Clinical and Molecular Characteristics and Antibacterial Strategies of Klebsiella pneumoniae in Pyogenic Infection

被引:3
作者
Yang, Zhiyu [1 ]
Zhou, Runmei [2 ]
Chen, Yusheng [3 ]
Zhang, Xiaotuan [1 ]
Liu, Luogen [4 ]
Luo, Min [1 ]
Chen, Jinlin [1 ]
Chen, Kuilin [1 ]
Zeng, Tong [5 ]
Liu, Bin [1 ]
Wu, Yuan [1 ]
Huang, Jielite [6 ]
Liu, Zhuoran [1 ]
Ouyang, Jinglin [4 ,7 ]
机构
[1] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Clin Lab, Hengyang, Peoples R China
[2] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Pharm, Hengyang, Peoples R China
[3] Ningyuan Cty Hosp Tradit Chinese Med, Dept Pharm, Ningyuan, Hunan, Peoples R China
[4] Univ South China, Affiliated Hosp 2, Clin Res Ctr, Hengyang, Peoples R China
[5] Xiangnan Univ, Key Lab Med Imaging & Artificial Intelligence Huna, Chenzhou, Peoples R China
[6] Univ South China, Affiliated Nanhua Hosp, Hengyang Med Sch, Clin Lab, Hengyang, Peoples R China
[7] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Ultrasound Med, Hengyang, Peoples R China
来源
MICROBIOLOGY SPECTRUM | 2023年 / 11卷 / 04期
关键词
Hypervirulent Klebsiella pneumoniae; classical Klebsiella pneumoniae; pyogenic infection; clinical and molecular characteristics; antibacterial strategies; NECROTIZING FASCIITIS; LIVER-ABSCESS; RESISTANCE; CHINA; SYSTEM;
D O I
10.1128/spectrum.00640-23
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Treatment of Klebsiella pneumoniae causing pyogenic infections is challenging. The clinical and molecular characteristics of Klebsiella pneumoniae causing pyogenic infections are poorly understood, and antibacterial treatment strategies are limited. We analyzed the clinical and molecular characteristics of K. pneumoniae from patients with pyogenic infections and used time-kill assays to reveal the bactericidal kinetics of antimicrobial agents against hypervirulent K. pneumoniae (hvKp). A total of 54 K. pneumoniae isolates were included, comprising 33 hvKp and 21 classic K. pneumoniae (cKp) isolates, and the hvKp and cKp isolates were identified using five genes (iroB, iucA, rmpA, rmpA2, and peg-344) that have been applied as hvKp strain markers. The median age of all cases was 54 years (25th and 75th percentiles, 50.5 to 70), 62.96% of individuals had diabetes, and 22.22% of isolates were sourced from individuals without underlying disease. The ratios of white blood cells/procalcitonin and C-reactive protein/procalcitonin were potential clinical markers for the identification of suppurative infection caused by hvKp and cKp. The 54 K. pneumoniae isolates were classified into 8 sequence type 11 (ST11) and 46 non-ST11 strains. ST11 strains carrying multiple drug resistance genes have a multidrug resistance phenotype, while non-ST11 strains carrying only intrinsic resistance genes are generally susceptible to antibiotics. Bactericidal kinetics revealed that hvKp isolates were not easily killed by antimicrobials at susceptible breakpoint concentrations compared with cKp. Given the varied clinical and molecular features and the catastrophic pathogenicity of K. pneumoniae, it is critical to determine the characteristics of such isolates for optimal management and effective treatment of K. pneumoniae causing pyogenic infections.IMPORTANCE Klebsiella pneumoniae may cause pyogenic infections, which are potentially life-threatening and bring great challenges for clinical management. However, the clinical and molecular characteristics of K. pneumoniae are poorly understood, and effective antibacterial treatment strategies are limited. We analyzed the clinical and molecular features of 54 isolates from patients with various pyogenic infections. We found that most patients with pyogenic infections had underlying diseases, such as diabetes. The ratio of white blood cells to procalcitonin and the ratio of C-reactive protein to procalcitonin were potential clinical markers for differentiating hypervirulent K. pneumoniae strains from classical K. pneumoniae strains that cause pyogenic infections. K. pneumoniae isolates of ST11 were generally more resistant to antibiotics than non-ST11 isolates. Most importantly, hypervirulent K. pneumoniae strains were more tolerant to antibiotics than classic K. pneumoniae isolates. Klebsiella pneumoniae may cause pyogenic infections, which are potentially life-threatening and bring great challenges for clinical management. However, the clinical and molecular characteristics of K. pneumoniae are poorly understood, and effective antibacterial treatment strategies are limited.
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页数:13
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