Hypervirulent <i>Klebsiella Pneumoniae</i>, an Emerging Cause of Endogenous Endophthalmitis in A French Center: A Comparative Cohort Study

Martellosio, Jean-Philippe; Gastli, Nabil; Farhat, Rebecca; Tazi, Asmaa; Duraffour, Pierre; Rossi, Benjamín; Canouï, Etienne; Morbieu, Caroline; Billöet, Annick; Mouthon, Luc; Poyart, Claire; Brézin, Antoine P.; Legendre, Paul

doi:10.1080/09273948.2022.2061521

Cited by 7 publications

(8 citation statements)

References 39 publications

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“…Endogenous endophthalmitis is an uncommon intraocular infection with potentially devastating consequences on vision. Klebsiella pneumoniae is highly prevalent in East Asian countries [ 1 , 2 , 3 , 4 ], with an increasing incidence recently worldwide [ 5 , 6 , 7 , 8 , 9 , 10 ]. Diabetic patients with K. pneumoniae hepatobiliary infections have a higher risk of developing endogenous K. pneumoniae endophthalmitis (EKE) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Klebsiella pneumoniae is highly prevalent in East Asian countries [ 1 , 2 , 3 , 4 ], with an increasing incidence recently worldwide [ 5 , 6 , 7 , 8 , 9 , 10 ]. Diabetic patients with K. pneumoniae hepatobiliary infections have a higher risk of developing endogenous K. pneumoniae endophthalmitis (EKE) [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. EKE has been found in patients with other infections, such as pneumonia and renal abscess [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Infection Sources and Klebsiella pneumoniae Antibiotic Susceptibilities in Endogenous Klebsiella Endophthalmitis

Chen

et al. 2022

Antibiotics

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Endogenous endophthalmitis is an uncommon intraocular infection with potentially devastating consequences on vision. Klebsiella pneumoniae is highly prevalent in East Asian countries, with an increasing incidence recently worldwide. This retrospective study investigates infection sources and antibiotic susceptibilities of K. pneumoniae in patients with endogenous K. pneumoniae endophthalmitis (EKE) in Northern Taiwan. One hundred and fifty-seven patients with EKE were reviewed between January 1996 and April 2019. Pyogenic liver abscess (120/157, 76.4%) was the most common infection source, followed by pneumonia (13, 8.3%), urinary tract infection (7, 4.5%), and intravenous drug use (4, 2.5%). Bilateral involvement was identified in 12.1% (19/157) of patients, especially in patients with pyogenic liver abscess (16/120, 13.3%), pneumonia (2/13, 15.4%), and urinary tract infection (1/7, 14.3%). The antibiotic susceptibility rates were 98.1%, 92.5%, 97.5%, 96.8%, 100%, 99.3%, and 100% for amikacin, cefuroxime, ceftazidime, ceftriaxone, carbapenems, ciprofloxacin, and levofloxacin, respectively. Four extended-spectrum β-lactamase-producing multidrug-resistant (MDR) K. pneumoniae isolates were identified. In conclusion, pyogenic liver abscess was the major infection source in EKE. In addition, K. pneumoniae was still highly susceptible to ceftazidime and amikacin, and the MDR K. pneumoniae isolates were not common in EKE.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Infection Sources and Klebsiella pneumoniae Antibiotic Susceptibilities in Endogenous Klebsiella Endophthalmitis

Chen

et al. 2022

Antibiotics

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“…29 Foreign data show that the incidence of EE in cases of endophthalmitis is 7.4% in India, 16.5% in Thailand, and 23.5% in the United States. 1,[30][31][32] K. pneumoniae endophthalmitis is increasingly reported globally and is a primary cause of EE in Southeast Asian countries, where Gram-negative bacteria are the primary causative agents. In contrast, Western countries report Gram-positive bacteria and fungi as the most common pathogens.…”

Section: Discussionmentioning

confidence: 99%

“…This type of endophthalmitis has a higher incidence among East Asian populations, particularly in patients with poorly controlled diabetes, with PLA being the most common source of infection. 24,[32][33][34][35] PLA caused by K. pneumoniae can occur through four pathways 36 : (1) the biliary tract pathway, which is usually associated with cholelithiasis, malignant tumors, or posthepaticojejunostomy stricture 37 ; (2) the portal vein pathway, which mainly originates from abdominal infections such as appendicitis, diverticulitis, colorectal cancer, and inflammatory bowel disease 38 ; (3) the hepatic artery pathway, which is usually caused by bacteremia from Staphylococcus aureus 38 ; and (4) direct infection from adjacent infected foci. Although some studies have suggested that K. pneumoniae-induced PLA is seldom associated with liver and biliary diseases, previous liver surgery, abdominal trauma, or biliary or portal vein infections caused by malignant tumors, 39,40 mouse model experiments have demonstrated that different mutant strains of K. pneumoniae have varying invasive abilities through different genes.…”

Section: Discussionmentioning

confidence: 99%

“…Recent research from the Second Affiliated Hospital of Nanchang University showed that trauma accounted for 71% of cases of endophthalmitis, while ocular surgery accounted for 18% and EE accounted for 7.8% 29 . Foreign data show that the incidence of EE in cases of endophthalmitis is 7.4% in India, 16.5% in Thailand, and 23.5% in the United States 1,30–32 …”

Section: Discussionmentioning

confidence: 99%

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Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: A case report and Literature Review

Chen

Gong

Song

et al. 2023

Immunity Inflam & Disease

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Objective Pyogenic liver abscess (PLA) is a common surgical infectious disease caused by various pathogens. Klebsiella pneumoniae is a relatively recent cause, often affecting patients with low immunity. Endogenous endophthalmitis (EE), a rare and serious complication of PLA, may appear with eye symptoms before PLA. By reviewing a case of Klebsiella pneumoniae‐induced PLA complicated with EE, we want to summarize the information about the characteristics, causes, and complications of PLA based on the literature review. Methods This case report describes a 37‐year‐old male who had fever high to 39°C for 10 days experienced blurred vision followed by nonlight perception vision. He reported a history of diabetes irregularly taking oral medications and insulin therapy. Imaging examination found a large low‐density area in the right lobe of the liver with an unclear border and vague surrounding fat gap. The blood culture was not positive. The culture of the drainage fluid from the liver puncture showed Klebsiella pneumonia. Blood and liver puncture drainage fluid were sent for microbial high‐throughput gene detection with next‐generation sequencing technology (NGS), which confirmed the diagnosis of Klebsiella pneumoniae‐induced PLA complicated with EE. Results The patient's surgical incision had healed well at discharge, and he could feel light at his left eye. But the patient was lost to follow‐up since the third month after discharge. Conclusion By reviewing this case and summarize the information about the characteristics, causes, and complications of PLA based on the literature review, we concluded that it is necessary to promptly perform liver puncture drainage and empirically use antibiotics for patients with PLA, especially those with poor glycemic control, to avoid serious complications such as EE.

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Endogenous endophthalmitis: New insights from a 12-year cohort study

Dedieu,

Contejean,

Gastli

et al. 2024

International Journal of Infectious Diseases

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Hypervirulent Klebsiella Pneumoniae, an Emerging Cause of Endogenous Endophthalmitis in A French Center: A Comparative Cohort Study

Cited by 7 publications

References 39 publications

Infection Sources and Klebsiella pneumoniae Antibiotic Susceptibilities in Endogenous Klebsiella Endophthalmitis

Infection Sources and Klebsiella pneumoniae Antibiotic Susceptibilities in Endogenous Klebsiella Endophthalmitis

Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: A case report and Literature Review

Endogenous endophthalmitis: New insights from a 12-year cohort study

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