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    標題: Klebsiella pneumoniae Isolates from Meningitis: Epidemiology, Virulence and Antibiotic Resistance
    作者: Ku, Yee-Huang
    Chuang, Yin-Ching
    Chen, Chi-Chung
    Lee, Mei-Feng
    Yang, Yan-Chang
    Tang, Hung-Jen
    Yu, Wen-Liang
    貢獻者: 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
    關鍵字: Acquired Bacterial-Meningitis
    Multilocus Sequence Types
    Pyogenic Liver-Abscess
    Southern Taiwan
    Clinical Characteristics
    Clonal Dissemination
    日期: 2017-07-26
    上傳時間: 2018-11-30 15:56:28 (UTC+8)
    出版者: Nature Publishing Group
    摘要: 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.
    關聯: Scientific Reports, v.7, pp.6634
    Appears in Collections:[保健營養系(所) ] 期刊論文

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