Abstract
We investigated the epidemiology of different serotypes of Klebsiella pneumoniae isolates causing bacteremic liver abscess (LA) using multilocus sequence typing (MLST). MLST and molecular typing were performed for 41 K1 (19 LA), 37 K2 (5 LA), and 33 non-K1/K2 (6 LA) isolates that were derived from a previous one-year K. pneumoniae bacteremia cohort. Capsular serotypes and rmpA of these isolates were determined by polymerase chain reaction (PCR) methods. Among the 41 K1 isolates, 39 were ST23 and the remaining two isolates were ST23 single-locus variant. There were 11 STs among K2 isolates. ST65 was the most common (n = 10), followed by ST86, ST373, and ST375. Only ST65 (n = 3), ST373 (n = 1), and ST375 (n = 1) caused LA, and ST65 was a three-locus variant of ST23. For non-K1/K2 isolates, the ST types varied widely. ST218 (K57) was the most common type (n = 6, 18 %), and it was a single-locus variant of ST23 and caused two cases of LA. The existences of rmpA among serotypes varied (100 % for K1, 89 % for K2, and 55 % for non-K1/K2). For isolates causing LA, all of them were positive for rmpA. For non-K1/K2 isolates causing infections other than LA, the positivity of rmpA ranged from 0 % (biliary tree infection) to 67 % (pneumonia). In this one-year cohort, all K1 isolates were ST23 or its single-locus variants, but the composition of ST types among K2 isolates was quite variable. ST23 and its one- (ST1005 and ST218) and three-locus (ST65) variants comprised 80 % of isolates causing LA.
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References
Liu YC, Cheng DL, Lin CL (1986) Klebsiella pneumoniae liver abscess associated with septic endophthalmitis. Arch Intern Med 146:1913–1916
Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC (2007) Klebsiella pneumoniae genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 45:284–293
Yu VL, Hansen DS, Ko WC, Sagnimeni A, Klugman KP, von Gottberg A, Goossens H, Wagener MM, Benedi VJ; International Klebsiella Study Group (2007) Virulence characteristics of Klebsiella and clinical manifestations of K. pneumoniae bloodstream infections. Emerg Infect Dis 13:986–993
Yu WL, Ko WC, Cheng KC, Lee CC, Lai CC, Chuang YC (2008) Comparison of prevalence of virulence factors for Klebsiella pneumoniae liver abscesses between isolates with capsular K1/K2 and non-K1/K2 serotypes. Diagn Microbiol Infect Dis 62:1–6
Yeh KM, Kurup A, Siu LK, Koh YL, Fung CP, Lin JC, Chen TL, Chang FY, Koh TH (2007) Capsular serotype K1 or K2, rather than magA and rmpA, is a major virulence determinant for Klebsiella pneumoniae liver abscess in Singapore and Taiwan. J Clin Microbiol 45:466–471
Shu HY, Fung CP, Liu YM, Wu KM, Chen YT, Li LH, Liu TT, Kirby R, Tsai SF (2009) Genetic diversity of capsular polysaccharide biosynthesis in Klebsiella pneumoniae clinical isolates. Microbiology 155:4170–4183
Fung CP, Siu LK (2007) Virulence of Klebsiella pneumoniae serotype K2 should not be underestimated in K. pneumoniae liver abscess. Clin Infect Dis 45:1530–1531
Liao CH, Huang YT, Lai CC, Chang CY, Chu FY, Hsu MS, Hsu HS, Hseuh PR (2011) Klebsiella pneumoniae bacteremia and capsular serotypes, Taiwan. Emerg Infect Dis 17:1113–1115
Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S (2005) Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol 43:4178–4182
Brisse S, Fevre C, Passet V, Issenhuth-Jeanjean S, Tournebize R, Diancourt L, Grimont P (2009) Virulent clones of Klebsiella pneumoniae: identification and evolutionary scenario based on genomic and phenotypic characterization. PLoS One 4:e4982
Lee CM, Liao CH, Lee WS, Liu YC, Mu JJ, Lee MC, Hsueh PR (2012) Outbreak of Klebsiella pneumoniae carbapenemase-2-producing K. pneumoniae sequence type 11 in Taiwan in 2011. Antimicrob Agents Chemother 56:5016–5022
Siu LK, Fung CP, Chang FY, Lee N, Yeh KM, Koh TH, Ip M (2011) Molecular typing and virulence analysis of serotype K1 Klebsiella pneumoniae strains isolated from liver abscess patients and stool samples from noninfectious subjects in Hong Kong, Singapore, and Taiwan. J Clin Microbiol 49:3761–3765
Chung DR, Lee H, Park MH, Jung SI, Chang HH, Kim YS, Son JS, Moon C, Kwon KT, Ryu SY, Shin SY, Ko KS, Kang CI, Peck KR, Song JH (2012) Fecal carriage of serotype K1 Klebsiella pneumoniae ST23 strains closely related to liver abscess isolates in Koreans living in Korea. Eur J Clin Microbiol Infect Dis 31:481–486
Decré D, Verdet C, Emirian A, Le Gourrierec T, Petit JC, Offenstadt G, Maury E, Brisse S, Arlet G (2011) Emerging severe and fatal infections due to Klebsiella pneumoniae in two university hospitals in France. J Clin Microbiol 49:3012–3014
Liao CH, Lai CC, Hsu MS, Huang YT, Chu FY, Hsu HS, Hsueh PR (2009) Correlation between time to positivity of blood cultures with clinical presentation and outcomes in patients with Klebsiella pneumoniae bacteraemia: prospective cohort study. Clin Microbiol Infect 15:1119–1125
Abbott SL (2003) Klebsiella, Enterobacter, Citrobacter, Serratia, Plesiomonas, and other Enterobacteriaceae. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH (eds) Manual of clinical microbiology, 8th edn. ASM Press, Washington, DC, pp 684–700
Pan YJ, Fang HC, Yang HC, Lin TL, Hsieh PF, Tsai FC, Keynan Y, Wang JT (2008) Capsular polysaccharide synthesis regions in Klebsiella pneumoniae serotype K57 and a new capsular serotype. J Clin Microbiol 46:2231–2240
Hsueh PR, Wu JJ, Teng LJ, Chen YC, Yang PC, Ho SW, Luh KT (2002) Primary liver abscess caused by one clone of Klebsiella pneumoniae with two colonial morphotypes and resistotypes. Emerg Infect Dis 8:100–102
Abate G, Koh TH, Gardner M, Siu LK (2012) Clinical and bacteriological characteristics of Klebsiella pneumoniae causing liver abscess with less frequently observed multi-locus sequences type, ST163, from Singapore and Missouri, US. J Microbiol Immunol Infect 45:31–36
Lin YT, Jeng YY, Chen TL, Fung CP (2010) Bacteremic community-acquired pneumonia due to Klebsiella pneumoniae: clinical and microbiological characteristics in Taiwan, 2001–2008. BMC Infect Dis 10:307
Ku YH, Chuang YC, Yu WL (2008) Clinical spectrum and molecular characteristics of Klebsiella pneumoniae causing community-acquired extrahepatic abscess. J Microbiol Immunol Infect 41:311–317
Yu WL, Ko WC, Cheng KC, Lee HC, Ke DS, Lee CC, Fung CP, Chuang YC (2006) Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis 42:1351–1358
Lin WH, Wang MC, Tseng CC, Ko WC, Wu AB, Zheng PX, Wu JJ (2010) Clinical and microbiological characteristics of Klebsiella pneumoniae isolates causing community-acquired urinary tract infections. Infection 38:459–464
Tsai FC, Huang YT, Chang LY, Wang JT (2008) Pyogenic liver abscess as endemic disease, Taiwan. Emerg Infect Dis 14:1592–1600
Jenney AW, Clements A, Farn JL, Wijburg OL, McGlinchey A, Spelman DW, Pitt TL, Kaufmann ME, Liolios L, Moloney MB, Wesselingh SL, Strugnell RA (2006) Seroepidemiology of Klebsiella pneumoniae in an Australian tertiary hospital and its implications for vaccine development. J Clin Microbiol 44:102–107
Acknowledgments
We thank the platform Genotyping of Pathogens and Public Health (Institut Pasteur, Paris, France) for coding the MLST alleles and profiles, available at http://www.pasteur.fr/mlst.
Funding
Funding for this study is provided by the Far Eastern Memorial Hospital (FEMH-2012-C-008).
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The authors declare that they have no conflict of interest.
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Liao, C.H., Huang, Y.T., Chang, C.Y. et al. Capsular serotypes and multilocus sequence types of bacteremic Klebsiella pneumoniae isolates associated with different types of infections. Eur J Clin Microbiol Infect Dis 33, 365–369 (2014). https://doi.org/10.1007/s10096-013-1964-z
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DOI: https://doi.org/10.1007/s10096-013-1964-z