Yee-Huang Ku1, Yin-Ching Chuang2, Wen-Liang Yu3,4
1Division of Infectious Disease, Department of Internal Medicine, Chi Mei Medical Center, Liouying; Departments of 2Medical Research and 3Intensive Care Medicine, Chi Mei Medical Center, Tainan; and 4Department of Medicine, Taipei Medical University, Taipei, Taiwan
Received: May 12, 2007 Revised: June 4, 2007 Accepted: July 26, 2007
Corresponding author: Dr. Wen-Liang Yu, Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan. E.mail:
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Background and Purpose: Klebsiella pneumoniae causes a wide spectrum of infections, including abscess and non-abscess formation. This study investigated the clinical spectrum and molecular characteristics of community-acquired Klebsiella infection with primary extrahepatic abscess.
Methods: From April 2004 through March 2007, a total of 18 strains of K. pneumoniae, 11 from blood and 7 from focal purulent specimens, were recovered from a medical center in southern Taiwan. The clinical data were collected from medical records. Hypermucoviscosity phenotype was defined as positive string test. The virulence genes, including rmpA (regulator of mucoid phenotype), magA (specific to K1 capsule serotype), k2A (specific to K2 capsule serotype), and kfu (an iron uptake system) were amplified by polymerase chain reaction using specific primers.
Results: Twelve men and 6 women with ages ranging from 37 to 74 years were enrolled. Fifteen patients had underlying diabetes mellitus. The duration of hospitalization ranged from 1 to 96 days. Three patients died by the end of treatment. All of the K. pneumoniae strains carried rmpA and 16 strains showed the hypermucoviscosity phenotype. Of the 18 strains, 7 strains were positive for k2A and 4 strains carried magA. kfu wasidentified in 4 magA-positive strains and 2 magA-negative/k2A-negative strains.
Conclusions: Diabetes mellitus was the most frequent underlying disease among our patients. The rmpA and/or hypermucoviscosity phenotype were the most common virulence factors in K. pneumoniae isolates causing extrahepatic abscesses, among which K2 capsule serotype (k2A+) was more prevalent than K1 capsule serotype (magA+).
Key words: Bacterial capsules; Bacterial proteins; Comorbidity; Klebsiella pneumoniae; Liver abscess; Virulence factors
J Microbiol Immunol Infect. 2008;41:311-317.
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