scholarly journals Clinical, microbiological, and molecular epidemiological characteristics of Klebsiella pneumoniae-induced pyogenic liver abscess in southeastern China

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Siqin Zhang ◽  
Xiucai Zhang ◽  
Qing Wu ◽  
Xiangkuo Zheng ◽  
Guofeng Dong ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Southeastern China ◽  
Antimicrobial Drugs ◽  
Tertiary Teaching ◽  
Epidemiological Characteristics

Abstract Background Klebsiella pneumoniae-induced pyogenic liver abscess (KP-PLA) has emerged as a life-threatening disease worldwide. However, to date, a limited number of scholars have attempted to systematically elucidate the characteristics of KP-PLA. The aim of the present study was to analyze clinical, microbiological, and molecular epidemiological characteristics of KP-PLA patients in Southeastern China. Methods The KP-PLA cases from a tertiary teaching hospital in China from January 2016 to December 2017 were systemically studied and elucidated comprehensively. The virulence factors, resistant spectrum, and clones of K. pneumoniae isolates were identified with string test, polymerase chain reaction (PCR), antimicrobial susceptibility test, and multilocus sequence typing. Moreover, the characteristics in KP-PLA patients with and without other hepatobiliary diseases (OHD) were also been compared. Results A total of 163 KP-PLA cases were enrolled, in which the majority of those cases were senior males, and often associated with multiple underlying diseases, including diabetes (49.7%). The remaining cases belonged to healthy individuals (50.3%). The clinical symptoms were common but nonspecific, characterized by increased inflammatory parameters and abnormal liver function parameters. The abscess was often right-sided solitary presentation (58.3%). Cephalosporin or carbapenem plus metronidazole combined with percutaneous puncture or catheter drainage were favorable therapeutics. Although low resistance rates of commonly used antimicrobial drugs (< 10%) were observed, twelve strains were identified as multidrug resistant (MDR) strains, and were mainly isolated from the OHD patients. The hypermucoviscosity, as well as K1 and K2 serotypes accounted for 30.7, 40.5, and 19.0%, respectively. Except for iroN (24.5%) and magA (45.4%), the high prevalence of virulence genes (e.g. aerobactin, rmpA, mrkD, fimH, uge, ureA, entB, ybtA, kfuBC, and wcaG) was identified (68.7–100.0%). Additionally, ST23 was found as a predominant sequence type (ST; 38.7%), and three novel STs (ST3507, ST3508 and ST3509) were noted as well. Conclusions The present study reported the abundant hvKp strains in KP-PLA, as well as convergence of hypervirulent and MDR K. pneumoniae isolates from the KP-PLA patients, particularly those cases with OHD. Given the various clinical manifestations and destructive pathogenicity, determination of the comprehensive characteristics of such isolates is highly essential to effectively carry out for optimal management and treatment of KP-PLA.

scholarly journals Virulence Characteristics and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2021 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Growth Curves ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Infection Model ◽  
Tertiary Teaching ◽  
String Test ◽  
Serum Killing

Abstract Background: To date, little is known about the virulence characteristics of pyogenic liver abscess (PLA) that cause multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae), and this might be due to that these strains are rare. This study aimed to analyze the virulence characteristics and molecular epidemiology of 12 MDR strains obtained from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes, and genotypes.Results: The results of growth curves, string test, capsular quantification, serum killing test, biofilm formation assay, and infection model revealed that the virulence phenotypes of the 12 PLA-causing MDR K. pneumoniae were similar or even more obvious than those of typical hypervirulent K. pneumoniae strains. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. The results of multilocus sequence typing (MLST) illustrated that the MDR strains were categorized into 9 sequence types.Conclusions: This study is the first to analyze the virulence characteristics in PLA-causing MDR strains. Our data exhibited the coexistence of hypervirulence and MDR in PLA-causing MDR K. pneumoniae strains, and the clones of those PLA-causing MDR strains were diverse and scattered. This study first found one ST11 carbapenem-resistant hypervirulent strain in PLA.

scholarly journals Virulence Factors and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2020 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Virulence Factors ◽  
Growth Curves ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Infection Model ◽  
Tertiary Teaching ◽  
String Test

Abstract Background: To date, little is known about virulence characteristics of pyogenic liver abscess (PLA) causing multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae). It may be that these strains are rare. The aim of this study was to analyze the virulence characteristics and molecular epidemiology of 12 MDR strains from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes and genotypes.Results: The virulence phenotypes of the 12 PLA-causing MDR K. pneumoniae were similar or even more obvious than those of typical hypervirulent Klebsiella pneumoniae control strains according to the results of growth curves, string test, capsular quantification, serum killing test, biofilm formation assay, and infection model. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. Multilocus sequence typing (MLST) illustrated that the MDR strains were categorized into nine sequence types.Conclusions: This study is the first analysis of the virulence factors in PLA-causing MDR strains. Our data exhibited the coexistence of hypervirulence and multidrug resistance in PLA-causing MDR K. pneumoniae strains, and the clones of those PLA-causing MDR strains were diverse and scattered. The study was firstly found one ST11 carbapenem-resistant hypervirulent strain in PLA.

scholarly journals Virulence Factors and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2020 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Virulence Factors ◽  
Virulence Genes ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Carbapenem Resistant ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital

Abstract Background: To date, little is known about virulence characteristics of pyogenic liver abscess (PLA) causing multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae). It may be these strains are rare. The aim of this study was to analyze the virulence and molecular epidemiology of 12 MDR strains from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes and genotypes.Results: The virulence phenotypes of the twelve PLA-causing MDR K. pneumoniae were similar or even more obvious than those of sensitive hypervirulent Klebsiella pneumoniae control strains. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. Multilocus sequence typing (MLST) revealed the PLA-causing MDR strains had low clone correlation.Conclusions: This study was the first analysis on virulence factors of PLA-causing MDR strains. The virulent factors exhibited the coexistence of hypervirulence and multidrug resistance in PLA-causing MDR K. pneumoniae strains, and these MDR strains were mainly polyclonal spread and there was firstly found one ST11 carbapenem-resistant hypervirulent strain in PLA.

scholarly journals Clinical Features and Development of Sepsis in Klebsiella Pneumoniae Infected Liver Abscess Patients: A Retrospective Analysis of 135 Cases

2021 ◽  
Author(s):  
Shixiao Li ◽  
Sufei Yu ◽  
Minfei Peng ◽  
Jiajia Qin ◽  
Chunyan Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Clinical Features ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
High Rate ◽  
Sepsis Group ◽  
Common Symptom ◽  
Tertiary Teaching ◽  
Infected Liver ◽  
And Control

Abstract Background Klebsiella pneumoniae is a primary pathogen of pyogenic liver abscess (PLA). However, little data are available on combination with sepsis. In this study, we aimed to evaluate the clinical characteristics and prognostic differences of PLA patients with sepsis. Methods This retrospective cohort study was conducted to investigate 135 patients with confirmed Klebsiella pneumoniae-caused liver abscesses (KPLA) from a tertiary teaching hospital, from 2013 to 2019. The patients were divided into two groups based on comorbidity with sepsis. The demographic characteristics, clinical features as well as laboratory and microbiologic findings was analyzed. Results The 135 patients were analyzed, with a mean age of 60.9 ± 12.7 years, and 59.3% were men. Among them, 37/135 (27.4%) had comorbid sepsis and mortality rate was 1.5%. The most common symptom was fever (91.1%). KPLA patients with sepsis had a significantly higher proportion of frailty, diarrhea, fatty liver, chronic renal insufficiency, and hepatic dysfunction (p < 0.05). Antibiotic therapy and percutaneous drainage were most frequently used. The incidences of sepsis shock, acute respiratory distress syndrome was higher in the sepsis group compared to the non-sepsis group. As for metastatic infections, the lung was the most common site. Respiratory symptoms were found in 11 patients, and endophthalmitis coexisted in 4 patients, and meningitis occurred in 1 patient. Conclusion Our findings emphasize that KPLA patients combined with and without sepsis have different clinical features, but KPLA patients with sepsis have a high rate of complications and metastatic infections. Further surveillance and control of septic spread is essential in KPLA patients.

scholarly journals Clinical features and development of Sepsis in Klebsiella pneumoniae infected liver abscess patients: a retrospective analysis of 135 cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shixiao Li ◽  
Sufei Yu ◽  
Minfei Peng ◽  
Jiajia Qin ◽  
Chunyan Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Clinical Features ◽  
Liver Abscess ◽  
Pyogenic Liver Abscess ◽  
Sepsis Group ◽  
Common Symptom ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Infected Liver ◽  
And Control

Abstract Background Klebsiella pneumoniae is a primary pathogen of pyogenic liver abscess (PLA). However, little data are available on combination with sepsis. In this study, we aimed to evaluate the clinical characteristics and prognostic differences of PLA patients with sepsis. Methods This retrospective cohort study was conducted to investigate 135 patients with confirmed Klebsiella pneumoniae-caused liver abscesses (KPLA) from a tertiary teaching hospital, from 2013 to 2019. The patients were divided into two groups, KPLA with sepsis and KPLA without sepsis. The demographic characteristics, clinical features as well as laboratory and microbiologic findings were analyzed. Results A total of 135 patients with KPLA were analyzed. The mean age of patients was 60.9 ± 12.7 years, and the percentage of men was 59.3%. Among them, 37/135 (27.4%) of patients had sepsis and the mortality rate was 1.5%. The most common symptom was fever (91.1%). KPLA patients with sepsis had a significantly higher proportion of frailty, diarrhea, fatty liver, chronic renal insufficiency, and hepatic dysfunction compared to KPLA patients without sepsis (p < 0.05). Antibiotic therapy and percutaneous drainage were most frequently therapeutic strategy. Furthermore, the incidences of sepsis shock and acute respiratory distress syndrome were higher in the sepsis group compared to the non-sepsis group. As for metastatic infections, the lung was the most common site. In addition, KPLA patients with sepsis showed respiratory symptoms in 11 patients, endophthalmitis in 4 patients, and meningitis in 1 patient. Conclusion Our findings emphasize that KPLA patients combined with or without sepsis have different clinical features, but KPLA patients with sepsis have higher rates of complications and metastatic infections. Taken together, further surveillance and control of septic spread is essential for KPLA patients.

scholarly journals PYOGENIC LIVER ABSCESS: DIAGNOSTIC AND THERAPEUTIC MANAGEMENT

2016 ◽  
Vol 29 (3) ◽  
pp. 194-197 ◽  
Author(s):  
Otto Mauro dos SANTOS-ROSA ◽  
Henrique Simonsen LUNARDELLI ◽  
Marcelo Augusto Fontenelle RIBEIRO-JUNIOR
Keyword(s):  
Liver Abscess ◽  
Percutaneous Drainage ◽  
Clinical Manifestations ◽  
Biliary Tract Disease ◽  
Positive Association ◽  
High Sensitivity ◽  
Pyogenic Liver Abscess ◽  
Treatment Method ◽  
Significant Positive Association ◽  
Epidemiological Characteristics

ABSTRACT Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource.

scholarly journals Foodborne Klebsiella pneumoniae: Virulence Potential, Antibiotic Resistance, and Risks to Food Safety

2020 ◽  
Vol 83 (7) ◽  
pp. 1096-1103 ◽  
Author(s):  
SRI HARMINDA PAHM HARTANTYO ◽  
MAN LING CHAU ◽  
TSE HSIEN KOH ◽  
MIN YAP ◽  
TSENG YI ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Antibiotic Resistance Genes ◽  
Pyogenic Liver Abscess ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Predisposing Factor ◽  
Phenotypic Resistance ◽  
Genetic Pool

ABSTRACT Gastrointestinal carriage of Klebsiella pneumoniae is a predisposing factor for liver abscess in several Asian countries. To determine whether hypervirulent K. pneumoniae in the gut may be transmitted through food, we screened a range of raw and ready-to-eat retail food by culture and recovered K. pneumoniae in 21% (147 of 698) of samples tested. Based on PCR, no K. pneumoniae isolates carried the rmpA gene linked to community-acquired pyogenic liver abscess, providing no evidence of a link between food and liver disease. However, phenotypic resistance to multiple antibiotic classes was seen through disk diffusion tests, and carriage of genetic elements (wcaG and capsule types K1, K2, and K54) associated with increased virulence (8%, 11 of 147) was observed by PCR. Multidrug-resistant isolates were from raw vegetables, chicken or pork liver, and a ready-to-eat poultry dish; one multidrug-resistant K. pneumoniae isolate from raw bean sprouts was resistant to a third-generation cephalosporin (ceftriaxone). Although K. pneumoniae may be present in food without causing harm, we found isolates belonging to the K1 capsular serotype coexisting with the wcaG gene, one also conferring multidrug resistance. K. pneumoniae that carry antibiotic resistance genes, regardless of pathogenicity, may increase the available genetic pool of resistance along the food chain. Hygienic food handling practices are necessary to lower risks of acquiring K. pneumoniae and other opportunistic pathogens.  HIGHLIGHTS

scholarly journals Virulence Characteristics and Molecular Epidemiology of Pyogenic Liver Abscess Causing Multidrug Resistant Klebsiella pneumoniae in Wenzhou, China

2021 ◽  
Author(s):  
Zhongyong Wang ◽  
Siqin Zhang ◽  
Na Huang ◽  
Shixing Liu ◽  
Ye Xu ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Liver Abscess ◽  
Biofilm Formation ◽  
Growth Curves ◽  
Pyogenic Liver Abscess ◽  
Multidrug Resistant ◽  
Infection Model ◽  
String Test ◽  
Serum Killing

Abstract Background To date, little is known about the virulence characteristics of pyogenic liver abscess (PLA) that cause multidrug resistant (MDR) Klebsiella pneumoniae (K. pneumoniae), which might be due to the rarity of these strains. This study aimed to analyze the virulence characteristics and molecular epidemiology of 12 MDR strains obtained from 163 PLA cases in a tertiary teaching hospital from the perspective of clinical characteristics, virulence phenotypes, and genotypes. Methods The MDR strains were obtained from sterile fluid samples collected from patients with PLA. The antimicrobial susceptibility testing was confirmed by the agar dilution method and microdilution broth method. The virulence phenotypes were analyzed by the growth curves, string test, capsular quantification, serum killing test, biofilm formation assay and infection model. Polymerase chain reaction (PCR) was used to investigate the virulence genotypes. The molecular epidemiology was identified by multilocus sequence typing (MLST). Results The results of growth curves, string test, capsular quantification, serum killing test, biofilm formation assay, and infection model revealed that the virulence phenotypes of the 12 PLA-causing MDR K. pneumoniae were similar to or more obvious than those of the typical hypervirulent K. pneumoniae strains. These MDR strains were mainly non-K1/K2 serotypes and carried multiple virulence genes. The results of MLST illustrated that the MDR strains were categorized into 9 sequence types. Conclusions This is the first study to analyze the virulence characteristics in PLA-causing MDR strains. The data revealed the coexistence of hypervirulence and MDR in PLA-causing MDR K. pneumoniae strains, and the clones of these strains were diverse and scattered. Also, one ST11 carbapenem-resistant hypervirulent strain was identified in PLA.

scholarly journals Importation of Entamoeba histolytica and predominance of Klebsiella pneumoniae in liver abscesses: a 7-year retrospective cohort study from the United Arab Emirates

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hussam Mousa ◽  
Ghada Salameh Mohammed Al-Bluwi ◽  
Zainab Fathi Mohammed Al Drini ◽  
Huda Imam Gasmelseed ◽  
Jamal Aldeen Alkoteesh ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
United Arab Emirates ◽  
Liver Abscess ◽  
Hospital Admissions ◽  
Indian Subcontinent ◽  
Pyogenic Liver Abscess ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Liver Abscesses ◽  
Potential Risk Factors

Abstract Background There is a dearth of information on liver abscesses in the United Arab Emirates. Herein, we describe the clinical features of liver abscesses and determine their incidence rates and clinical outcomes. Methods We retrospectively reviewed the clinical charts of adult patients with a primary diagnosis of liver abscess at a major hospital over a 7-year period. Results Amongst 45 patients, 82.2% (37/45) had a pyogenic liver abscess (PLA) and 17.8% (8/45) had amoebic liver abscesses (ALA). Overall, patients were young (median age 42 years, IQR 35–52), mostly males (77.8%, 35/45) from the Indian subcontinent (55.6%, 25/45), presented with fever (88.9%, 40/45) and abdominal pain (88.9%, 40/45), and had a solitary abscess on imaging (71.1% (32/45). Crude annual incidence rates were 35.9/100,000 hospital admissions (95% CI 26.2–48.0) and 5.9/100,000 inhabitants (95% CI 4.3–7.9). All ALA patients were from the Indian subcontinent (100%, 8/8). Klebsiella pneumoniae was the most frequent pathogen in PLA (43.2% [16/37], 95% CI 27.1–60.5%). The hospital stay was shorter in ALA (7.5 days, IQR 7–8.5) than in PLA (14 days, IQR 9–17). No deaths were recorded within 30 days of hospitalisation. Conclusions ALA was exclusively seen in migrants from the Indian subcontinent, suggesting importation. Further research to characterise K. pneumoniae isolates and assess potential risk factors is needed.

Sign in / Sign up

Export Citation Format

Share Document