Klebsiella pneumoniae Isolates from Meningitis: Epidemiology, Virulence and Antibiotic Resistance

doi:10.1038/s41598-017-06878-6

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Title:	Klebsiella pneumoniae Isolates from Meningitis: Epidemiology, Virulence and Antibiotic Resistance
Authors:	Ku, Yee-Huang Chuang, Yin-Ching Chen, Chi-Chung Lee, Mei-Feng Yang, Yan-Chang Tang, Hung-Jen Yu, Wen-Liang
Contributors:	Chi Mei Med Ctr Liouying, Dept Internal Med, Div Infect Dis Chi Mei Med Ctr, Dept Med Res Chi Mei Hosp, Dept Internal Med, Div Infect Dis Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Chi Mei Med Ctr, Dept Intens Care Med Taipei Med Univ, Coll Med, Sch Med, Dept Med
Keywords:	Acquired Bacterial-Meningitis Multilocus Sequence Types Pyogenic Liver-Abscess Prognostic-Factors Southern Taiwan Clinical Characteristics Clonal Dissemination Hong-Kong Prevalence Serotypes
Date:	2017-07-26
Issue Date:	2018-11-30 15:56:28 (UTC+8)
Publisher:	Nature Publishing Group
Abstract:	Klebsiella pneumoniae (KP) resistance to broad-spectrum cephalosporin (BSC) in meningitis is important because of limited therapeutic options. To investigate the antibiotic resistance, virulence and epidemiology of KP in meningitis, we conducted a retrospective study for 33 non-metastatic isolates, including primary meningitis (n = 20) and post-craniotomy meningitis (n = 13) collected from 1999 to 2013. BSC resistance was found in 9 (27.3%) isolates, all from post-craniotomy meningitis, harboring bla(SHV-5) (n = 6), bla(CMY-2) (n = 2), bla(DHA-1) (n = 2), and bla(TEM-1B) (n = 1). Positive virulence factors were hypermucoviscosity (n = 22), larger bacterial size (n = 24), virulent capsule serotypes (n = 24, K2, 11; K1, 5; K57, 3; K5, 2; K20, 2 and K54, 1), rmpA (n = 23), rmpA2 (n = 20), aerobactin gene (n = 22) and high-grade serum resistance (n = 23, 69.7%). Higher mouse lethality (LD50 < 10(6)) was found in 16 isolates (48.5%). Post-craniotomy isolates were significantly less virulent than primary meningitis isolates, except for similar serum resistance capability. The pulsotype and sequence typing (ST) results were diverse. A minor cluster with pulsotype C and ST23 (n = 5) was identified in primary meningitis isolates. In conclusion, virulence factors and BSC resistance corresponded to about 70% and 30% of KP meningitis isolates respectively. BSC remains appropriate for treating primary meningitis, whereas meropenem is indicated for post-craniotomy meningitis empirically.
Relation:	Scientific Reports, v.7, pp.6634
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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