&lt;p&gt;Clinical and Microbiological Characteristics of Invasive and Hypervirulent &lt;em&gt;Klebsiella pneumoniae&lt;/em&gt; Infections in a Teaching Hospital in China&lt;/p&gt;

Li, Lijuan; Ziyang, Yuan; Chen, Dan‐Na; Xie, Xiaoyan; Zhang, Bashan

doi:10.2147/idr.s282982

Cited by 12 publications

(13 citation statements)

References 37 publications

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“…The cardiovascular disease was an independent predictor of CR-hvKP infections; such patients with underlying diseases typically received inappropriate empiric therapy. However, more frequent hospital contact may result in exposure to CR-hvKP and are more likely to develop hvKP infections (40,41). While old age and serious complications could reduce immunity and also increase the risk of infection/settlement and even death (42).…”

Section: Discussionmentioning

confidence: 99%

Emergence of Hypervirulent ST11-K64 Klebsiella pneumoniae Poses a Serious Clinical Threat in Older Patients

Tian

Zou

Qin

et al. 2022

Front. Public Health

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The carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) poses a severe therapeutic challenge to global public health, and research on CR-hvKP in older patients remain limited. In this study, we aimed to investigate the clinical and molecular characteristics and risk factors of CR-hvKP infections in older patients. We retrospectively investigated older patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in the intensive care unit (ICU) between January 2020 and December 2020. The clinical data, and microbiological data including antimicrobial susceptibility testing, phenotype experiment and detection of carbapenemases, string test, virulence genes, capsular serotype-specific (cps) genes, and multilocus sequence typing, of the CR-hvKP group defined by the presence of any one of the virulence genes, including rmpA, rmpA2, iucA, iroN, and peg-344 were compared with those of CR-non-hvKP strains. Of the 80 CRKP strains, 51 (63.8%) met the definition of CR-hvKP. The main mechanism of resistance to carbapenems was the presence of the blaKPC−2 gene. Sequence type (ST)11 (81.3%, 65/80) and ST15 (16.3%, 13/80) were the most common STs in CRKP strains. The minimum inhibitory concentration (MIC)50 values of the CR-hvKP group against the six tested antibiotics (ceftazidime, ceftazidime-avibactam, imipenem-avibactam, tigecycline, levofloxacin, and Cefoperazone-Sulbactam) exhibited elevated levels than the CR-non-hvKP group. Ceftazidime and imipenem by combining avibactam (4 μg/mL) significantly decreased the MIC90 values more than 16-fold than ceftazidime and imipenem alone against Klebsiella pneumoniae carbapenemase (KPC)-2-producing K. pneumoniae. Cardiovascular disease [odds ratio (OR) = 11.956] and ST11-K64 (OR = 8.385) appeared to be independent variables associated with CR-hvKP infection by multivariate analysis. In conclusion, higher MICs of the last line antibiotic agents (ceftazidime-avibactam, tigecycline) might be a critical consideration in the clinical management of older patients where the concentration of these toxic antibiotics matters because of underlying comorbidities. Caution regarding KPC-2-producing ST11-K64 CR-hvKP as being new significant “superbugs” is required as they are widespread, and infection control measures should be strengthened to curb further dissemination in nosocomial settings in China.

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Section: Discussionmentioning

confidence: 99%

Emergence of Hypervirulent ST11-K64 Klebsiella pneumoniae Poses a Serious Clinical Threat in Older Patients

Tian

Zou

Qin

et al. 2022

Front. Public Health

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“… 11 Diabetes is generally considered to be a significant risk factor for acquiring a hvKP infection, but not cKP infection. 12 , 13 The reason for this may be that increased serum glucose levels can increase capsule production. Moreover, hyperglycemia may inhibit the chemotaxis, adhesion and phagocytosis of white blood cells, as well as impairing intestinal barrier function and promoting the spread of K. pneumoniae .…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Features of Klebsiella pneumoniae Infection in the Hepatobiliary System of Patients in Yantai, China, Based on Clinical and Genetic Analyses

Yang¹,

Wang²,

Zhao³

et al. 2022

IDR

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“…RmpA is a gene that regulates the synthesis of extracellular polysaccharide capsules and is responsible for hypermucoviscosity and is found in 95.1–99.4% of hvKP ( 6 , 10 ). IutA is a gene encoding the aerobactin system, which is crucial for growth and infection ( 11 ), and is present in 85.3–90.7% of hvKP ( 10 , 12 ). Concurrence of rmpA and iutA may increase the risk of developing a severe form of infection ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

“…Septic shock and multi-organ failure are more common in patients infected with hvKP than in those infected by classical K. pneumoniae (cKP). The mortality rate of hvKP infection is higher in the elderly and those who are infected with carbapenem-resistant strains, but it appears to be similar in the general population between carbapenem-sensitive hvKP and cKP groups ( 12 ). In our study, the patient had type 2 diabetes without taking any hypoglycemics.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of acute respiratory distress syndrome caused by hypervirulent Klebsiella pneumoniae with extracorporeal membrane oxygenation and continuous renal replacement therapy: A case report and literature review

Peng

et al. 2022

Front. Med.

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Hypervirulent Klebsiella pneumoniae (hvKP) causes invasive infections and leads to high morbidity and mortality rates. Here, we report the case of a Chinese man with diabetes mellitus who developed acute respiratory distress syndrome and septic shock due to hvKP belonging to the K1 strain. The patient was treated with venovenous extracorporeal membrane oxygenation and continuous renal replacement therapy, in combination with antibiotics and recovered well. Clinicians should be aware of fatal infections caused by hvKP and investigate the best treatment options for patients at various stages of infection.

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<p>Clinical and Microbiological Characteristics of Invasive and Hypervirulent <em>Klebsiella pneumoniae</em> Infections in a Teaching Hospital in China</p>

Cited by 12 publications

References 37 publications

Emergence of Hypervirulent ST11-K64 Klebsiella pneumoniae Poses a Serious Clinical Threat in Older Patients

Emergence of Hypervirulent ST11-K64 Klebsiella pneumoniae Poses a Serious Clinical Threat in Older Patients

Epidemiological Features of Klebsiella pneumoniae Infection in the Hepatobiliary System of Patients in Yantai, China, Based on Clinical and Genetic Analyses

Successful treatment of acute respiratory distress syndrome caused by hypervirulent Klebsiella pneumoniae with extracorporeal membrane oxygenation and continuous renal replacement therapy: A case report and literature review

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