PMID- 31673355 OWN - NLM STAT- MEDLINE DCOM- 20200707 LR - 20200707 IS - 2047-2994 (Electronic) IS - 2047-2994 (Linking) VI - 8 DP - 2019 TI - Clinical, microbiological, and molecular epidemiological characteristics of Klebsiella pneumoniae-induced pyogenic liver abscess in southeastern China. PG - 166 LID - 10.1186/s13756-019-0615-2 [doi] LID - 166 AB - 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. CI - (c) The Author(s). 2019. FAU - Zhang, Siqin AU - Zhang S AD - 1Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China. FAU - Zhang, Xiucai AU - Zhang X AD - 1Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China. FAU - Wu, Qing AU - Wu Q AD - 1Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China. FAU - Zheng, Xiangkuo AU - Zheng X AD - 2School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325000 China. FAU - Dong, Guofeng AU - Dong G AD - 2School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325000 China. FAU - Fang, Renchi AU - Fang R AD - 1Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China. FAU - Zhang, Yizhi AU - Zhang Y AD - 1Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China. FAU - Cao, Jianming AU - Cao J AD - 2School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, 325000 China. FAU - Zhou, Tieli AU - Zhou T AUID- ORCID: 0000-0002-2171-4710 AD - 1Department of Clinical Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20191029 PL - England TA - Antimicrob Resist Infect Control JT - Antimicrobial resistance and infection control JID - 101585411 RN - 0 (Virulence Factors) SB - IM MH - Adult MH - Aged MH - China/epidemiology MH - Female MH - Humans MH - Klebsiella Infections/*epidemiology/*microbiology MH - Klebsiella pneumoniae/classification/*genetics/pathogenicity MH - Liver Abscess, Pyogenic/*epidemiology/*microbiology MH - Male MH - Middle Aged MH - Molecular Epidemiology MH - Multilocus Sequence Typing MH - Retrospective Studies MH - Virulence/genetics MH - Virulence Factors PMC - PMC6819602 OTO - NOTNLM OT - Clinical characteristics OT - Hypervirulent K. pneumoniae OT - Multidrug resistant OT - Pyogenic liver abscess OT - Sequence type OT - Virulence factors COIS- Competing interestsThe authors declare that they have no competing interests. EDAT- 2019/11/02 06:00 MHDA- 2020/07/08 06:00 PMCR- 2019/10/29 CRDT- 2019/11/02 06:00 PHST- 2019/07/07 00:00 [received] PHST- 2019/09/26 00:00 [accepted] PHST- 2019/11/02 06:00 [entrez] PHST- 2019/11/02 06:00 [pubmed] PHST- 2020/07/08 06:00 [medline] PHST- 2019/10/29 00:00 [pmc-release] AID - 615 [pii] AID - 10.1186/s13756-019-0615-2 [doi] PST - epublish SO - Antimicrob Resist Infect Control. 2019 Oct 29;8:166. doi: 10.1186/s13756-019-0615-2. eCollection 2019.