Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan

Wen-Liang Yu, Wen Chien Ko, Kuo-Chen Cheng, Hsin Chun Lee, Der Shin Ke, Ching Chien Lee, Chang Phone Fung, Yin Ching Chuang

Research output: Contribution to journalArticle

188 Citations (Scopus)

Abstract

Background. The association of the magA gene with the hypermucoviscosity phenotype relevant to the pathogenesis of Klebsiella pneumoniae liver abscess has been reported in Taiwan. Similarly, the rmpA gene, known as a positive regulator of extracapsular polysaccharide synthesis that confers a mucoid phenotype, may be another candidate gene causing hypermucoviscosity. However, the association of rmpA with K. pneumoniae clinical syndromes is unreported. We aimed to investigate the clinical correlation between rmpA and primary Klebsiella abscess, focusing on sites other than the liver. Methods. From July 2003 through December 2004, a total of 151 K. pneumoniae isolates recovered from 151 patients with bacteremia were collected from 2 large medical centers in southern Taiwan. Clinical data were collected from medical records. The genes rmpA and magA were amplified by polymerase chain reaction using specific primers. Results. The prevalences of hypermucoviscosity, rmpA, and magA were 38%, 48%, and 17%, respectively. As determined by statistical multivariate analysis, strains carrying rmpA were significantly associated with the hypermucoviscosity phenotype, and there was a significant correlation with purulent tissue infections, such as liver abscess and lung, neck, psoas muscle, or other focal abscess. Conclusion. Our data support a statistical correlation between the rmpA gene and virulence in terms of abscess formation for these hypermucoviscous K. pneumoniae strains. Hypermucoviscosity associated with rmpA, together with a thorough physical examination, may be helpful as a guide to carry out appropriate diagnostic tests on patients with an initially unknown source of K. pneumoniae bacteremia, particularly when looking for the occurrence of an underlying abscess.

Original languageEnglish
Pages (from-to)1351-1358
Number of pages8
JournalClinical Infectious Diseases
Volume42
Issue number10
DOIs
Publication statusPublished - May 15 2006

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Klebsiella pneumoniae
Taiwan
Abscess
Liver Abscess
Genes
Bacteremia
Phenotype
Psoas Muscles
Neck Muscles
Klebsiella
Routine Diagnostic Tests
Physical Examination
Medical Records
Polysaccharides
Virulence
Multivariate Analysis
Polymerase Chain Reaction
Lung
Liver
Infection

ASJC Scopus subject areas

  • Immunology

Cite this

Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. / Yu, Wen-Liang; Ko, Wen Chien; Cheng, Kuo-Chen; Lee, Hsin Chun; Ke, Der Shin; Lee, Ching Chien; Fung, Chang Phone; Chuang, Yin Ching.

In: Clinical Infectious Diseases, Vol. 42, No. 10, 15.05.2006, p. 1351-1358.

Research output: Contribution to journalArticle

Yu, W-L, Ko, WC, Cheng, K-C, Lee, HC, Ke, DS, Lee, CC, Fung, CP & Chuang, YC 2006, 'Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan', Clinical Infectious Diseases, vol. 42, no. 10, pp. 1351-1358. https://doi.org/10.1086/503420
Yu, Wen-Liang ; Ko, Wen Chien ; Cheng, Kuo-Chen ; Lee, Hsin Chun ; Ke, Der Shin ; Lee, Ching Chien ; Fung, Chang Phone ; Chuang, Yin Ching. / Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan. In: Clinical Infectious Diseases. 2006 ; Vol. 42, No. 10. pp. 1351-1358.
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abstract = "Background. The association of the magA gene with the hypermucoviscosity phenotype relevant to the pathogenesis of Klebsiella pneumoniae liver abscess has been reported in Taiwan. Similarly, the rmpA gene, known as a positive regulator of extracapsular polysaccharide synthesis that confers a mucoid phenotype, may be another candidate gene causing hypermucoviscosity. However, the association of rmpA with K. pneumoniae clinical syndromes is unreported. We aimed to investigate the clinical correlation between rmpA and primary Klebsiella abscess, focusing on sites other than the liver. Methods. From July 2003 through December 2004, a total of 151 K. pneumoniae isolates recovered from 151 patients with bacteremia were collected from 2 large medical centers in southern Taiwan. Clinical data were collected from medical records. The genes rmpA and magA were amplified by polymerase chain reaction using specific primers. Results. The prevalences of hypermucoviscosity, rmpA, and magA were 38{\%}, 48{\%}, and 17{\%}, respectively. As determined by statistical multivariate analysis, strains carrying rmpA were significantly associated with the hypermucoviscosity phenotype, and there was a significant correlation with purulent tissue infections, such as liver abscess and lung, neck, psoas muscle, or other focal abscess. Conclusion. Our data support a statistical correlation between the rmpA gene and virulence in terms of abscess formation for these hypermucoviscous K. pneumoniae strains. Hypermucoviscosity associated with rmpA, together with a thorough physical examination, may be helpful as a guide to carry out appropriate diagnostic tests on patients with an initially unknown source of K. pneumoniae bacteremia, particularly when looking for the occurrence of an underlying abscess.",
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AB - Background. The association of the magA gene with the hypermucoviscosity phenotype relevant to the pathogenesis of Klebsiella pneumoniae liver abscess has been reported in Taiwan. Similarly, the rmpA gene, known as a positive regulator of extracapsular polysaccharide synthesis that confers a mucoid phenotype, may be another candidate gene causing hypermucoviscosity. However, the association of rmpA with K. pneumoniae clinical syndromes is unreported. We aimed to investigate the clinical correlation between rmpA and primary Klebsiella abscess, focusing on sites other than the liver. Methods. From July 2003 through December 2004, a total of 151 K. pneumoniae isolates recovered from 151 patients with bacteremia were collected from 2 large medical centers in southern Taiwan. Clinical data were collected from medical records. The genes rmpA and magA were amplified by polymerase chain reaction using specific primers. Results. The prevalences of hypermucoviscosity, rmpA, and magA were 38%, 48%, and 17%, respectively. As determined by statistical multivariate analysis, strains carrying rmpA were significantly associated with the hypermucoviscosity phenotype, and there was a significant correlation with purulent tissue infections, such as liver abscess and lung, neck, psoas muscle, or other focal abscess. Conclusion. Our data support a statistical correlation between the rmpA gene and virulence in terms of abscess formation for these hypermucoviscous K. pneumoniae strains. Hypermucoviscosity associated with rmpA, together with a thorough physical examination, may be helpful as a guide to carry out appropriate diagnostic tests on patients with an initially unknown source of K. pneumoniae bacteremia, particularly when looking for the occurrence of an underlying abscess.

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