J Korean Med Sci.  2020 Jan;35(2):e18. 10.3346/jkms.2020.35.e18.

Characteristics of Klebsiella pneumoniae Isolates from Stool Samples of Patients with Liver Abscess Caused by Hypervirulent K. pneumoniae

Affiliations
  • 1Division of Infectious Diseases, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. macropha@korea.ac.kr
  • 2Department of Laboratory Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Hypervirulent Klebsiella pneumoniae (hvKP) has been the most significant pathogen for liver abscesses in East Asia including the Republic of Korea (ROK). Although gastrointestinal colonization of K. pneumoniae may cross the intestinal barrier to invade the liver, characteristics of gastrointestinal carriage K. pneumoniae of hvKP liver abscess patients in the ROK are not well known.
METHODS
Characteristics of K. pneumoniae isolated from stool samples and liver aspirate samples of patients with hvKP liver abscess at a tertiary care hospital in the ROK between 2017 and 2018 were evaluated.
RESULTS
Out of 37 patients with hvKP liver abscess, 11 patients were noted to have K. pneumoniae isolated from stool samples and were enrolled for analysis. The median age was 71 years. For hvKP isolates from the liver aspirate samples, the most common serotype was K1 (72.7%) followed by K2 (27.3%). For K. pneumoniae isolates from the stool sample, the majority was non-K1/K2 serotype (72.7%). Among non-K1/K2 serotype isolates, high variability of sequence type (ST; ST15, ST307, ST37, ST273, ST2622, and ST42) with high rate of presence of extended-spectrum beta-lactamase (100.0%) was noted. The concordance rate of the K. pneumoniae isolates between the liver aspirate samples and the stool samples from the primary hvKP liver abscess was low (27.3%).
CONCLUSION
This study suggests that significant heterogeneity of K. pneumoniae colonizing intestinal tract of the hvKP liver abscess patients. Further studies involving a larger number of hvKP liver abscess patients with continuing surveillance are needed to define the changing epidemiology and the role of gastrointestinal K. pneumoniae in the hvKP liver abscess patients in the ROK.

Keyword

Klebsiella pneumoniae; Hypervirulent; Liver Abscess; Gastrointestinal Carriage

MeSH Terms

beta-Lactamases
Colon
Epidemiology
Far East
Humans
Klebsiella pneumoniae*
Klebsiella*
Liver Abscess*
Liver*
Pneumonia*
Population Characteristics
Republic of Korea
Serogroup
Tertiary Healthcare
beta-Lactamases
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