Abstract
Klebsiella pneumoniae liver abscess (KPLA) has been described as an invasive syndrome with extrahepatic complications. The majority of KPLA is caused by capsular serotype K1 and K2 isolates. We report a case of carbapenem resistant Klebsiella pneumoniae liver abscess. The patient initially presented with infected right above-the-knee amputation and was later found with a large liver abscess. Initial antimicrobial susceptibility showed carbapenem resistant K. pneumoniae (CRKP). Further molecular workup revealed that the isolate was a less virulent non-K1/K2 serotype, and both rmpA and kfu genes were negative. The lack of outer membrane porins likely contributed to the carbapenem resistance. To our knowledge, this is a first reported case of carbapenem resistant, non-K1/K2 serotype K. pneumoniae liver abscess in the United States.
Highlights
Klebsiella pneumoniae liver abscess (KPLA) has been described as an invasive syndrome with extrahepatic complications via hematologic spread
We report a case of carbapenem resistant Klebsiella pneumoniae liver abscess
We describe the first case of non-K1/K2 KPLA in the United States
Summary
Klebsiella pneumoniae liver abscess (KPLA) has been described as an invasive syndrome with extrahepatic complications via hematologic spread. The hypermucoviscosity phenotype and capsular serotype (K1 and K2) are the major virulence factors, along with capsular polysaccharide synthesis regulator gene rmpA, iron chelator aerobactin, and iron uptake gene kfu, which have been described to contribute to the virulence and invasive features of K. pneumoniae [1,2,3]. We describe the first case of non-K1/K2 KPLA in the United States
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