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Mahoko Ikeda, 1,2, * Miyuki Mizoguchi, 1, * Yukie Oshida, 3 Keita Tatsuno, 1 Ryoichi Saito, 4 Mitsuhiro Okazaki, 5 Shu Okugawa, 2 Kyoji Moriya 1,2
1 Department of Prevention and Control infections, the University Hospital of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan; 2 Department of Infectious Diseases, Tokyo University Hospital, Hongo, Bunkyo-ku, Tokyo, Japan; 3 Division of Infectious Diseases, Shizuoka Cancer Center, Simonagakubo, Nagaizumi-cabbage, Suntou-gun, Shizuoka, Japan; 4 Department of Microbiology and Immunity, Graduate School of Health Sciences, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan; 5 Department of Medical Technology, School of Health Sciences, Tokyo University of Technology, Kamata, Ota-ku, Tokyo, Japan
* These authors contributed equally to this book
] Klebsiella pneumoniae is a pathogen that causes pneumonia and urinary tract infection. Hypervirulent K. pneumoniae often show hypermucoviscosity, are serotype K1 or K2, and harbor the genes rmpA and magA . However, differences in the prevalence of K. pneumoniae with these hypervirulent characteristics between infection and the colonization state are not well understood. Therefore, in this study, we compared the clinical and microbiological characteristics of K. pneumoniae isolated from urine samples or sputum of cases of tuberculosis. infection and colonization.
Patients and Methods: This retrospective study was conducted in a tertiary care tertiary hospital in Tokyo, Japan. Patients whose sputum or urine were tested positive for the presence of K. pneumoniae isolates were included at random in the study. Clinical and microbiological data were collected from medical records.
Results: Of the 130 cases studied, 68 and 62 cases showed the presence of K. pneumoniae in sputum and urine, respectively. There were 49 cases of infection, including 21 in the sputum group and 28 in the urine group. Infections were not accompanied by liver abscess. Of the 130 K. pneumoniae isolates, 25 (19.2%) had a K1 or K2 capsular serotype, while 33 (25.4%) had hypermucoviscosity. Predominance of virulence genes magA allS rmpA mrkD, uge, kfu-BC and wabG was 10% (while K1), 13, 1%, 16.9%, 85.4%, 79.2%, 36.9% and 91.5%, respectively. In both sputum and urine groups, there was no difference in the characteristics of patients with an infection and those with colonization. The badysis of microbiological characteristics revealed that only rmpA was significantly more common in cases of infection than in the colonization / asymptomatic cases in both sputum and blood groups. # 39; urine.
Conclusion: The rmpA -positive K. pneumoniae isolates were dominant in cases of infection compared with those in colonization / asymptomatic cases, suggesting that rmpA could play a crucial role in the development of urinary tract infection and pneumonia. Keywords: Klebsiella pneumoniae hypermucoviscosity, rmpA capsular polysaccharide serotype, infection, colonization, pneumonia, urinary tract infection
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