scholarly journals A case of death within 72 hours after community-acquired bloodstream infection caused by klebsiella variicola

2021 ◽  
Author(s):  
Dali Long ◽  
Yuhui Wang ◽  
Jinlong Wang ◽  
Sijie Mu ◽  
Li Chen ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Rare Case ◽  
Bacterial Culture ◽  
Drug Susceptibility ◽  
Klebsiella Pneumonia ◽  
Gene Detection ◽  
Laboratory Methods ◽  
Short Period ◽  
Genetic Detection ◽  
Illness Progression

Abstract Klebsiella subspecies infection is widely misdiagnosed and underestimated in clinic. We report a patient who was admitted to hospital due to unknown high fever. Bacterial culture only revealed the klebsiella pneumonia. Broad-spectrum antibiotics failed to improve patient's symptoms, although these antibiotics are sensitive to klebsiella pneumonia according to the drug susceptibility results. Patient rapidly entered sepsis and subsequent sepsis shock, and died within 72 hours. The delayed PMseq-DNA Pro high throughput gene detection revealed the mixed infection of klebsiella pneumoniae and klebsiella variicola. This is a very rare case that patient suffered so rapid deterioration and died from bacterial infection within short period of time. Klebsiella variicola could contribute to rapid illness progression, while it was revealed by gene detection rather than classic laboratory methods. Which suggests that early genetic detection should be recommended in cases of complex infection.

Fatal Community-Acquired Bloodstream Infection Caused By Klebsiella Variicola: A Case Report

2021 ◽  
Author(s):  
Dali Long ◽  
Yuhui Wang ◽  
Jinlong Wang ◽  
Sijie Mu ◽  
Li Chen ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Parasitic Infection ◽  
Drug Susceptibility ◽  
Klebsiella Pneumonia ◽  
Gene Detection ◽  
Case Presentation ◽  
First Case ◽  
Short Period ◽  
Genetic Detection

Abstract Background Klebsiella pneumoniae infection leads to significant concerns because of its varied manifestation and resultant mortality. While recent genetic structure analysis reveals that the higher virulence and mortality could be from its subspecies rather than Klebsiella pneumoniae. However, which is often misdiagnosed and underestimated in clinic because it’s difficult to distinguish Klebsiella pneumoniae from its subspecies using classic clinical examinations. This case study is the first in clinic to report the fast and fatal effect of Klebsiella subspecies, and serve as reference for doctors diagnosing similar diseases. Case presentation A 52-years male patient was admitted to hospital due to unknown high fever. All examinations excluded the viruses, fungi, mycoplasma/chlamydia and parasitic infection. Classic bacterial culture revealed the klebsiella pneumonia, however sensitive antibacterial adheres to drug susceptibility results failed to improve patient’s symptoms. His condition worsened and rapidly entered sepsis and subsequent sepsis shock, died within 72 hours of symptom onset. The PMseq-DNA Pro High throughput gene detection was acquired on second day after death revealing the mixed infection of klebsiella variicola and klebsiella pneumoniae. Clinic evidences suggested that Klebsiella variicola rather than klebsiella pneumoniae contributed to patient’s poor prognosis. Conclusions: This is the first case reported that patient died from klebsiella subspecies infection within short period of time. Which suggests that we should be alert to the clinical hazards and fatal effect of klebsiella subspecies. Classic method is limited in guiding the anti-infection therapy for complex cases, early genetic detection should be recommended in the diagnosis and management of complex infection.

scholarly journals Klebsiella pneumoniae do Serotipo K1 e do Clone Hipervirulento ST23: Primeiro Caso Documentado em Portugal

2017 ◽  
Vol 30 (6) ◽  
pp. 496 ◽  
Author(s):  
Aida Pereira ◽  
Tiago Petrucci ◽  
Maria João Simões
Keyword(s):  
Klebsiella Pneumoniae ◽  
Clinical Cure ◽  
Virulent Strain ◽  
Pyogenic Liver Abscess ◽  
Caucasian Woman ◽  
Klebsiella Pneumonia ◽  
Asian Countries ◽  
Catheter Drainage ◽  
Epidemiological Risk ◽  
Old Portuguese

The hypervirulent K1 serotype Klebsiella pneumoniae is responsible for a new invasive syndrome, typically associated to hepatic abscesses with extra-hepatic complications. Initially described in Taiwan, it has significantly spread to several Asian countries and more recently to Europe and North America, thus constituting an emerging and global problem. The authors describe a case report of a 64-years-old portuguese caucasian woman without any previous diseases or epidemiological risk factors such as trips or contact with Asian products or population, diagnosed with a pyogenic liver abscess with pleural effusion caused by this hyper-virulent strain. A successful clinical cure was achieved after the etiological identification and treatment with antimicrobial therapy combined with catheter drainage. This is the first identification of hypervirulent Klebsiella pneumonia ST 23 clone in Portugal in the context of an invasive syndrome.

scholarly journals Antimicrobial resistance of Klebsiella pneumoniae strains isolated from urine in hospital patients and outpatients

2021 ◽  
Vol 5 (1) ◽  
pp. 001-007
Author(s):  
Ostojic Maja ◽  
Hubana Mahir ◽  
Cvetnić Marija ◽  
Benić Miroslav ◽  
Cvetnić Zeljko
Keyword(s):  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Bacterial Species ◽  
Urine Samples ◽  
Klebsiella Pneumonia ◽  
Immunocompromised Patients ◽  
Therapeutic Results ◽  
Highly Effective ◽  
Hospital Patients ◽  
Almost All

Background: Klebsiella pneumoniae is a bacterial species that often causes infections in humans. Infections occur most frequently in hospitalised or immunocompromised patients and are treated with antimicrobials. In recent decades, K. pneumoniae has developed significant resistance to many antimicrobials. Objective: The main goal of this study was to determine the frequency of resistance of isolated K. pneumoniae strains from urine samples of hospital patients and outpatients, and to find evidence of ESBL strains and their resistance to certain antibiotics. Methods: During the study period, Klebsiella pneumonia was isolated from the urine samples of 430 patients. The procedure for processing of urine samples, identification, susceptibility toward antimicrobials and evidence of ESBL strains were carried out according to the recommended standards. Results: Of the total K. pneumoniae isolates, 153 (35.6%) were isolated from hospital patients and 277 (64.4%) from outpatients. Strains isolated from hospital patients were resistant to each tested antibiotic. ESBL strains were detected in 169 (39.30%) samples, 92 (60.13%) from hospital patients and 77 (27.8%) from outpatients. Conclusion: Strains of K. pneumoniae isolated from the urine of hospital patients and outpatients have developed significant resistance against all tested antibiotic substances. A higher occurrence of ESBL strains was observed in hospital patients than in outpatients. ESBL strains were resistant to all penicillins and almost all cephalosporins. Highly effective antimicrobials were amikacin, colistine, carbapenem and fosfomycin. The best therapeutic results were achieved when patients were treated with fosfomycin and imipenem.

scholarly journals Hemophagocytic Lymphohistiocytosis Associated to Klebsiella pneumoniae Infection: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiyu Zhang ◽  
Junqian Liu ◽  
Jinggyue Wang ◽  
Yushi Wang
Keyword(s):  
Case Report ◽  
Klebsiella Pneumoniae ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Klebsiella Pneumonia ◽  
Initial Condition ◽  
Organ Function ◽  
Cardiac Intensive Care Unit ◽  
Function Impairment ◽  
Cardiac Intensive Care

This is a case analysis of a 73-year-old Chinese man admitted to the cardiac intensive care unit (ICU) with fever and general pain. Based on the patient’s initial condition of multi-organ function impairment and increased serum ferritin, and after a series of examinations, the patient was diagnosed with Klebsiella pneumonia-induced hemophagocytic lymphohistiocytosis (HLH). Meropenem and dexamethasone were used in combination to treat the patient, and the results were very successful. In this case report, it is further suggested that Klebsiella pneumoniae is a possible trigger of HLH, and a combination of antibiotics and corticosteroids can be effective in treating HLH. It is also recommended that doctors in the ICU of each department should pay attention to the role of hyperferritinemia in the diagnosis of HLH, and ICU admission teams should include ferritin in their monitoring.

scholarly journals Changing Trends of Antimicrobial Resistance in Neonatal Sepsis: Experience from a Tertiary Care Hospital from West Bengal, India

2021 ◽  
Author(s):  
Manjula Dutta ◽  
Piyali Mitra ◽  
Shankha Subhra Nag ◽  
Abhijit Dutta
Keyword(s):  
Staphylococcus Aureus ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Neonatal Sepsis ◽  
West Bengal ◽  
Tertiary Care ◽  
World Health ◽  
Klebsiella Pneumonia ◽  
High Degree ◽  
Very High

Introduction: Sepsis is the second leading cause of neonatal mortality in India. Emergence of highly resistant microorganisms as an aetiology of neonatal sepsis is a matter of serious concern. Aim: To study the prevailing aetiological agents in neonatal sepsis and their antimicrobial susceptibility pattern. Materials and Methods: A prospective observational study was performed in a tertiary care teaching hospital in neonatal care units in North Bengal Medical College and Hospital, West Bengal, India, over a period of two years from March 2017 to February 2019. All the neonates having clinical features suggestive of sepsis were subjected to blood culture using BacT/ALERT® PF Plus. Microbial identification and antibiotic susceptibility testing was done by VITEK-2 automated systems. Chi-square test was done using Epi info software version 7.1 and p-value <0.05 was considered significant. Results: Out of 403 neonates investigated for suspected sepsis, 156 (38.7%) were found to be culture positive. Klebsiella pneumoniae was the most common organism isolated (n=90, 57.7%) followed by Staphylococcus aureus (n=24, 15.4%) and Acinetobacter baumannii (n=10, 6.4%). Klebsiella pneumoniae showed a very high degree of resistance to ampicillin, amoxycillin- clavulenic acid (100% each), cefotaxime (93.4%), ceftazidime (92.3%), gentamycin (94.5%) and tobramycin (94.5%). High resistance of Staphylococcus aureus was seen against ampicillin (100%), cloxacillin (62.5%), amoxicillin-clavulenic acid (70.9%), and cefotaxime (79.2%). Few isolates of Klebsiella pneumonia (6.6%), Acinetobacter baumannii (60%) and Enterobacter cloacae (50%) were sensitive only to colistin and tigecycline. Conclusion: Most of the isolates showed very high degree of resistance against first line of antibiotics recommended by World Health Organisation (WHO) (ampicillin and gentamycin or amikacin) for empirical treatment of neonatal sepsis. Emergence of highly resistant organisms sensitive only to colistin and tigecycline should be considered as an eye opener. Strict adherence to sepsis prevention along with regular surveillance of organisms and their sensitivity patterns is the need of the hour to improve survival by contributing to antibiotic stewardship.

In silico Repurposing of Anticancer Drug (5-Fluorouracil) as an Antibacterial Agent against Klebsiella pneumoniae

2021 ◽  
Vol 18 ◽  
Author(s):  
Amey Sharma ◽  
Apoorva Rana ◽  
Lakshya Mangtani ◽  
Aakanksha Kalra ◽  
Ravi Ranjan Kumar Niraj
Keyword(s):  
Molecular Docking ◽  
Klebsiella Pneumoniae ◽  
Thymidylate Synthase ◽  
In Silico ◽  
Homology Modelling ◽  
Klebsiella Pneumonia ◽  
Drug Resistant ◽  
Vitro Analysis ◽  
In Vitro Analysis

Background: Infections caused by drug resistant microorganisms have been increasing worldwide thereby being one of the major causes of morbidity in the 21st century. Klebsiella pneumoniae is one such bacteria causing lung inflammation, lung injury and death. Emergence of hyper-virulent and drug resistant species such as ESBL and CRKP has made this microbe a serious and urgent threat. The pace of emergence of these species is outgrowing the development of novel drug and vaccine candidates thereby focusing on drug repurposing approach. Objective: 1. Homology Modelling of Thymidylate Synthase. 2. Verification of Modelled Structure. 3. Molecular Docking. 4. Molecular Dynamic Simulation of Docked Complex. 5. In vitro analysis of 5-FU activity against Klebsiella pneumonia. Method: The 3-D structure of Thymidylate Synthase was predicted using Swiss-Model server and validated by in silico approaches. - Determination protein-protein interactions using STRING database. - Molecular docking. - MD simulations of 5-FU with predicted structure of thymidylate synthase. - In vitro antimicrobial drug sensitivity assay at different concentrations. Result: Hydrogen bond was observed in Molecular Docking - Protein-ligand complex remains stable during simulation. - 5-FU shows antimicrobial activity against Klebsiella pneumonia during In vitro study. Conclusion: Both In silico as well as in vitro analysis have indicated that 5-FU can potentially be developed as an antimicrobial agent towards Klebsiella pneumonia

A Pyogenic Liver Abscess Leading to Massive Pleural Effusion: A Case Report

2021 ◽  
Author(s):  
Ahmad E Al-Mulla
Keyword(s):  
Abdominal Pain ◽  
Pleural Effusion ◽  
Rare Case ◽  
Pyogenic Liver Abscess ◽  
Klebsiella Pneumonia ◽  
Liver Abscesses ◽  
Massive Pleural Effusion ◽  
Atypical Presentations ◽  
Upper Abdominal ◽  
To Receive

Pyogenic liver abscesses are common in tropical developing countries. They are typically present with right and upper abdominal pain; nevertheless, occasionally, we encounter atypical presentations. Here we present a rare case of complicated large liver abscesses caused by Klebsiella pneumonia, which manifests in massive pleural effusion in a young, healthy gentleman. The patient stayed ten days in the hospital for drainage and to receive appropriate antibiotics.

scholarly journals Cutaneous Myiasis Around Gastrostomy (PEG) Tube Insertion Site: The Second Case Report

2019 ◽  
Vol 12 ◽  
pp. 117954761986900
Author(s):  
Mohammed N Bani Hani ◽  
Abdel Rahman Al Manasra ◽  
Hamzeh Daradkah ◽  
Farah Bani Hani ◽  
Zeina Bani Hani
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Insertion Site ◽  
Clinical Form ◽  
Tube Insertion ◽  
Endoscopic Gastrostomy ◽  
Short Period ◽  
Cutaneous Myiasis ◽  
Peg Tube ◽  
Systemic Agents

Background: Myiasis refers to the infestation of live human with 2-winged larvae (maggots). Cutaneous myiasis is the most commonly encountered clinical form. It is divided into 3 main forms: furuncular, creeping (migratory), and wound (traumatic) myiasis. Case report: In this article, we report an extremely rare case of myiasis around percutaneous endoscopic gastrostomy (PEG) tube in a 71-year-old female patient. She had the tube placed for feeding purposes, 8 months prior to her presentation. Family noticed alive worms emerging from skin at the gastrostomy tube insertion site. Patient was treated conservatively with daily dressing with no debridement or use of systemic agents. Conclusions: PEG tube cutaneous myiasis is an extremely rare disease. Conservative management with petroleum-based and sterilizing agents is shown to be efficient to clear the disease in a short period of time.

Species distribution and antimicrobial susceptibility profile of gram-negative bacteria in hospitalized cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20730-e20730
Author(s):  
H. M. Ashour ◽  
A. El-Sharif
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Cancer Patients ◽  
Solid Tumor ◽  
Klebsiella Pneumonia ◽  
Gram Negative Bacteria ◽  
Isolation And Identification ◽  
Tumor Patients ◽  
Acinetobacter Species ◽  
Gram Negative

e20730 Background: Nosocomial infections pose significant threats to hospitalized patients, especially the immunocompromised ones, such as cancer patients. Methods: This study examined the microbial spectrum of gram-negative bacteria in various infection sites in patients with leukemia and solid tumors. The antimicrobial resistance patterns of the isolated bacteria were studied. Results: The most frequently isolated gram-negative bacteria were Klebsiella pneumonia (31.2%) followed by Escherichia coli (22.2%). We report the first-time isolation and identification of a number of less-frequent gram negative bacteria (Chromobacterium violacum, Burkholderia cepacia, Kluyvera ascorbata, Stenotrophomonas maltophilia, Yersinia pseudotuberculosis, and Salmonella arizona). Most of the gram-negative isolates from RTI, GITI, UTI, and BSI were obtained from leukemic patients. All gram-negative isolates from SI were obtained from solid-tumor patients. In both leukemic and solid-tumor patients, gram-negative bacteria causing UTI were mainly Escherichia coli and Klebsiella pneumoniae, while gram-negative bacteria causing RTI were mainly Klebsiella pneumoniae. Escherichia coli was the main gram-negative pathogen causing BSI in solid-tumor patients and GITI in leukemic patients. Isolates of Escherichia coli, Klebsiella, Enterobacter, Pseudomonas, and Acinetobacter species were resistant to most antibiotics tested. There was significant imipenem-resistance in Acinetobacter (40.9%), Pseudomonas (40%), and Enterobacter (22.2%) species, and noticeable imipinem-resistance in Klebsiella (13.9%) and Escherichia coli (8%). Conclusions: This is the first study to report the evolution of imipenem-resistant gram-negative strains in Egypt. Mortality rates were higher in cancer patients with nosocomial Pseudomonas infections than any other bacterial infections. Policies restricting antibiotic consumption should be implemented to avoid the evolution of newer generations of antibiotic resistant-pathogens. No significant financial relationships to disclose.

scholarly journals Inhibitors of Antibiotic Efflux in Resistant Enterobacter aerogenes and Klebsiella pneumoniae Strains

2004 ◽  
Vol 48 (3) ◽  
pp. 1043-1046 ◽  
Author(s):  
Jacqueline Chevalier ◽  
Jérôme Bredin ◽  
Abdallah Mahamoud ◽  
Monique Malléa ◽  
Jacques Barbe ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Klebsiella Pneumoniae ◽  
Efflux Pump ◽  
Enterobacter Aerogenes ◽  
Drug Susceptibility ◽  
Multidrug Resistant ◽  
Resistance Phenotype ◽  
Pump Mechanism ◽  
Energy Dependent ◽  
Antibiotic Efflux

ABSTRACT In Enterobacter aerogenes and Klebsiella pneumoniae, efflux provides efficient extrusion of antibiotics and contributes to the multidrug resistance phenotype. One of the alkoxyquinoline derivatives studied here, 2,8-dimethyl-4-(2′-pyrrolidinoethyl)-oxyquinoline, restores noticeable drug susceptibility to resistant clinical strains. Analyses of energy-dependent chloramphenicol efflux indicate that this compound inhibits the efflux pump mechanism and improves the activity of structurally unrelated antibiotics on multidrug-resistant E. aerogenes and K. pneumoniae isolates.

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