Skip to main content Accesibility Help
×
×
Home

Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea

  • S. W. JUNG (a1), H. J. CHAE (a1), Y. J. PARK (a1), J. K. YU (a1), S. Y. KIM (a2), H. K. LEE (a3), J. H. LEE (a4), J. M. KAHNG (a5), S. O. LEE (a6), M. K. LEE (a7), J. H. LIM (a8), C. H. LEE (a9), S. J. CHANG (a10), J. Y. AHN (a11), J. W. LEE (a12) and Y. G. PARK (a13)...
Summary

Hypermucoviscous (HV) isolates of Klebsiella pneumoniae have been linked to virulence potential in experimental infections. We examined 33 isolates of K. pneumoniae from patients with bacteraemia for the HV phenotype on agar culture, and determined their virulence potential by screening for capsular (K) serotype by polymerase chain reaction and the presence of seven virulence factor genes. Fourteen (42·4%) isolates expressed the HV phenotype and 11 of these were serotype K1 or K2; these serotypes were not identified in HV-negative isolates. The genes rmpA, rmpA2, aerobactin, wabG and allS were significantly more frequent in HV than non-HV isolates. Multilocus sequence typing identified 21 sequence types (ST), eight of which were found in HV-positive isolates and the clonal relatedness of isolates of the most frequent types (ST23 and ST11) from different hospitals was confirmed by pulsed-field gel electrophoresis. The HV phenotype was more associated with community-acquired infection with a lower frequency of fatal underlying illness, but with significantly more focal infections, notably liver abscesses. Clinicians should be aware of such clinical impacts of the HV phenotype.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Microbiological and clinical characteristics of bacteraemia caused by the hypermucoviscosity phenotype of Klebsiella pneumoniae in Korea
      Available formats
      ×
Copyright
Corresponding author
*Author for correspondence: Y. J. Park, M.D., Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul St Mary's Hospital, 505 Banpo-dong, Seocho-ku, Seoul 137-701, Korea. (Email: yjpk@catholic.ac.kr)
References
Hide All
1.Brook, I, Frazier, EH. Microbiology of liver and spleen abscesses. Journal of Medical Microbiology 1998; 47: 10751080.
2.Seo, TJ, et al. A clinical study on liver abscess for recent 15 years in Gwang, Cjuhonnam province. Korean Journal of Medicine 2005; 68: 2638.
3.Chung, DR, et al. Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. Journal of Infection 2007; 54: 578583.
4.Fung, CP, et al. A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? Gut 2002; 50: 420424.
5.Jaureguy, F, et al. Phylogenetic and genomic diversity of human bacteremic Escherichia coli strains. BMC Genomics 2008; 26: 560.
6.Sukhnanand, S, et al. DNA sequence-based subtyping and evolutionary analysis of selected Salmonella enterica serotypes. Journal of Clinical Microbiology 2005; 43: 36883698.
7.Brisse, S, et al. Virulent clones of Klebsiella pneumoniae: identification and evolutionary scenario based on genomic and phenotypic characterization. PLoS One 2009; 4: e4982.
8.Moses, AE, et al. Relative contributions of hyaluronic acid capsule and M protein to virulence in a mucoid strain of the group A Streptococcus. Infection and Immunity 1997; 65: 6471.
9.Fang, CT, et al. A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. Journal of Experimental Medicine 2004; 199: 697705.
10.Struve, C, et al. Investigation of the putative virulence gene magA in a worldwide collection of 495 Klebsiella isolates: magA is restricted to the gene cluster of Klebsiella pneumoniae capsule serotype K1. Journal of Medical Microbiology 2005; 54: 11111113.
11.Yeh, KM, et al. MagA is not a specific virulence gene for Klebsiella pneumoniae strains causing liver abscess but is part of the capsular polysaccharide gene cluster of K. pneumoniae serotype K1. Journal of Medical Microbiology 2006; 55: 803804.
12.Nassif, X, et al. Positive control of colanic acid synthesis in Escherichia coli by rmpA and rmpB, two virulence-plasmid genes of Klebsiella pneumoniae. Molecular Microbiology 1989; 3: 13491359.
13.Yu, WL, et al. Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clinical Infectious Diseases 2006; 15: 13511358.
14.Pomakova, DK, et al. Clinical and phenotypic differences between classic and hypervirulent Klebsiella pneumoniae: an emerging and under-recognized pathogenic variant. European Journal of Clinical Microbiology & Infectious Diseases. Published online: 15 September 2011. doi:10.1007/s10096-011-1396-6.
15.Turton, JF, et al. Genetically similar isolates of Klebsiella pneumoniae serotype K1 causing liver abscesses in three continents. Journal of Medical Microbiology 2007; 56: 593597.
16.Yu, VL, et al. Virulence characteristics of Klebsiella and clinical manifestations of K. pneumoniae bloodstream infections. Emerging Infectious Diseases 2007; 13: 986993.
17.McCabe, WR, Jackson, GG. Gram-negative bacteremia: I. Etiology and ecology. Archives of Internal Medicine 1962; 110: 847855.
18.Song, W, et al. Detection of extended-spectrum beta-lactamases by using boronic acid as an AmpC beta-lactamase inhibitor in clinical isolates of Klebsiella spp. and Escherichia coli. Journal of Clinical Microbiology 2007; 45: 11801184.
19.Wacharotayankun, R, et al. Enhancement of extracapsular polysaccharide synthesis in Klebsiella pneumoniae by RmpA2, which shows homology to NtrC and FixJ. Infection and Immunity 1993; 61: 31643174.
20.Lee, CH, et al. Hypermucoviscosity associated with Klebsiella pneumoniae-mediated invasive syndrome: a prospective cross-sectional study in Taiwan. International Journal of Infectious Diseases 2010; 14: e688692.
21.Lin, WH, et al. Clinical and microbiologic characteristics of Klebsiella pneumoniae isolates causing community-acquired urinary tract infections. Infection 2010; 38: 459464.
22.Diancourt, L, et al. Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. Journal of Clinical Microbiology 2005; 43: 41784182.
23.Böhm, H, et al. DNA fingerprinting of Escherichia coli O157: H7 strains by pulsed-field gel electrophoresis. Journal of Clinical Microbiology 1992; 30: 21692172.
24.Tenover, FC, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. Journal of Clinical Microbiology 1995; 33: 22332239.
25.Nassif, X, et al. Correlation of the virulence of Klebsiella pneumoniae K1 and K2 with the presence of a plasmid encoding aerobactin. Infection and Immunity 1986; 54: 603608.
26.Nassif, X, et al. Mucoid phenotype of Klebsiella pneumoniae is a plasmid-encoded virulence factor. Infection and Immunity 1989; 57: 546552.
27.Simoons-Smit, AM, et al. Virulence of Klebsiella strains in experimentally induced skin lesions in the mouse. Journal of Medical Microbiology 1984; 17: 6777.
28.Mizuta, LG, et al. Virulence for mice of Klebsiella strains belonging to the O1 group: relationship to their capsular (K) types. Infection and Immunity 1983; 40: 5661.
29.Yu, WL, et al. Comparison of prevalence of virulence factors for Klebsiella pneumoniae liver abscesses between isolates with capsular K1/K2 and non-K1/K2 serotypes. Diagnostic Microbiology and Infectious Disease 2008; 62: 16.
30.Fang, CT, et al. Klebsiella pneumonia genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clincal Infectious Diseases 2007; 45: 284293.
31.Decré, D, et al. Emerging severe and fatal infections due to Klebsiella pneumoniae in two university hospitals in France. Journal of Clinical Microbiology 2011; 49: 30123014.
32.Jeong, SH, et al. Molecular characterization of extended-spectrum beta-lactamases produced by clinical isolates of Klebsiella pneumoniae and Escherichia coli from a Korean nationwide survey. Journal of Clinical Microbiology 2004; 42: 29022906.
33.Ko, KS, et al. Predominance of an ST11 extended-spectrum beta-lactamase producing Klebsiella pneumoniae clone causing bacteraemia and urinary tract infections in Korea. Journal of Medical Microbiology 2010; 59: 822828.
34.Kang, YS, et al. Trade-off between antibiotic resistance and biological fitness in Acinetobacter sp. strain DR1. Environmental Microbiology 2010; 12: 13041318.
35.Tang, HL, et al. Correlation between Klebsiella pneumoniae carrying pLVPK-derived loci and abscess formation. European Journal of Clinical Microbiology & Infectious Diseases 2010; 29: 689698.
36.Kitchel, B, et al. Molecular epidemiology of KPC producing Klebsiella pneumoniae isolates in the United States: clonal expansion of multilocus sequence type 258. Antimicrobial Agents and Chemotherapy 2009; 53: 33653370.
37.Rhee, JY, et al. KPC-producing extreme drug-resistant Klebsiella pneumoniae isolate from a patient with diabetes mellitus and chronic renal failure on hemodialysis in South Korea. Antimicrobial Agents and Chemotherapy 2010; 54: 22782279.
38.Qi, Y, et al. ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China. Journal of Antimicrobial Chemotherapy 2011; 66: 307312.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed