<i>Klebsiella pneumoniae</i> invasion syndrome: a case of liver abscess combined with lung abscess, endophthalmitis, and brain abscess

Zhang, Chen-Guang; Wang, Yan; Duan, Min; Zhang, Xiangyang; Chen, Xuyan

doi:10.1177/03000605221084881

Cited by 9 publications

(13 citation statements)

References 27 publications

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“…It was consistent with previous reports. 3,8,[31][32][33][34] In our study, the pathogen identified was concordant in seven of 10 culture-positive cases. Discordance between mNGS and culture was also reported in the literature.…”

Section: Discussionsupporting

confidence: 62%

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Zhu

Tang

et al. 2022

Retina

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Purpose: To investigate the utility of metagenomic next-generation sequencing (mNGS) in identifying the pathogens in endophthalmitis.Methods: In this prospective study, 36 cases of endophthalmitis were recruited. All patients received surgical treatment and intraocular drug lavage. The samples of vitreous or aqueous humor were extracted for mNGS and microbiological culture. The diagnostic performance of pathogens was compared between mNGS and culture.Results: The positive rates of mNGS and culture were 88.89% (32/36) and 27.78% (10/ 36), respectively. There was a statistically significant difference between mNGS and culture (Chi-square = 27.657; P , 0.01). Staphylococcus epidermidis, Streptococcus pneumoniae, and Klebsiella pneumoniae were the most pathogenic bacteria in traumatic, postoperative, and endogenous endophthalmitis, respectively. The concordance of pathogen identified by mNGS and culture was 70% for culture-positive cases. Antibiotic resistance genes were identified in 9 cases. There was a marginal correlation between the final visual acuity and the microbial sequence read (Spearman correlation coefficient = 0.498; P = 0.05).Conclusion: Metagenomic next-generation sequencing has a higher positive rate of identifying pathogens in endophthalmitis than in culture. It can also provide information on antibiotic resistance and visual prognosis. However, caution must be taken when interpreting the results of mNGS because they may not be concordant with culture.

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Section: Discussionsupporting

confidence: 62%

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Zhu

Tang

et al. 2022

Retina

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“…Diabetes is considered a significant risk factor for IKPLAS, and up to 63% of patients with a bacterial liver abscess in Taiwan have diabetes. This may be related to the impaired phagocytosis of K1/K2 Klebsiella pneumoniae in diabetic patients [ 31 ] and the more excellent vascular permeability in diabetic patients, which is conducive to bacterial invasion [ 11 ]. The above two serotypes of Klebsiella pneumoniae are also highly virulent Klebsiella pneumoniae, which show high viscosity in the String test [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…As can be seen from the SHAP plot, the higher the SOFA score, the greater the risk of progression to IKPLAS. Although the pathogenesis of IKPLAS is currently unclear, the study by Chen-Guang Zhang et al shows that most diabetic patients with IKPLAS are prone to sepsis [ 11 ]. Blood-borne transmission may be one of the more important ways.…”

Section: Discussionmentioning

confidence: 99%

Machine learning models for prediction of invasion Klebsiella pneumoniae liver abscess syndrome in diabetes mellitus: a singled centered retrospective study

et al. 2023

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Objective This study aimed to develop and validate a machine learning algorithm-based model for predicting invasive Klebsiella pneumoniae liver abscess syndrome(IKPLAS) in diabetes mellitus and compare the performance of different models. Methods The clinical signs and data on the admission of 213 diabetic patients with Klebsiella pneumoniae liver abscesses were collected as variables. The optimal feature variables were screened out, and then Artificial Neural Network, Support Vector Machine, Logistic Regression, Random Forest, K-Nearest Neighbor, Decision Tree, and XGBoost models were established. Finally, the model's prediction performance was evaluated by the ROC curve, sensitivity (recall), specificity, accuracy, precision, F1-score, Average Precision, calibration curve, and DCA curve. Results Four features of hemoglobin, platelet, D-dimer, and SOFA score were screened by the recursive elimination method, and seven prediction models were established based on these variables. The AUC (0.969), F1-Score(0.737), Sensitivity(0.875) and AP(0.890) of the SVM model were the highest among the seven models. The KNN model showed the highest specificity (1.000). Except that the XGB and DT models over-estimates the occurrence of IKPLAS risk, the other models' calibration curves are a good fit with the actual observed results. Decision Curve Analysis showed that when the risk threshold was between 0.4 and 0.8, the net rate of intervention of the SVM model was significantly higher than that of other models. In the feature importance ranking, the SOFA score impacted the model significantly. Conclusion An effective prediction model of invasion Klebsiella pneumoniae liver abscess syndrome in diabetes mellitus could be established by a machine learning algorithm, which had potential application value.

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“…[ 1 ] Endophthalmitis caused by Klebsiella pneumoniae induced liver abscess (KP-PLA) was first reported in Taiwan in the 1980s, [ 2 ] and some rare complications of liver abscess such as brain abscess and lung abscess have been reported successively in recent years. [ 3 , 4 ] As medicine progressed, acute pancreatitis (AP) was characterized by bacterial infections, including salmonella and tuberculosis, in addition to the common causes such as Biliary tract disease, alcohol, and high triglycerides. [ 5 , 6 ] Klebsiella pneumoniae usually causes secondary infection after AP, there have been no cases of primary infectious pancreatitis caused by Klebsiella pneumoniae excluding other causes.…”

Section: Introductionmentioning

confidence: 99%

Occult colon cancer with liver abscess and pancreatitis as the first manifestations: A case report

2023

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Introduction: Klebsiella pneumoniae-induced liver abscess (KP-PLA) is a common type of pyogenic liver abscess, severe acute pancreatitis (SAP) has high mortality, and poor prognosis in advanced colon cancer. There have been no report of SAP complicated with colon cancer after KP-PLA as so far. In this study, we reported a case of SAP secondary to KP-PLA with colon cancer for the first time, so as to provide reference for clinical diagnosis and treatment of these diseases.Patient concerns and diagnosis: A 64-year-old woman with a history of diabetes visited our hospital with abdominal pain for 5 + days. He was diagnosed with KP-PLA a month ago, which had not healed when he was admitted. He was diagnosed with SAP, and histological examination of colonic biopsy confirmed the diagnosis of moderately differentiated adenocarcinoma.Interventions and outcomes: He was treated with intravenous antibiotics and underwent modified endoscopic mucosal resection under colonoscopy. We conducted a 2-month follow-up, and there was no recurrence of liver abscess and pancreatitis. Conclusion:Screening for intestinal tumors is necessary in patients with cryptogenic liver abscess, especially KP-PLA with diabetes.

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Klebsiella pneumoniae invasion syndrome: a case of liver abscess combined with lung abscess, endophthalmitis, and brain abscess

Cited by 9 publications

References 27 publications

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Metagenomic Next-Generation Sequencing Detects Pathogens in Endophthalmitis Patients

Machine learning models for prediction of invasion Klebsiella pneumoniae liver abscess syndrome in diabetes mellitus: a singled centered retrospective study

Occult colon cancer with liver abscess and pancreatitis as the first manifestations: A case report

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