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 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 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 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 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 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 Molecular Characterization of blaIMP–4-Carrying Enterobacterales in Henan Province of China

2021 ◽  
Vol 12 ◽  
Author(s):  
Wentian Liu ◽  
Huiyue Dong ◽  
Tingting Yan ◽  
Xuchun Liu ◽  
Jing Cheng ◽  
...  
Keyword(s):  
Plasmid Stability ◽  
Multidrug Resistant ◽  
Complete Sequence ◽  
Molecular Characteristics ◽  
Carbapenem Resistant ◽  
Predominant Type ◽  
Tertiary Teaching ◽  
Query Coverage ◽  
Tertiary Teaching Hospital ◽  
Positive Isolate

Carbapenem-resistant Enterobacterales (CRE) pose a serious threat to clinical management and public health. We investigated the molecular characteristics of 12 IMP-4 metallo-β-lactamase-producing strains, namely, 5 Enterobacter cloacae, 3 Escherichia coli, 2 Klebsiella pneumoniae, and 2 Citrobacter freundii. These strains were collected from a tertiary teaching hospital in Zhengzhou from 2013 to 2015. The minimum inhibitory concentration (MIC) results showed that each blaIMP–4-positive isolate was multidrug-resistant (MDR) but susceptible to colistin. All of the E. coli belonged to ST167, two C. freundii isolates belonged to ST396, and diverse ST types were identified in E. cloacae and K. pneumoniae. S1-PFGE, Southern blotting, and PCR-based replicon typing assays showed that the blaIMP–4-carrying plasmids ranged from ∼52 to ∼360 kb and belonged to FII, FIB, HI2/HI2A, and N types. N plasmids were the predominant type (8/12, 66.7%). Plasmid stability testing indicated that the blaIMP–4-carrying N-type plasmid is more stable than the other types of plasmids. Conjugative assays revealed that three of the blaIMP–4-carrying N plasmids were transferrable. Complete sequence analysis of a representative N type (pIMP-ECL14–57) revealed that it was nearly identical to pIMP-FJ1503 (KU051710) (99% nucleotide identity and query coverage), an N-type blaIMP–4-carrying epidemic plasmid in a C. freundii strain. PCR mapping indicated that a transposon-like structure [IS6100-mobC-intron (K1.pn.I3)-blaIMP–4-IntI1-IS26] was highly conserved in all of the N plasmids. IS26 involved recombination events that resulted in variable structures of this transposon-like module in FII and FIB plasmids. The blaIMP–4 gene was captured by a sul1-type integron In1589 on HI2/HI2A plasmid pIMP-ECL-13–46.

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 Detection of Several Carbapenems Resistant and Virulence Genes in Classical and Hyper-virulent Strains of Klebsiella pneumoniae Isolated from Hospitalized Neonates and Adults in Khartoum

2020 ◽  
Author(s):  
Aalaa Mahgoub Albasha ◽  
Esraa Hassan Osman ◽  
Saga Abd Alhalim ◽  
Elianz Alshaib ◽  
Leena Al-Hassan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Nosocomial Infections ◽  
Virulence Genes ◽  
Virulence Gene ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Carbapenem Resistant ◽  
Extensively Drug Resistant ◽  
Virulent Strains

Abstract Objective Klebsiella pneumoniae (K. pneumoniae) involves both community-acquired and nosocomial infections. It is responsible for a wide variety of infections, including infections of the urinary tract, pneumonia, bacteremia, meningitis, wound infection and purulent abscesses. We constructed this study to detect several carbapenems resistant and virulence genes in classical and hyper-virulent strains of K. pneumoniae isolated from hospitalized neonates and adults in Khartoum state. Results Seventy percent of the isolates were resistant to ceftazidime, 18(30%) to ciprofloxacin, 23(38.3%) to chloramphenicol, 24(40%) to gentamicin and 8% to imipenem, 35% were multidrug-resistant, and 7% extensively drug-resistant, all blood isolates (n=14) were resistant to ceftazidime. entB was the most predominant virulence gene (93.3%), followed by mrkD (78.3%), kfu (60%), K2 (51.7%), magA (18.3%) and rmpA (5%). blaOXA-48 was the most predominant carbapenem-resistant gene (68.3%), followed by blaNDM (10%), blaKPC (8.3%), and blaIMP (3.3%). Eight hyper-virulent strains were positive for blaOXA-48 and two for blaNDM genes.

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