Primary osteomyelitis caused by hypervirulent Klebsiella pneumoniae

Prokesch, Bonnie C; TeKippe, Michael; Kim, Jiwoong; Raj, Prithvi; TeKippe, Erin Mc Elvania; Greenberg, David E.

doi:10.1016/s1473-3099(16)30021-4

Cited by 102 publications

(83 citation statements)

References 50 publications

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“…The HMKP strains usually have a distinct hypermucoviscosity phenotype when grown on agar plates (Struve et al, 2015). Since its emergency in Southeast Asia, HMKP has caused sporadic infections in many countries from North America, Europe, South America, Middle East, Australia and Africa (Fang et al, 2005; Siu et al, 2012; Shon et al, 2013; Bialek-Davenet et al, 2014; Yang et al, 2014; Struve et al, 2015; Prokesch et al, 2016). A number of putative virulence genes, including mucoviscosity-associated gene A ( magA ), regulator of mucoid phenotype A ( rmpA ) and aerobactin genes ( aerobactin ), have been found to be associated with HMKP (Fang et al, 2004; Yu et al, 2006; Russo et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Zhan

Wang

Guo

et al. 2017

Front. Cell. Infect. Microbiol.

143

134

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Hypervirulent and multidrug resistant Klebsiella pneumoniae strains pose a significant threat to the public health. In the present study, 21 carbapenem-resistant K. pneumoniae isolates (CRKP) were determined by the string test as hypermucoviscous K. pneumoniae (HMKP), with the prevalence of 15.0% (21/140) among CRKP, and 1.1% (21/1838) among all K. pneumoniae isolates. Among them, 7 (33.3%), and 1 (4.76%) isolate belonged to capsular serotype K20 and K2 respectively, while 13 (61.9%, 13/21) weren't successfully typed by capsular serotyping. All the 21 isolates were carbapenemase-producers and were positive for blaKPC-2. In addition to blaKPC-2, all the 21 isolates except one harbor blaSHV-11, and 15 carry extended-spectrum β-lactamase gene blaCTX-M-65. The virulence-associated genes with more than 90% of positive rates among 21 isolates included ureA (100%, 21/21), wabG (100%, 21/21), fimH (95.2%, 20/21), entB (95.2%, 20/21), ycf (95.2%, 20/21), ybtS (95.2%, 20/21), and iutA (90.5%, 19/21). rmpA and aerobactin were found in 57.1% (12/21) isolates. Five sequence types (STs) were identified by multilocus sequence typing (MLST), including ST11 (11 K-non capsule typable and 5 K20 isolates), ST268 (1 K20 isolate and 1 K-non capsule typable isolate), ST65 (1 K2 isolate), ST692 (1 K-non capsule typable isolate), and ST595, a novel sequence type (1 K-non capsule typable isolate). Pulsed-field gel electrophoresis (PFGE) results showed two major PFGE clusters, of which cluster A accounts for 6 ST11 isolates (28.6%) and cluster B includes 8 ST11 isolates (38.1%, 8/21). Ten and six ST11 isolates were isolated from 2014 and 2015, respectively, while 8 were isolated from the same month of December in 2014. Ten isolates were collected from the intensive care unit (ICU), and all except one belonged to ST11. Additional 4 ST11 isolates were collected from patients in non-ICU wards, who had more than 10 days of ICU stay history in 2014 prior to transfer to their current wards where the isolates were recovered. Taken together, the present study showed a hospital outbreak and dissemination of ST11 HMKP with carbapenem resistance caused by KPC-2. Effective surveillance and strict infection control strategies should be implemented to prevent outbreak by HMKP with carbapenem resistance in hospitals.

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Section: Introductionmentioning

confidence: 99%

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Zhan

Wang

Guo

et al. 2017

Front. Cell. Infect. Microbiol.

143

134

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“…Klebsiella pneumoniae is associated with a wide range of diseases, including urinary tract infections, respiratory tract infections, septicemia, pyogenic liver abscess, primary osteomyelitis and so on (Podschun and Ullmann, 1998; Brisse et al, 2009; Prokesch et al, 2016). This organism is considered as an opportunistic pathogen which commonly causes nosocomial infections (Podschun and Ullmann, 1998; Pitout et al, 2015; Campos et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Defining and Evaluating a Core Genome Multilocus Sequence Typing Scheme for Whole-Genome Sequence-Based Typing of Klebsiella pneumoniae

et al. 2017

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At present, the most used methods for Klebsiella pneumoniae subtyping are multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). However, the discriminatory power of MLST could not meet the need for distinguishing outbreak and non-outbreak isolates and the PFGE is time-consuming and labor-intensive. A core genome multilocus sequence typing (cgMLST) scheme for whole-genome sequence-based typing of K. pneumoniae was developed for solving the disadvantages of these traditional molecular subtyping methods. Firstly, we used the complete genome of K. pneumoniae strain HKUOPLC as the reference genome and 907 genomes of K. pneumoniae download from NCBI database as original genome dataset to determine cgMLST target genes. A total of 1,143 genes were retained as cgMLST target genes. Secondly, we used 26 K. pneumoniae strains from a nosocomial infection outbreak to evaluate the cgMLST scheme. cgMLST enabled clustering of outbreak strains with <10 alleles difference and unambiguous separation from unrelated outgroup strains. Moreover, cgMLST revealed that there may be several sub-clones of epidemic ST11 clone. In conclusion, the novel cgMLST scheme not only showed higher discriminatory power compared with PFGE and MLST in outbreak investigations but also showed ability to reveal more population structure characteristics than MLST.

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“…In the last two decades, a new hypervirulent strain of K. pneumoniae (hvKP) has increasingly reported in Southeastern Asia and other non‐Asian countries, including Brazil . The invasive strain of hvKP has caused a fatal syndrome in humans including pulmonary embolism, abscesses, meningitis, endophthalmitis, osteomyelitis, or brain abscess and pyogenic liver abscess . Clinical signs and bacterial genotypic and phenotypic features distinguish this variant from the opportunistic K. pneumoniae .…”

Section: Introductionmentioning

confidence: 99%

First case report of non‐human primates (Alouatta clamitans) with the hypervirulent Klebsiella pneumoniae serotype K1 strain ST 23: A possible emerging wildlife pathogen

Anzai

Júnior

Peruchi

et al. 2017

J of Medical Primatology

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Primary osteomyelitis caused by hypervirulent Klebsiella pneumoniae

Cited by 102 publications

References 50 publications

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Outbreak by Hypermucoviscous Klebsiella pneumoniae ST11 Isolates with Carbapenem Resistance in a Tertiary Hospital in China

Defining and Evaluating a Core Genome Multilocus Sequence Typing Scheme for Whole-Genome Sequence-Based Typing of Klebsiella pneumoniae

First case report of non‐human primates (Alouatta clamitans) with the hypervirulent Klebsiella pneumoniae serotype K1 strain ST 23: A possible emerging wildlife pathogen

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