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- Title
First report of two rapid-onset fatal infections caused by a newly emerging hypervirulent K. Pneumonia ST86 strain of serotype K2 in China.
- Authors
Yibo Zhang; Jingyong Sun; Chenrong Mi; Wenhui Li; Shengyuan Zhao; Qun Wang; Dake Shi; Luo Liu; Bingyu Ding; Yung-Fu Chang; Hongxiong Guo; XiaoKui Guo; Qingtian Li; Yongzhang Zhu; Dimopoulos, George; Giannitsioti, Efthymia
- Abstract
Here, we present the first report of one suspected dead case and two confirmed rapidonset fatal infections caused by a newly emerging hypervirulent Klebsiella pneumoniae ST86 strain of serotype K2. The three cases occurred in a surgery ward during 2013 in Shanghai, China. A combination of multilocus sequence typing, pulsed-field gel electrophoresis, phenotypic and PCR tests for detecting virulence factors (VFs) was used to identify the isolates as K2 ST86 strains with common VFs, including Aerobactin and rmpA. Furthermore, the two K2 ST86 strains additionally harbored a distinct VF kfu (responsible for iron uptake system), which commonly existed in invasive K1 strains only. Thus, the unusual presence of both K1 and K2 VFs in the lethal ST86 strain might further enhance its hypervirulence and cause rapid onset of a life-threatening infection. Nevertheless, despite the administration of a combined antibiotic treatment, these three patients all died within 24 h of acute onset, thereby highlighting that the importance of early diagnosis to determine whether the ST86 strains harbor key K2 VF and unusual K1 kfu and whether patients should receive a timely and targeted antibiotic therapy to prevent ST86 induced fatal pneumonia. Finally, even though these patients are clinically improved, keeping on with oral antibiotic treatment for additional 2-3 weeks will be also vital for successfully preventing hvKP reinfection or relapse.
- Subjects
KLEBSIELLA infections; VIRULENCE of bacteria; SEROTYPES
- Publication
Frontiers in Microbiology, 2015, p1
- ISSN
1664-302X
- Publication type
Article
- DOI
10.3389/fmicb.2015.00721