Differences in severity of bacteraemia caused by hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae

Namikawa, Hiroki; Oinuma, Ken-Ichi; Yamada, Koichi; Kaneko, Yukihiro; Kakeya, Hiroshi; Shuto, Taichi

doi:10.1016/j.ijantimicag.2023.106767

Cited by 9 publications

(5 citation statements)

References 43 publications

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“…In contrast to K. pneumoniae , where genes responsible for the hmv phenotype have been identified [ 26 ], the genetic background of this trait is yet to be investigated and described in E. coli. The hmv phenotype is frequently associated with hypervirulence in K. pneumoniae , in the case of which the hmv strains seem to be more capable of causing abscesses and spreading metastatically [ 30 ], suggesting that this phenotype deserves attention when characterizing and treating ExPEC infections in humans and animals.…”

Section: Discussionmentioning

confidence: 99%

Molecular Markers and Antimicrobial Resistance Patterns of Extraintestinal Pathogenic Escherichia coli from Camel Calves Including Colistin-Resistant and Hypermucoviscuous Strains

Sváb,

Somogyi,

Tóth

et al. 2024

TropicalMed

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Extraintestinal pathogenic Escherichia coli (ExPEC) strains are capable of causing various systemic infections in both humans and animals. In this study, we isolated and characterized 30 E. coli strains from the parenchymatic organs and brains of young (<3 months of age) camel calves which died in septicemia. Six of the strains showed hypermucoviscous phenotype. Based on minimum inhibitory concentration (MIC) values, seven of the strains were potentially multidrug resistant, with two additional showing colistin resistance. Four strains showed mixed pathotypes, as they carried characteristic virulence genes for intestinal pathotypes of E. coli: three strains carried cnf1, encoding cytotoxic necrotizing factor type 1, the key virulence gene of necrotoxigenic E. coli (NTEC), and one carried eae encoding intimin, the key virulence gene of enteropathogenic E. coli (EPEC). An investigation of the integration sites of pathogenicity islands (PAIs) and the presence of prophage-related sequences showed that the strains carry diverse arrays of mobile genetic elements, which may contribute to their antimicrobial resistance and virulence patterns. Our work is the first to describe ExPEC strains from camels, and points to their veterinary pathogenic as well as zoonotic potential in this important domestic animal.

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Section: Discussionmentioning

confidence: 99%

Molecular Markers and Antimicrobial Resistance Patterns of Extraintestinal Pathogenic Escherichia coli from Camel Calves Including Colistin-Resistant and Hypermucoviscuous Strains

Sváb,

Somogyi,

Tóth

et al. 2024

TropicalMed

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“…It is difficult to distinguish a more recent acquisition of the strain from chronic enteric colonization. Serotyping and molecular testing were not done in our case, but a string test (as shown in Figure 2 ) was clearly positive, with a thread of more than 10 cm [ 3 ]. The susceptibility of HvKP strain to antimicrobials is variable, ranging from pan-susceptible, as in this case, to multidrug-resistant.…”

Section: Discussionmentioning

confidence: 99%

“…This, along with its global spread, makes it a potential cause of devastating morbidity and mortality worldwide. Going forward, this strain needs to be considered when empirically treating devastating infections, including endocarditis, meningitis, and endophthalmitis in the appropriate clinical and epidemiological setting [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Hypermucoviscous Klebsiella pneumoniae: A Hypervirulent Strain Masquerading as Metastasis

Ombada¹,

Perwez²,

Campitelli³

et al. 2023

Cureus

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Hypermucoviscous Klebsiella pneumoniae (HvKP) is a hypervirulent strain of Klebsiella that causes metastatic spread and life-threatening infection. While it is more common among people of Asian descent, it has been increasingly reported globally among people of other ethnicities as well. We report a case of pan-susceptible HvKP infection in a male patient of Asian descent who has been living in the US for 20 years. It caused a liver abscess, perigastric abscess, perisplenic abscess, multifocal pneumonia, septic emboli, and tricuspid valve infective endocarditis. He was treated with ceftriaxone, but his septic shock was refractory, ultimately leading to death. This case highlights the severity of infection caused by this strain, and its ability to present with radiographic signs suggestive of malignancy with metastasis. This case also suggests that this strain can become pathogenic after a very prolonged period of gastrointestinal colonization.

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“…The systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Furthermore, the research model was constructed based on previous studies [ 15 , 16 ], with slight modifications. A methodical search for the reviewed literature was conducted in PubMed and Cochrane Library databases for all publications from January 2000 to August 2022.…”

Section: Methodsmentioning

confidence: 99%

Predictors of mortality from extended-spectrum beta-lactamase-producing Enterobacteriaceae bacteremia

Namikawa¹,

Imoto

Yamada

et al. 2023

Emerging Microbes & Infections

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Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) bacteremia can have poor clinical outcomes. Thus, determining the predictors of mortality from ESBL-PE bacteremia is very important. The present systematic review and meta-analysis aimed to evaluate studies to determine predictors associated with ESBL-PE bacteremia mortality. We searched PubMed and Cochrane Library databases for all relevant publications from January 2000 to August 2022. The outcome measure was mortality rate. In this systematic review of 22 observational studies, 4607 patients with ESBL-PE bacteremia were evaluated, of whom 976 (21.2%) died. The meta-analysis showed that prior antimicrobial therapy (RR, 2.89; 95% CI, 1.22–6.85), neutropenia (RR, 5.58; 95% CI, 2.03–15.35), nosocomial infection (RR, 2.46; 95% CI, 1.22–4.95), rapidly fatal underlying disease (RR, 4.21; 95% CI, 2.19–8.08), respiratory tract infection (RR, 2.12; 95% CI, 1.33–3.36), Pitt bacteremia score (PBS) (per1) (RR, 1.35; 95% CI, 1.18–1.53), PBS ≥ 4 (RR, 4.02; 95% CI, 2.77–5.85), severe sepsis (RR, 11.74; 95% CI, 4.68–29.43), and severe sepsis or septic shock (RR, 4.19; 95% CI, 2.83–6.18) were found to be mortality predictors. Moreover, urinary tract infection (RR, 0.15; 95% CI, 0.04–0.57) and appropriate empirical therapy (RR, 0.39; 95% CI, 0.18–0.82) were found to be a protective factor against mortality. Patients with ESBL-PE bacteremia who have the aforementioned require prudent management for improved outcomes. This research will lead to better management and improvement of clinical outcomes of patients with bacteremia caused by ESBL-PE.

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Differences in severity of bacteraemia caused by hypermucoviscous and non-hypermucoviscous Klebsiella pneumoniae

Cited by 9 publications

References 43 publications

Molecular Markers and Antimicrobial Resistance Patterns of Extraintestinal Pathogenic Escherichia coli from Camel Calves Including Colistin-Resistant and Hypermucoviscuous Strains

Molecular Markers and Antimicrobial Resistance Patterns of Extraintestinal Pathogenic Escherichia coli from Camel Calves Including Colistin-Resistant and Hypermucoviscuous Strains

Hypermucoviscous Klebsiella pneumoniae: A Hypervirulent Strain Masquerading as Metastasis

Predictors of mortality from extended-spectrum beta-lactamase-producing Enterobacteriaceae bacteremia

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