BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneum...BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.展开更多
Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this stud...Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this study was to determine antimicrobial resistance due to Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase enzymes in Klebsiella spp. isolated from patients consulted at four hospitals. Methodology: The study was cross-sectional and descriptive. A total of 4190 non-repetitive patients specimens from 13 types of clinical specimens were analysed from February to November 2020. Two hundred and twenty-five (225) Klebsiella spp isolates were identified using API 20E and antimicrobial susceptibility testing done according to the Kirby Bauer disc diffusion method. ESBL and AmpC phenotypes were determined by the combination disc method and carbapenemases by double disc synergy method, referenced by EUCAST guidelines for the resistance testing. Results: The frequency of the species was Klebsiella pneumoniae (69%, 155/255), K. oxytoca (14%, 31/255), K. ozaenae (12%, 27/225) and K. rhinoscleromatis (5%, 11/225). Isolates were most resistant to sulphomethoxazole trimethoprim (84%, 189/225), cepaholosporins (80%, 180/225), and least resistant to carbapenems (10.7%, 24/225). Two K. oxytoca and one K. pneumoniae were resistant to all antibiotics tested. Klebsiella pneumoniae had the most multidrug resistant isolates (59.4%, 134/225). Most isolates (83.6%, 188/225) expressed at least one enzyme, while 63.6% (143/225) of the isolates expressed at least two enzymes. Some isolates were ESBL (71.6%, 161/225), carbapenemase (10.7%, 24/225) and AmpC (6.6%, 15/225) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected. Conclusion: These results revealed that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated by co-expression of AmpC and carbapenemases aggravating associated patient morbidity and mortality. Monitoring of antimicrobial resistance of local strains is necessary for informed decisions on empirical treatment. .展开更多
Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selecte...Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.Methods:A total of 192 K.pneumoniae isolates were collected and subjected to antibiotic susceptibility,hypermucoviscosity test and multiplex PCR to detect the presence of K1-and K2-serotype associated genes.Multilocus sequence typing(MLST)was performed on ESBL-producing K.pneumoniae isolates presented with K1 and K2 serotypes,followed by phylogenetic analysis.Results:A total of 87 out of 192(45.3%)of the K.pneumoniae isolates collected were ESBL producers.However,only 8.3%(16/192)and 10.9%(21/192)of the total isolates were detected to carry K1-and K2-serotype associated genes,respectively.Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype(P=0.196).However,they were significantly associated with hypervirulent,as demonstrated by the positive string test(P<0.001).MLST analysis revealed that ST23 as the predominant sequence type(ST)in the K1 serotype,while the ST in the K2 serotype is more diverse.Conclusions:Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low,their coexistence warrants the need for continuous surveillance.MLST showed that these isolates were genetically heterogeneous.展开更多
It is often said that the emergence of antimicrobial drug resistance(AMR)in pathogens is the major cause of mortality.In the present study,clinical microbiology data on infections caused by Klebsiella pneumoniae strai...It is often said that the emergence of antimicrobial drug resistance(AMR)in pathogens is the major cause of mortality.In the present study,clinical microbiology data on infections caused by Klebsiella pneumoniae strains and their antimicrobial drug resistance specifically to carbapenems retrieved from Clinical Epidemiology database of the Institute were analysed to determine the impact of carbapenem resistance in Klebsiellae isolated from the clinical samples of veterinary cases and outcome of the infection because in a few recent reports it is claimed that the presence of carbapenem-resistant Klebsiellae is associated with higher mortality in humans due to Klebsiella infections.The retrospective analysis of Klebsiella infections in animals and birds revealed that 21.8%of K.pneumoniae causing pneumonic or septicemic infections were carbapenem-resistant but the carbapenem resistance was not associated with increased numbers of deaths or recovery.It may be probably due to the fact that carbapenem drugs were not used for the treatment of infected animals and carbapenem resistance may not be associated with the lethality potential of Klebsiellae.展开更多
BACKGROUND Klebsiella variicola(K.variicola)is a member of the Klebsiella genus and is often misidentied as Klebsiella pneumoniae.In this report,we present a rare case of invasive liver abscess caused by K.variicola.C...BACKGROUND Klebsiella variicola(K.variicola)is a member of the Klebsiella genus and is often misidentied as Klebsiella pneumoniae.In this report,we present a rare case of invasive liver abscess caused by K.variicola.CASE SUMMARY We report a rare case of liver abscess due to K.variicola.A 57-year-old female patient presented with back pain for a month.She developed a high-grade fever associated with chills,and went into a coma and developed shock.The clinical examinations and tests after admission confirmed a diagnosis of primary liver abscess caused by K.variicola complicated by intracranial infection and septic shock.The patient successfully recovered following early percutaneous drainage of the abscess,prompt appropriate antibiotic administration,and timely open surgical drainage.CONCLUSION This is a case of successful treatment of invasive liver abscess syndrome caused by K.variicola,which has rarely been reported.The findings of this report point to the need for further study of this disease.展开更多
Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding of important clinical and biological aspects of this bacterial species. ...Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding of important clinical and biological aspects of this bacterial species. It is responsible for serious and potentially fatal infections, with a prevalence of multi-resistance to routine antibiotics. We present through three clinical observations, the case of three newborns having been hospitalized in the neonatal intensive care unit and whose evolution was complicated by the occurrence of a nosocomial infection in front of which a blood culture was done on blood agar, with a manual antibiogram on antibiotic disks, isolated the germ Klebsiella variicola. The management of the newborns was initially centered on non-invasive ventilation with a bi-antibiotic therapy based on carbapenem and amikacin for two newborns and switched to colymicin for the third case. Newborn follow-up was based on assessment of general condition, clinical signs of infection, as well as a biological control made of a blood count, a c-reactive protein, a complete ionogram, and a blood culture, every four days or if signs of clinical call. The evolution was favorable for two cases with good clinical and biological improvement, and complicated by death due to alveolar hemorrhage in the third case. Given the high pathogenicity of this germ, and the frequency of misidentification, it is crucial to know the clinical spectrum of Klebsiella variicola infections in neonatal intensive care units, in order to adapt the antibiotic therapy and to mitigate the fulminant evolution of this germ.展开更多
Purpose: Recently, it was reported that Klebsiella pneumoniae is related to the onset of inflammatory bowel disease including the Crohn disease. It was frequently reported that K. pneumoniae was detected in human oral...Purpose: Recently, it was reported that Klebsiella pneumoniae is related to the onset of inflammatory bowel disease including the Crohn disease. It was frequently reported that K. pneumoniae was detected in human oral cavities. Regrettably, it currently remains unclear whether K. pneumoniae is part of the normal oral flora. The aim of this study was to establish the isolation and identification methods for K. pneumoniae from human oral cavities, and investigate its transmission pattern. Methods: A selective medium, OKPSM, for the isolation of K. pneumoniae from oral cavities was developed in this study. Also, PCR primer for the identification and detection at subspecies level of K. pneumoniae was designed. Results: OKPSM and PCR method using the primers designed in this study were useful for the isolation and identification of K. pneumoniae from human oral cavities. K. pneumoniae subsp. pneumoniae was detected at 10.0% in 30 saliva samples. On the other hand, K. pneumoniae subsp. ozaenae and K. pneumoniae subsp. rhinoscleromatis were detected from no sample. Moreover, K. pneumoniae subsp. pneumoniae isolates from same subject at 0 month and after 3 months showed same genotypes on AP-PCR using OPA-07 primer. Conclusion: These results indicated that human oral cavities were not suitable for the habitat of K. pneumoniae.展开更多
Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial ...Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial infection of pompholyx can happen and result in pain, swelling and pustules.Patient concerns: A 15-year-old girl complained of progressive wound and small bumps containing yellowish pus and crusts on her hands and feet for over 6 months and worsened in the last month before admission. She also had Ebstein anomaly.Diagnosis: Atypical pompholyx with secondary Staphylococcus and Klebsiella infections. Interventions: Wound care with wet dressing and applying moisturizer on crusts, application of antibiotics for Gram positive and negative bacteria and giving nutritional support with reckoning of proper calories. Outcomes: Skin lesions were completely healed and the patient was discharged after 10 days of hospitalization.Lessons: Atypical manifestation of pompholyx makes it hard to diagnose. The diagnosis can be confirmed with meticulous historytaking and physical examination. Wound caring and controlling of the infection should be done to earn an optimal outcome.展开更多
Objective: Class B carbapenemases are bacterial enzymes that catalyze the hydrolysis of β-lactam core antibiotics, except for monobactams. The objective of this study was to identify the carbapenemase gene bla<sub...Objective: Class B carbapenemases are bacterial enzymes that catalyze the hydrolysis of β-lactam core antibiotics, except for monobactams. The objective of this study was to identify the carbapenemase gene bla<sub>IMP</sub> in the genus Klebsiella at the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) of Ouagadougou, Burkina Faso. Methods: The study involved 17 bacterial strains responsible for human infection and isolated from various biological samples during the period from 2009 to 2013. The strains were tested for antimicrobial susceptibility to cefotaxime, ceftazidime and imipenem using the Mueller-Hinton agar diffusion method. The carbapenemases resistance genes were detected by conventional PCR using specific primers at the molecular biology laboratory of CERBA/LABIOGENE, Ouagadougou, Burkina Faso. Results: The antibiotic susceptibility test showed high resistance of the 17 Klebsiella isolates tested to cephalosporins. A high cefotaxime-resistance rate (82.35%) and ceftazidime-resistance rate (88.23%) was found among the strains tested against 11.76% resistance rate for imipenem. Analysis of PCR products by gel electrophoresis revealed 4 strains (23.53%) with bla<sub>IMP</sub>-type gene. Conclusion: Klebsiella is a well-known bacterium in clinical practice. The present study demonstrated the bla<sub>IMP</sub>-type gene in cephalosporin-resistant strains of Klebsiella at CHUP-CDG. More effective monitoring and treatment solutions are needed to prevent the spread of these resistant strains.展开更多
Background: Urinary tract infection (UTI) is a severe public health issue that affects a wide range of people around the world with Klebsiella pneumoniae accounting for up to 25% of all urinary tract infections. The h...Background: Urinary tract infection (UTI) is a severe public health issue that affects a wide range of people around the world with Klebsiella pneumoniae accounting for up to 25% of all urinary tract infections. The higher rate of UTI associated with uropathogenic Klebsiella species has been associated with the emergence of hypervirulent and antibiotic-resistant strains facilitated by the misuse and overuse of antibiotics as well as other sociodemographic and behavioural practices of susceptible individuals. This study was aimed at investigating the prevalence and associated risk factors of uropathogenic Klebsiella species in Port Harcourt, Nigeria. Methodology: The study employed a descriptive cross-sectional study design comprising 300 subjects clinically suspected of having urinary tract infections attending the Rivers State University Medical Centre and the Rivers State University Teaching Hospital between March to August 2022. A standard urine culture procedure was used to ascertain significant bacteriuria after which Klebsiella colonies were isolated and identified using standard bacteriological techniques. The data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using Chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. Result: The prevalence of uropathogenic Klebsiella sp. was 16%, with sex, pregnancy status, and religion of the individuals substantially linked (p p Klebsiella species. Conclusion: This study reports a relatively high prevalence of uropathogenic Klebsiella species at 16%, with the sex and pregnancy status of the subjects being significantly associated (p Klebsiella species in the current study. Health promotion and awareness efforts should be prioritised to inform susceptible demographics about their risks for urinary tract infections associated with uropathogenic Klebsiella species via targeted educational campaigns, collaboration with healthcare providers, use of social media and online platforms, workplace wellness programs, and community outreach programs amongst others. Antimicrobial susceptibility testing before prescriptions and treatment should be emphasized and upheld in all clinical settings.展开更多
Sclerotinia stem rot,caused by Sclerotinia sclerotiorum,is a destructive soil-borne disease leading to huge yield loss.We previously reported that Klebsiella variicola FH-1 could degrade atrazine herbicides,and the ve...Sclerotinia stem rot,caused by Sclerotinia sclerotiorum,is a destructive soil-borne disease leading to huge yield loss.We previously reported that Klebsiella variicola FH-1 could degrade atrazine herbicides,and the vegetative growth of atrazine-sensitive crops(i.e.,soybean)was significantly increased in the FH-1-treated soil.Interestingly,we found that FH-1 could promote soybean growth and induce resistance to S.sclerotiorum.In our study,strain FH-1 could grow in a nitrogen-free environment,dissolve inorganic phosphorus and potassium,and produce indoleacetic acid and a siderophore.The results of pot experiments showed that K.variicola FH-1 promoted soybean plant development,substantially improving plant height,fresh weight,and root length,and induced resistance against S.sclerotiorum infection in soybean leaves.The area under the disease progression curve(AUDPC)for treatment with strain FH-1 was significantly lower than the control and was reduced by up to 42.2%within 48 h(P<0.001).Moreover,strain FH-1 rcovered the activities of catalase,superoxide dismutase,peroxidase,phenylalanine ammonia lyase,and polyphenol oxidase,which are involved in plant protection,and reduced malondialdehyde accumulation in the leaves.The mechanism of induction of resistance appeared to be primarily resulted from the enhancement of transcript levels of PR10,PR12,AOS,CHS,and PDF1.2 genes.The colonization of FH-1 on soybean root,determined using CLSM and SEM,revealed that FH-1 colonized soybean root surfaces,root hairs,and exodermis to form biofilms.In summary,K.variicola FH-1 exhibited the biological control potential by inducing resistance in soybean against S.sclerotiorum infection,providing new suggestions for green prevention and control.展开更多
Objective The prevalence of carbapenem-resistant Klebsiella pneumoniae(CR-KP)is a global public health problem.It is mainly caused by the plasmid-carried carbapenemase gene.Outer membrane vesicles(OMVs)contain toxins ...Objective The prevalence of carbapenem-resistant Klebsiella pneumoniae(CR-KP)is a global public health problem.It is mainly caused by the plasmid-carried carbapenemase gene.Outer membrane vesicles(OMVs)contain toxins and other factors involved in various biological processes,includingβ-lactamase and antibiotic-resistance genes.This study aimed to reveal the transmission mechanism of OMV-mediated drug resistance of Klebsiella(K.)pneumoniae.Methods We selected CR-KP producing K.pneumoniae carbapenemase-2(KPC-2)to study whether they can transfer resistance genes through OMVs.The OMVs of CR-KP were obtained by ultracentrifugation,and incubated with carbapenem-sensitive K.pneumoniae for 4 h.Finally,the carbapenem-sensitive K.pneumoniae was tested for the presence of bla_(KPC-2)resistance gene and its sensitivity to carbapenem antibiotics.Results The existence of OMVs was observed by the electron microscopy.The extracted OMVs had bla_(KPC-2)resistance gene.After incubation with OMVs,bla_(KPC-2)resistance gene was detected in sensitive K.pneumoniae,and it became resistant to imipenem and meropenem.Conclusion This study demonstrated that OMVs isolated from KPC-2-producing CR-KP could deliver bla_(KPC-2)to sensitive K.pneumoniae,allowing the bacteria to produce carbapenemase,which may provide a novel target for innovative therapies in combination with conventional antibiotics for treating carbapenem-resistant Enterobacteriaceae.展开更多
基金approved by the Ethics Committee of the Third Xiangya Hospital in accordance with the Declaration of Helsinki(No.24029).
文摘BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.
文摘Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections which are often difficult to treat because of resistance to one or several antimicrobials. The aim of this study was to determine antimicrobial resistance due to Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase enzymes in Klebsiella spp. isolated from patients consulted at four hospitals. Methodology: The study was cross-sectional and descriptive. A total of 4190 non-repetitive patients specimens from 13 types of clinical specimens were analysed from February to November 2020. Two hundred and twenty-five (225) Klebsiella spp isolates were identified using API 20E and antimicrobial susceptibility testing done according to the Kirby Bauer disc diffusion method. ESBL and AmpC phenotypes were determined by the combination disc method and carbapenemases by double disc synergy method, referenced by EUCAST guidelines for the resistance testing. Results: The frequency of the species was Klebsiella pneumoniae (69%, 155/255), K. oxytoca (14%, 31/255), K. ozaenae (12%, 27/225) and K. rhinoscleromatis (5%, 11/225). Isolates were most resistant to sulphomethoxazole trimethoprim (84%, 189/225), cepaholosporins (80%, 180/225), and least resistant to carbapenems (10.7%, 24/225). Two K. oxytoca and one K. pneumoniae were resistant to all antibiotics tested. Klebsiella pneumoniae had the most multidrug resistant isolates (59.4%, 134/225). Most isolates (83.6%, 188/225) expressed at least one enzyme, while 63.6% (143/225) of the isolates expressed at least two enzymes. Some isolates were ESBL (71.6%, 161/225), carbapenemase (10.7%, 24/225) and AmpC (6.6%, 15/225) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected. Conclusion: These results revealed that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated by co-expression of AmpC and carbapenemases aggravating associated patient morbidity and mortality. Monitoring of antimicrobial resistance of local strains is necessary for informed decisions on empirical treatment. .
基金supported by the Ministry of Higher Education under the Fundamental Research Grant Scheme(FRGS/1/2021/SKK0/UPM/02/8)the Universiti Putra Malaysia Research University Grant Scheme(GP/IPS/2021/9702000).
文摘Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.Methods:A total of 192 K.pneumoniae isolates were collected and subjected to antibiotic susceptibility,hypermucoviscosity test and multiplex PCR to detect the presence of K1-and K2-serotype associated genes.Multilocus sequence typing(MLST)was performed on ESBL-producing K.pneumoniae isolates presented with K1 and K2 serotypes,followed by phylogenetic analysis.Results:A total of 87 out of 192(45.3%)of the K.pneumoniae isolates collected were ESBL producers.However,only 8.3%(16/192)and 10.9%(21/192)of the total isolates were detected to carry K1-and K2-serotype associated genes,respectively.Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype(P=0.196).However,they were significantly associated with hypervirulent,as demonstrated by the positive string test(P<0.001).MLST analysis revealed that ST23 as the predominant sequence type(ST)in the K1 serotype,while the ST in the K2 serotype is more diverse.Conclusions:Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low,their coexistence warrants the need for continuous surveillance.MLST showed that these isolates were genetically heterogeneous.
文摘It is often said that the emergence of antimicrobial drug resistance(AMR)in pathogens is the major cause of mortality.In the present study,clinical microbiology data on infections caused by Klebsiella pneumoniae strains and their antimicrobial drug resistance specifically to carbapenems retrieved from Clinical Epidemiology database of the Institute were analysed to determine the impact of carbapenem resistance in Klebsiellae isolated from the clinical samples of veterinary cases and outcome of the infection because in a few recent reports it is claimed that the presence of carbapenem-resistant Klebsiellae is associated with higher mortality in humans due to Klebsiella infections.The retrospective analysis of Klebsiella infections in animals and birds revealed that 21.8%of K.pneumoniae causing pneumonic or septicemic infections were carbapenem-resistant but the carbapenem resistance was not associated with increased numbers of deaths or recovery.It may be probably due to the fact that carbapenem drugs were not used for the treatment of infected animals and carbapenem resistance may not be associated with the lethality potential of Klebsiellae.
文摘BACKGROUND Klebsiella variicola(K.variicola)is a member of the Klebsiella genus and is often misidentied as Klebsiella pneumoniae.In this report,we present a rare case of invasive liver abscess caused by K.variicola.CASE SUMMARY We report a rare case of liver abscess due to K.variicola.A 57-year-old female patient presented with back pain for a month.She developed a high-grade fever associated with chills,and went into a coma and developed shock.The clinical examinations and tests after admission confirmed a diagnosis of primary liver abscess caused by K.variicola complicated by intracranial infection and septic shock.The patient successfully recovered following early percutaneous drainage of the abscess,prompt appropriate antibiotic administration,and timely open surgical drainage.CONCLUSION This is a case of successful treatment of invasive liver abscess syndrome caused by K.variicola,which has rarely been reported.The findings of this report point to the need for further study of this disease.
文摘Klebsiella variicola is a human pathogen that has been misidentified as K. pneumoniae. This misidentification has led to a lack of understanding of important clinical and biological aspects of this bacterial species. It is responsible for serious and potentially fatal infections, with a prevalence of multi-resistance to routine antibiotics. We present through three clinical observations, the case of three newborns having been hospitalized in the neonatal intensive care unit and whose evolution was complicated by the occurrence of a nosocomial infection in front of which a blood culture was done on blood agar, with a manual antibiogram on antibiotic disks, isolated the germ Klebsiella variicola. The management of the newborns was initially centered on non-invasive ventilation with a bi-antibiotic therapy based on carbapenem and amikacin for two newborns and switched to colymicin for the third case. Newborn follow-up was based on assessment of general condition, clinical signs of infection, as well as a biological control made of a blood count, a c-reactive protein, a complete ionogram, and a blood culture, every four days or if signs of clinical call. The evolution was favorable for two cases with good clinical and biological improvement, and complicated by death due to alveolar hemorrhage in the third case. Given the high pathogenicity of this germ, and the frequency of misidentification, it is crucial to know the clinical spectrum of Klebsiella variicola infections in neonatal intensive care units, in order to adapt the antibiotic therapy and to mitigate the fulminant evolution of this germ.
文摘Purpose: Recently, it was reported that Klebsiella pneumoniae is related to the onset of inflammatory bowel disease including the Crohn disease. It was frequently reported that K. pneumoniae was detected in human oral cavities. Regrettably, it currently remains unclear whether K. pneumoniae is part of the normal oral flora. The aim of this study was to establish the isolation and identification methods for K. pneumoniae from human oral cavities, and investigate its transmission pattern. Methods: A selective medium, OKPSM, for the isolation of K. pneumoniae from oral cavities was developed in this study. Also, PCR primer for the identification and detection at subspecies level of K. pneumoniae was designed. Results: OKPSM and PCR method using the primers designed in this study were useful for the isolation and identification of K. pneumoniae from human oral cavities. K. pneumoniae subsp. pneumoniae was detected at 10.0% in 30 saliva samples. On the other hand, K. pneumoniae subsp. ozaenae and K. pneumoniae subsp. rhinoscleromatis were detected from no sample. Moreover, K. pneumoniae subsp. pneumoniae isolates from same subject at 0 month and after 3 months showed same genotypes on AP-PCR using OPA-07 primer. Conclusion: These results indicated that human oral cavities were not suitable for the habitat of K. pneumoniae.
文摘Rationale: Pompholyx refers to pruritic vesicles or bullous rash that mainly distribute on the palms and lateral surfaces of the fingers. It is less common among Asians, and in a severe condition, secondary bacterial infection of pompholyx can happen and result in pain, swelling and pustules.Patient concerns: A 15-year-old girl complained of progressive wound and small bumps containing yellowish pus and crusts on her hands and feet for over 6 months and worsened in the last month before admission. She also had Ebstein anomaly.Diagnosis: Atypical pompholyx with secondary Staphylococcus and Klebsiella infections. Interventions: Wound care with wet dressing and applying moisturizer on crusts, application of antibiotics for Gram positive and negative bacteria and giving nutritional support with reckoning of proper calories. Outcomes: Skin lesions were completely healed and the patient was discharged after 10 days of hospitalization.Lessons: Atypical manifestation of pompholyx makes it hard to diagnose. The diagnosis can be confirmed with meticulous historytaking and physical examination. Wound caring and controlling of the infection should be done to earn an optimal outcome.
文摘Objective: Class B carbapenemases are bacterial enzymes that catalyze the hydrolysis of β-lactam core antibiotics, except for monobactams. The objective of this study was to identify the carbapenemase gene bla<sub>IMP</sub> in the genus Klebsiella at the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) of Ouagadougou, Burkina Faso. Methods: The study involved 17 bacterial strains responsible for human infection and isolated from various biological samples during the period from 2009 to 2013. The strains were tested for antimicrobial susceptibility to cefotaxime, ceftazidime and imipenem using the Mueller-Hinton agar diffusion method. The carbapenemases resistance genes were detected by conventional PCR using specific primers at the molecular biology laboratory of CERBA/LABIOGENE, Ouagadougou, Burkina Faso. Results: The antibiotic susceptibility test showed high resistance of the 17 Klebsiella isolates tested to cephalosporins. A high cefotaxime-resistance rate (82.35%) and ceftazidime-resistance rate (88.23%) was found among the strains tested against 11.76% resistance rate for imipenem. Analysis of PCR products by gel electrophoresis revealed 4 strains (23.53%) with bla<sub>IMP</sub>-type gene. Conclusion: Klebsiella is a well-known bacterium in clinical practice. The present study demonstrated the bla<sub>IMP</sub>-type gene in cephalosporin-resistant strains of Klebsiella at CHUP-CDG. More effective monitoring and treatment solutions are needed to prevent the spread of these resistant strains.
文摘Background: Urinary tract infection (UTI) is a severe public health issue that affects a wide range of people around the world with Klebsiella pneumoniae accounting for up to 25% of all urinary tract infections. The higher rate of UTI associated with uropathogenic Klebsiella species has been associated with the emergence of hypervirulent and antibiotic-resistant strains facilitated by the misuse and overuse of antibiotics as well as other sociodemographic and behavioural practices of susceptible individuals. This study was aimed at investigating the prevalence and associated risk factors of uropathogenic Klebsiella species in Port Harcourt, Nigeria. Methodology: The study employed a descriptive cross-sectional study design comprising 300 subjects clinically suspected of having urinary tract infections attending the Rivers State University Medical Centre and the Rivers State University Teaching Hospital between March to August 2022. A standard urine culture procedure was used to ascertain significant bacteriuria after which Klebsiella colonies were isolated and identified using standard bacteriological techniques. The data generated from this study was represented as frequency and percentages, and inferential statistics were carried out using Chi-square with the aid of GraphPad Prism Software Version 9. Statistical significance was defined as a p-value of less than 0.05 at a 95% confidence interval. Result: The prevalence of uropathogenic Klebsiella sp. was 16%, with sex, pregnancy status, and religion of the individuals substantially linked (p p Klebsiella species. Conclusion: This study reports a relatively high prevalence of uropathogenic Klebsiella species at 16%, with the sex and pregnancy status of the subjects being significantly associated (p Klebsiella species in the current study. Health promotion and awareness efforts should be prioritised to inform susceptible demographics about their risks for urinary tract infections associated with uropathogenic Klebsiella species via targeted educational campaigns, collaboration with healthcare providers, use of social media and online platforms, workplace wellness programs, and community outreach programs amongst others. Antimicrobial susceptibility testing before prescriptions and treatment should be emphasized and upheld in all clinical settings.
基金financially supported by the grants from the Inter-governmental International Cooperation Special Project of National Key R&D Program of China(2019YFE0114200)the Natural Science Foundation Project of Science and Technology Department of Jilin Province,China(20200201215JC).
文摘Sclerotinia stem rot,caused by Sclerotinia sclerotiorum,is a destructive soil-borne disease leading to huge yield loss.We previously reported that Klebsiella variicola FH-1 could degrade atrazine herbicides,and the vegetative growth of atrazine-sensitive crops(i.e.,soybean)was significantly increased in the FH-1-treated soil.Interestingly,we found that FH-1 could promote soybean growth and induce resistance to S.sclerotiorum.In our study,strain FH-1 could grow in a nitrogen-free environment,dissolve inorganic phosphorus and potassium,and produce indoleacetic acid and a siderophore.The results of pot experiments showed that K.variicola FH-1 promoted soybean plant development,substantially improving plant height,fresh weight,and root length,and induced resistance against S.sclerotiorum infection in soybean leaves.The area under the disease progression curve(AUDPC)for treatment with strain FH-1 was significantly lower than the control and was reduced by up to 42.2%within 48 h(P<0.001).Moreover,strain FH-1 rcovered the activities of catalase,superoxide dismutase,peroxidase,phenylalanine ammonia lyase,and polyphenol oxidase,which are involved in plant protection,and reduced malondialdehyde accumulation in the leaves.The mechanism of induction of resistance appeared to be primarily resulted from the enhancement of transcript levels of PR10,PR12,AOS,CHS,and PDF1.2 genes.The colonization of FH-1 on soybean root,determined using CLSM and SEM,revealed that FH-1 colonized soybean root surfaces,root hairs,and exodermis to form biofilms.In summary,K.variicola FH-1 exhibited the biological control potential by inducing resistance in soybean against S.sclerotiorum infection,providing new suggestions for green prevention and control.
基金supported by the National Natural Science Foundation of China(No.31771189)the Wuhan Health Commission(No.WX18C17 and No.WX19Q31)the Natural Science Foundation of Hubei Province,China(No.2017CFA065 and No.WJ2019H378).
文摘Objective The prevalence of carbapenem-resistant Klebsiella pneumoniae(CR-KP)is a global public health problem.It is mainly caused by the plasmid-carried carbapenemase gene.Outer membrane vesicles(OMVs)contain toxins and other factors involved in various biological processes,includingβ-lactamase and antibiotic-resistance genes.This study aimed to reveal the transmission mechanism of OMV-mediated drug resistance of Klebsiella(K.)pneumoniae.Methods We selected CR-KP producing K.pneumoniae carbapenemase-2(KPC-2)to study whether they can transfer resistance genes through OMVs.The OMVs of CR-KP were obtained by ultracentrifugation,and incubated with carbapenem-sensitive K.pneumoniae for 4 h.Finally,the carbapenem-sensitive K.pneumoniae was tested for the presence of bla_(KPC-2)resistance gene and its sensitivity to carbapenem antibiotics.Results The existence of OMVs was observed by the electron microscopy.The extracted OMVs had bla_(KPC-2)resistance gene.After incubation with OMVs,bla_(KPC-2)resistance gene was detected in sensitive K.pneumoniae,and it became resistant to imipenem and meropenem.Conclusion This study demonstrated that OMVs isolated from KPC-2-producing CR-KP could deliver bla_(KPC-2)to sensitive K.pneumoniae,allowing the bacteria to produce carbapenemase,which may provide a novel target for innovative therapies in combination with conventional antibiotics for treating carbapenem-resistant Enterobacteriaceae.
