Infections caused by carbapenem-resistant Klebsiella pneumoniae with hypermucoviscous phenotype: A case report and literature review

Virulence

Volumn 8, Issue 8, 2017, Pages 1900-1908

  Arena, Fabio ^a   Henrici De Angelis, Lucia ^a   D'Andrea, Marco Maria ^b   Cannatelli, Antonio ^a   Fossati, Lucina ^c   Di Pilato, Vincenzo ^d   Giani, Tommaso ^a   Cavallo, Rossana ^c   Rossolini, Gian Maria ^a,b,e,f  

^a UNIVERSITY OF SIENA   (Italy)

^b UNIVERSITY OF FLORENCE   (Italy)

^c UNIVERSITY OF TURIN   (Italy)

^d UNIVERSITY OF FLORENCE   (Italy)

^e CAREGGI UNIVERSITY HOSPITAL   (Italy)

^f IRCCS FONDAZIONE DON CARLO GNOCCHI   (Italy)

Author keywords

animal model; bacteremia; capsular type; carbapenemase; hypercapsule; liver abscess; liver transplantation; string test; virulence

Indexed keywords

METHOTREXATE; PREDNISONE; ANTIINFECTIVE AGENT; CARBAPENEM DERIVATIVE;

ACUTE MYELOID LEUKEMIA; ANTIBIOTIC RESISTANCE; BACTEREMIA; BLOODSTREAM INFECTION; FIMK GENE; GENE; GENE CLUSTER; GENOME SIZE; HUMAN; INTENSIVE CARE UNIT; KLEBSIELLA PNEUMONIAE INFECTION; LETTER; LIVER TRANSPLANTATION; LUNG DYSPLASIA; MORTALITY RATE; NONSENSE MUTATION; SEPTIC SHOCK; SEPTICEMIA; SEROTYPING; URINARY TRACT INFECTION; CASE REPORT; DRUG EFFECT; GENETICS; ISOLATION AND PURIFICATION; KLEBSIELLA INFECTION; KLEBSIELLA PNEUMONIAE; MALE; MICROBIOLOGY; MIDDLE AGED; PHENOTYPE; PHYSIOLOGY;

ANTI-BACTERIAL AGENTS; CARBAPENEMS; DRUG RESISTANCE, BACTERIAL; HUMANS; KLEBSIELLA INFECTIONS; KLEBSIELLA PNEUMONIAE; MALE; MIDDLE AGED; PHENOTYPE;

EID: 85013649645     PISSN: 21505594     EISSN: 21505608     Source Type: Journal    
DOI: 10.1080/21505594.2017.1286439     Document Type: Letter

References (44)

1. Liu YC, Cheng DL, Lin CL. Klebsiella pneumoniae liver abscess associated with septic endophthalmitis. JAMA Intern Med 1986; 10:1913-6; https://doi.org/10.1001/archinte.1986.00360220057011
2. Liu YC, Lee SS, Yen MY, Chen YS, Wang JH, Wann SR, Lin HH. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin Infect Dis 1998; 26:1434-8; PMID:9636876; https://doi.org/10.1086/516283
3. Wang J, Yan Y, Xue X, Wang K, Shen D. Comparison of pyogenic liver abscesses caused by hypermucoviscous Klebsiella pneumoniae and non-Klebsiella pneumoniae pathogens in Beijing: a retrospective analysis. J Int Med Res 2013; 41:1088-97; PMID:23729468; https://doi.org/10.1177/0300060513487645
4. Shon AS, Bajwa RPS, Russo TA. Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: a new and dangerous breed. Virulence 2013; 4:107-18; PMID:23302790; https://doi.org/10.4161/viru.22718
5. Arena F, Spanu T, De Angelis LH, Liotti FM, D'Andrea MM, Menchinelli G, De Maio F, Rossolini GM. First case of bacteremic liver abscess caused by an ST260-related (ST1861), hypervirulent Klebsiella pneumoniae. J Infect 2016; 1:88-91; https://doi.org/10.1016/j.jinf.2016.04.006
6. Insua JL, Llobet E, Moranta D, Pérez-Gutiérrez C, Tomás A, Garmendia J, Bengoechea JA. Modeling Klebsiella pneumoniae pathogenesis by infection of the wax moth Galleria mellonella. Infect Immun 2013; 81:3552-65; PMID:23836821; https://doi.org/10.1128/IAI.00391-13
7. Russo TA, Olson R, Macdonald U, Metzger D, Maltese LM, Drake EJ, Gulick AM. Aerobactin mediates virulence and accounts for increased siderophore production under iron-limiting conditions by hypervirulent (hypermucoviscous) Klebsiella pneumoniae. Infect Immun 2014; 82:2356-67; PMID:24664504; https://doi.org/10.1128/IAI.01667-13
8. Chou HC, Lee CZ, Ma LC, Fang CT, Chang SC, Wang JT. Isolation of a chromosomal region of Klebsiella pneumoniae associated with allantoin metabolism and liver infection. Infect Immun 2004; 72:3783-92; PMID:15213119; https://doi.org/10.1128/IAI.72.7.3783-3792.2004
9. Struve C, Roe CC, Stegger M, Stahlhut SG, Hansen DS, Engelthaler DM, Andersen PS, Driebe EM, Keim P, Krogfelt KA. Mapping the Evolution of Hypervirulent Klebsiella pneumoniae. MBio 2015; 6:e00630-15-12; https://doi.org/10.1128/mBio.00630-15
10. Paczosa MK, Mecsas J. Klebsiella pneumoniae: Going on the Offense with a strong defense. Microbiol Mol Biol Rev 2016; 80:629-61PMID:27307579; https://doi.org/10.1128/MMBR.00078-15
11. Cheng HY, Chen YS, Wu CY, Chang HY, Lai YC, Peng HL. RmpA regulation of capsular polysaccharide biosynthesis in Klebsiella pneumoniae CG43. J Bacteriol 2010; 192:3144-58PMID:20382770; https://doi.org/10.1128/JB.00031-10
12. Lai YC, Peng HL, Chang HY. RmpA2, an activator of capsule biosynthesis in Klebsiella pneumoniae CG43, regulates K2 cps gene expression at the transcriptional level. J Bacteriol 2003; 185:788-800; PMID:12533454; https://doi.org/10.1128/JB.185.3.788-800.2003
13. Peirano G, Pitout JD, Laupland KB, Meatherall B, Gregson DB. Population-based surveillance for hypermucoviscosity Klebsiella pneumoniae causing community-acquired bacteremia in Calgary, Alberta. Can J Infect Dis Med Microbiol 2013; 24:e61-4; PMID:24421832
14. Cubero M, Grau I, Tubau F, Pallares R, Dominguez MA, Liñares J, Ardanuy C. Hypervirulent Klebsiella pneumoniae clones causing bacteraemia in adults in a teaching hospital in Barcelona, Spain (2007–2013). Clin Microbiol Infect 2015; 2:154-60
15. Wiskur BJ, Hunt JJ, Callegan MC. Hypermucoviscosity as a Virulence Factor in Experimental Klebsiella pneumoniae Endophthalmitis. Invest Ophthalmol Vis Sci 2008; 49:4931-20; PMID:18586871; https://doi.org/10.1167/iovs.08-2276
16. Yu WL, Ko WC, Cheng KC, Lee HC, Ke DS, Lee CC, Fung CP, Chuang YC. Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. Clin Infect Dis 2006; 42:1351-8; PMID:16619144; https://doi.org/10.1086/503420
17. Arena F, De Angelis LH, Cannatelli A, Di Pilato V, Amorese M, D'Andrea MM, Giani T, Rossolini GM. Colistin resistance caused by inactivation of the MgrB regulator is not associated with decreased virulence of ST258 KPC carbapenemase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 2016; 60:2509-12; PMID:26824959; https://doi.org/10.1128/AAC.02981-15
18. Diago-Navarro E, Chen L, Passet V, Burack S, Ulacia-Hernando A, Kodiyanplakkal RP, Levi MH, Brisse S, Kreiswirth BN, Fries BC. Carbapenem-resistant Klebsiella pneumoniae exhibit variability in capsular polysaccharide and capsule associated virulence traits. J Infect Dis 2014; 210:803-13; PMID:24634498; https://doi.org/10.1093/infdis/jiu157
19. Tzouvelekis LS, Miriagou V, Kotsakis SD, Spyridopoulou K, Athanasiou E, Karagouni E, Tzelepi E, Daikos GL. KPC-producing, multidrug-resistant Klebsiella pneumoniae sequence type 258 as a typical opportunistic pathogen. Antimicrob Agents Chemother 2013; 57:5144-6; PMID:23856769; https://doi.org/10.1128/AAC.01052-13
20. Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 1998; 11:589-603; PMID:9767057
21. Rossolini GM. Extensively drug-resistant carbapenemase-producing Enterobacteriaceae: an emerging challenge for clinicians and healthcare systems. J Intern Med 2015; 277:528-31; PMID:25627464; https://doi.org/10.1111/joim.12350
22. Chen L, Mathema B, Chavda KD, Deleo FR, Bonomo RA, Kreiswirth BN. Carbapenemase-producing Klebsiella pneumoniae: molecular and genetic decoding. Trends Microbiol 2014; 22:686-96; PMID:25304194; https://doi.org/10.1016/j.tim.2014.09.003
23. Nordmann P, Naas T, Poirel L. Global spread of Carbapenemase-producing Enterobacteriaceae. Emerging Infect Dis 2011; 17:1791-8; PMID:22000347; https://doi.org/10.3201/eid1710.110655
24. Woodford N, Turton JF, Livermore DM. Multiresistant Gram-negative bacteria: the role of high-risk clones in the dissemination of antibiotic resistance. FEMS Microbiol Rev 2011; 35:736-55; PMID:21303394; https://doi.org/10.1111/j.1574-6976.2011.00268.x
25. Holt KE, Wertheim H, Zadoks RN, Baker S, Whitehouse CA, Dance D, Jenney A, Connor TR, Hsu LY, Severin J, et al. Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health. Proc Natl Acad Sci USA 2015; 112:E3574-81; PMID:26100894; https://doi.org/10.1073/pnas.1501049112
26. Li W, Sun G, Yu Y, Li N, Chen M, Jin R, Jiao Y, Wu H. Increasing occurrence of antimicrobial-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in China. Clin Infect Dis 2014; 58:225-32; PMID:24099919; https://doi.org/10.1093/cid/cit675
27. Andrade LN, Vitali L, Gaspar GG, Bellissimo-Rodrigues F, Martinez R, Darini ALC. Expansion and evolution of a virulent, extensively drug-resistant (polymyxin B-resistant), QnrS1-, CTX-M-2-, and KPC-2-producing Klebsiella pneumoniae ST11 international high-risk clone. J Clin Microbiol 2014; 52:2530-5; PMID:24808234; https://doi.org/10.1128/JCM.00088-14
28. Cejas D, Fernández Canigia L, Rincón Cruz G, Elena AX, Maldonado I, Gutkind GO, Radice MA. First isolate of KPC-2-producing Klebsiella pneumonaie sequence type 23 from the Americas. J Clin Microbiol 2014; 52:3483-5; PMID:25031447; https://doi.org/10.1128/JCM.00726-14
29. Yao B, Xiao X, Wang F, Zhou L, Zhang X, Zhang J. Clinical and molecular characteristics of multi-clone carbapenem-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in a tertiary hospital in Beijing, China. Int J Infect Dis 2015; 37:107-12; PMID:26141415; https://doi.org/10.1016/j.ijid.2015.06.023
30. Zhang Y, Zeng J, Liu W, Zhao F, Hu Z, Zhao C, Wang Q, Wang X, Chen H, Li H, et al. Emergence of a hypervirulent carbapenem- resistant Klebsiella pneumoniae isolate from clinical infections in China. J Infect 2015; 71:553-60; PMID:26304687; https://doi.org/10.1016/j.jinf.2015.07.010
31. Zhang R, Lin D, Chan EW-C, Gu D, Chen GX, Chen S. Emergence of carbapenem-resistant Serotype K1 hypervirulent Klebsiella pneumoniae (hvKP) strains in China. Antimicrob Agents Chemother 2015; 60:709-11; PMID:26574010; https://doi.org/10.1128/AAC.02173-15
32. Wei DD, Wan LG, Zeng LB, Deng Q, Liu Y. Emergence of KPC-producing Klebsiella pneumoniae hypervirulent clone of capsular serotype K1 that belongs to Sequence Type 11 in Mainland China. Diagn Microbiol Infect Dis 2016; 85:192-4; PMID:27049969; https://doi.org/10.1016/j.diagmicrobio.2015.03.012
33. Rafiq Z, Sam N, Vaidyanathan R. Whole genome sequence of Klebsiella pneumoniae U25, a hypermucoviscous, multidrug resistant, biofilm producing isolate from India. Mem Inst Oswaldo Cruz 2016; 111:144-6; PMID:26872343; https://doi.org/10.1590/0074-02760150423
34. Shankar C, Nabarro LEB, Devanga Ragupathi NK, Muthuirulandi Sethuvel DP, Daniel JLK, Doss C GP, Veeraraghavan B. Draft genome sequences of three hypervirulent carbapenem-resistant Klebsiella pneumoniae isolates from bacteremia. Genome Announc 2016; 4:e01081-16; PMID:27932638
35. Bankevich A, Nurk S, Antipov D, Gurevich AA, Dvorkin M, Kulikov AS, Lesin VM, Nikolenko SI, Pham S, Prjibelski AD, et al. SPAdes: a new genome assembly algorithm and its applications to single-cell sequencing. J Comput Biol 2012; 19:455-77; PMID:22506599; https://doi.org/10.1089/cmb.2012.0021
36. Aziz RK, Bartels D, Best AA, DeJongh M, Disz T, Edwards RA, Formsma K, Gerdes S, Glass EM, Kubal M, et al. The RAST Server: rapid annotations using subsystems technology. BMC Genomics 2008; 9:75; PMID:18261238; https://doi.org/10.1186/1471-2164-9-75
37. Cannatelli A, Di Pilato V, Giani T, Arena F, Ambretti S, Gaibani P, D'Andrea MM, Rossolini GM. In vivo evolution to colistin resistance by PmrB sensor kinase mutation in KPC-producing Klebsiella pneumoniae is associated with low-dosage colistin treatment. Antimicrob Agents Chemother 2014; 58:4399-403; PMID:24841267; https://doi.org/10.1128/AAC.02555-14
38. Laing C, Buchanan C, Taboada EN, Zhang Y, Kropinski A, Villegas A, Thomas JE, Gannon VPJ. Pan-genome sequence analysis using Panseq: an online tool for the rapid analysis of core and accessory genomic regions. BMC Bioinformatics 2010; 11:461; PMID:20843356; https://doi.org/10.1186/1471-2105-11-461
39. Cannatelli A, Giani T, D'Andrea MM, Di Pilato V, Arena F, Conte V, Tryfinopoulou K, Vatopoulos A, Rossolini GM, Group CS, et al. MgrB inactivation is a common mechanism of colistin resistance in KPC carbapenemase-producing Klebsiella pneumoniae of clinical origin. Antimicrob Agents Chemother 2014; 58:5696-703; PMID:25022583; https://doi.org/10.1128/AAC.03110-14
40. Rosen DA, Hilliard JK, Tiemann KM, Todd EM, Morley SC, Hunstad DA. Klebsiella pneumoniae FimK promotes virulence in murine pneumonia. J Infect Dis 2016; 213:649-58; PMID:26347570; https://doi.org/10.1093/infdis/jiv440
41. D'Andrea MM, Amisano F, Giani T, Conte V, Ciacci N, Ambretti S, Santoriello L, Rossolini GM. Diversity of capsular polysaccharide gene clusters in Kpc-producing Klebsiella pneumoniae clinical isolates of sequence type 258 involved in the Italian epidemic. PLoS One 2014; 9:e96827; PMID:24823690; https://doi.org/10.1371/journal.pone.0096827
42. Collins RF, Beis K, Dong C, Botting CH, McDonnell C, Ford RC, Clarke BR, Whitfield C, Naismith JH. The 3D structure of a periplasm-spanning platform required for assembly of group 1 capsular polysaccharides in Escherichia coli. Proc Natl Acad Sci USA 2007; 104:2390-5; PMID:17283336; https://doi.org/10.1073/pnas.0607763104
43. Fang CT, Chuang YP, Shun CT, Chang SC, Wang JT. A novel virulence gene in Klebsiella pneumoniae strains causing primary liver abscess and septic metastatic complications. J Exp Med 2004; 199:697-705; PMID:14993253; https://doi.org/10.1084/jem.20030857
44. Wyatt GR, Loughheed TC, Wyatt SS. The chemistry of insect hemolymph; organic components of the hemolymph of the silkworm, Bombyx mori, and two other species. J Gen Physiol 1956; 39:853-68; PMID:13346040; https://doi.org/10.1085/jgp.39.6.853