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Comparison of clinical and microbiological characteristics of community-acquired hypervirulent Klebsiella pneumoniae liver abscess in diabetic and non-diabetic patients.
- Source :
-
Yi chuan = Hereditas [Yi Chuan] 2023 Nov 20; Vol. 45 (11), pp. 1052-1061. - Publication Year :
- 2023
-
Abstract
- Invasive infection caused by hypervirulent Klebsiella pneumoniae (HvKP) has been reported worldwide. Most of the patients are community population, related to diabetes mellitus (DM), chronic liver disease and other basic diseases, which prone to systemic migratory infection. In this study, we collected 377 patients with community acquired Klebsiella pneumoniae liver abscess in our hospital from January 2013 to December 2018, 65.8% of whom were male, and 49.6% had DM. Patients with DM are prone to eye and central nervous system (CNS) infection, which need continuous local abscess drainage during treatment. Among them, patients with poor blood glucose control have a higher rate of blood stream infections (BSI). 219 strains of HvKP were obtained, with K1/K2 Serotype accounted for 81.7%. The incidence of BSI in K2 patients was higher than that in K1 patients. The PCR results indicate that the carrying rate of virulence genes (rmpA、areo、kfu、allS、iroN、magA、uge、wcaG) in K1/K2 type strains is significantly higher than that in non K1/K2 type strains. ST23 and ST65 are the most common multilocus sequence typing (MLST), which belong to K1 and K2 Serotype respectively. All of HvKP strains showed high sensitivity to commonly used clinical antibiotics other than ampicillin, with 54.3% of the strains exhibiting high viscosity characteristics. Meanwhile, 35 classic Klebsiella pneumoniae (cKP) strains were collected, and their serum typing is mainly non K1/K2. The carrying rate of virulence genes and viscosity degree in HvKP are significantly higher than those in cKP. Primary liver abscess caused by HvKP is prone to multiple tissue and organ infections, but it shows higher sensitivity to most commonly used antibiotics in clinical practice except for ampicillin. After effective treatment, the overall prognosis of patients is better. This study analyzes the pathogenic characteristics of HvKP and elaborates on the clinical characteristics of patients, which can provide reference for clinical and scientific research work.
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Virulence
Anti-Bacterial Agents therapeutic use
Anti-Bacterial Agents pharmacology
Adult
Diabetes Mellitus microbiology
Multilocus Sequence Typing
Diabetes Complications microbiology
Virulence Factors genetics
Microbial Sensitivity Tests
Klebsiella pneumoniae pathogenicity
Klebsiella pneumoniae genetics
Klebsiella pneumoniae isolation & purification
Klebsiella Infections microbiology
Klebsiella Infections epidemiology
Liver Abscess microbiology
Community-Acquired Infections microbiology
Community-Acquired Infections epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 0253-9772
- Volume :
- 45
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Yi chuan = Hereditas
- Publication Type :
- Academic Journal
- Accession number :
- 38764270
- Full Text :
- https://doi.org/10.16288/j.yczz.23-167