is a major bacterial and opportunistic human pathogen, increasingly recognized as a healthcare burden globally. The convergence of resistance and virulence in K. pneumoniae strains has led to the formation of hypervirulent and multidrug-resistant strains with dual risk, limiting treatment options. K. pneumoniae clones are known to emerge locally and spread globally. Therefore, an understanding of the dynamics and evolution of the emerging strains in hospitals is warranted to prevent future outbreaks. Methods In this study, we conducted an in-depth genomic analysis on a large-scale collection of 328 multidrug-resistant (MDR) K. pneumoniae strains recovered from 239 patients from a single major hospital in the western coastal city of Jeddah in Saudi Arabia from 2014 through 2022. We employed a broad range of phylogenetic and phylodynamic methods to understand the evolution of the predominant clones on epidemiological time scales, virulence and resistance determinants, and their dynamics. We also integrated the genomic data with detailed electronic health record (EHR) data for the patients to understand the clinical implications of the resistance and virulence of different strains. Results We discovered a diverse population underlying the infections, with most strains belonging to Clonal Complex 14 (CC14) exhibiting dominance. Specifically, we observed the emergence and continuous expansion of strains belonging to the dominant ST2096 in the CC14 clade across hospital wards in recent years. These strains acquired resistance mutations against colistin and extended spectrum β-lactamase (ESBL) and carbapenemase genes, namely blaOXA-48 and blaOXA-232, located on three distinct plasmids, on epidemiological time scales. Strains of ST2096 exhibited a high virulence level with the presence of the siderophore aerobactin (iuc) locus situated on the same mosaic plasmid as the ESBL gene. Integration of ST2096 with EHR data confirmed the significant link between colonization by ST2096 and the diagnosis of sepsis and elevated in-hospital mortality (p-value < 0.05). Conclusions Overall, these results demonstrate the clinical significance of ST2096 clones and illustrate the rapid evolution of an emerging hypervirulent and MDR K. pneumoniae in a clinical setting.

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Community-acquired liver abscess caused by capsular genotype K2-ST375 hypervirulent Klebsiella pneumoniae isolates

Cited by 12 publications

References 19 publications

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

Detection of extensively drug-resistant and hypervirulent Klebsiella pneumoniae ST15, ST147, ST377 and ST442 in Iran

<p>Case Report of Primary Lung Abscesses Due to Hypervirulent <em>Klebsiella pneumoniae</em> (Serotype K2, Sequence Type 375): an Emerging Isolate in Okinawa, Japan</p>

The emergence of highly resistant and hypervirulent Klebsiella pneumoniae CC14 clone in a tertiary hospital over 8 years

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