Klebsiella pneumoniae Isolates from Meningitis

Epidemiology, Virulence and Antibiotic Resistance

Yee Huang Ku, Yin Ching Chuang, Chi Chung Chen, Mei Feng Lee, Yan Chang Yang, Hung Jen Tang, Wen Liang Yu

Research output: Contribution to journalArticle

8 Citations (Scopus)

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), rmpA 2 (n = 20), aerobactin gene (n = 22) and high-grade serum resistance (n = 23, 69.7%). Higher mouse lethality (LD50 < 106) 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.

Original languageEnglish
Article number6634
JournalScientific Reports
Volume7
Issue number1
DOIs
Publication statusPublished - Dec 1 2017

Fingerprint

Klebsiella pneumoniae
Microbial Drug Resistance
Meningitis
Virulence
Epidemiology
Craniotomy
Cephalosporin Resistance
meropenem
Virulence Factors
Cephalosporins
Lethal Dose 50
Serum
Capsules
Retrospective Studies

ASJC Scopus subject areas

  • General

Cite this

Klebsiella pneumoniae Isolates from Meningitis : Epidemiology, Virulence and Antibiotic Resistance. / Ku, Yee Huang; Chuang, Yin Ching; Chen, Chi Chung; Lee, Mei Feng; Yang, Yan Chang; Tang, Hung Jen; Yu, Wen Liang.

In: Scientific Reports, Vol. 7, No. 1, 6634, 01.12.2017.

Research output: Contribution to journalArticle

Ku, Yee Huang ; Chuang, Yin Ching ; Chen, Chi Chung ; Lee, Mei Feng ; Yang, Yan Chang ; Tang, Hung Jen ; Yu, Wen Liang. / Klebsiella pneumoniae Isolates from Meningitis : Epidemiology, Virulence and Antibiotic Resistance. In: Scientific Reports. 2017 ; Vol. 7, No. 1.
@article{8fbd016f2ef842f98b8f59002ae46537,
title = "Klebsiella pneumoniae Isolates from Meningitis: Epidemiology, Virulence and Antibiotic Resistance",
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), rmpA 2 (n = 20), aerobactin gene (n = 22) and high-grade serum resistance (n = 23, 69.7{\%}). Higher mouse lethality (LD50 < 106) 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.",
author = "Ku, {Yee Huang} and Chuang, {Yin Ching} and Chen, {Chi Chung} and Lee, {Mei Feng} and Yang, {Yan Chang} and Tang, {Hung Jen} and Yu, {Wen Liang}",
year = "2017",
month = "12",
day = "1",
doi = "10.1038/s41598-017-06878-6",
language = "English",
volume = "7",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

TY - JOUR

T1 - Klebsiella pneumoniae Isolates from Meningitis

T2 - Epidemiology, Virulence and Antibiotic Resistance

AU - Ku, Yee Huang

AU - Chuang, Yin Ching

AU - Chen, Chi Chung

AU - Lee, Mei Feng

AU - Yang, Yan Chang

AU - Tang, Hung Jen

AU - Yu, Wen Liang

PY - 2017/12/1

Y1 - 2017/12/1

N2 - 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), rmpA 2 (n = 20), aerobactin gene (n = 22) and high-grade serum resistance (n = 23, 69.7%). Higher mouse lethality (LD50 < 106) 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.

AB - 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), rmpA 2 (n = 20), aerobactin gene (n = 22) and high-grade serum resistance (n = 23, 69.7%). Higher mouse lethality (LD50 < 106) 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.

UR - http://www.scopus.com/inward/record.url?scp=85026196064&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026196064&partnerID=8YFLogxK

U2 - 10.1038/s41598-017-06878-6

DO - 10.1038/s41598-017-06878-6

M3 - Article

VL - 7

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

M1 - 6634

ER -