Eight cases of invasive Klebsiella pneumoniae infection from a public teaching medical institution in the USA

Jon Persichino,Hayley Lee,Daniel Kim,Made Sutjita

doi:10.1099/jmmcr.0.000048

Jon Persichino, Hayley Lee + Show 2 more

Open Access

https://doi.org/10.1099/jmmcr.0.000048

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Abstract

Background: Klebsiella pneumoniae is a common human bacterial pathogen known to cause invasive infections such as primary liver abscesses, necrotizing fasciitis, meningitis and endophthalmitis with bacteraemia among patients in eastern Asia. Over the last decade, geographical spread and emergence of invasive K. pneumoniae infection has occurred in the USA. The majority of reported cases involve males with diabetes mellitus, of Asian ethnicity and who have recently travelled to Asia. Results: We identified eight invasive cases with liver abscesses and necrotizing fasciitis at our institution. The most common risk factors associated with invasive infection were male gender and diabetes mellitus, which is consistent with other reported cases. However, Caucasians and Hispanics represented the majority of invasive disease (n = 7), and history of recent travel to Asia was not identified in any of the cases. Discussion: Further studies with larger cohorts involving multiple healthcare institutions in the USA are warranted to confirm these two unusual characteristics of infection. Healthcare professionals should be informed of the possible association between K. pneumoniae and invasive disease in male diabetic persons of non-Asian descent and without recent travel to Asia in the USA.

Highlights

Klebsiella pneumoniae is a common human bacterial pathogen known to cause invasive infections such as primary liver abscesses, necrotizing fasciitis, meningitis and endophthalmitis with bacteraemia among patients in eastern Asia
Over the past few decades, invasive infection caused by K. pneumoniae has been characterized and defined by bacteraemia associated with liver abscesses, necrotizing fasciitis, meningitis and endophthalmitis (Fang et al, 2005; Frazee et al, 2009; Gunnarsson et al, 2009; Lederman & Crum, 2005; Lee et al, 2008; McCabe et al, 2010; Nadasy et al, 2007; Pastagia & Arumugam, 2008; Persichino et al, 2012; Shon et al, 2013; Siu et al, 2012; Yu et al, 2007)
Whilst invasive K. pneumoniae infections are common in eastern Asia, they are rare in the USA

Summary

Background

Klebsiella pneumoniae is a common human bacterial pathogen that can cause urinary tract infections, pneumonia, skin and soft-tissue infections, and bacteraemia. Invasive infection occurs predominantly in eastern Asia, an increasing trend of invasive cases has recently been reported in the USA (Fang et al, 2005; Frazee et al, 2009; Gunnarsson et al, 2009; Lederman & Crum, 2005; McCabe et al, 2010; Nadasy et al, 2007; Pastagia & Arumugam, 2008; Persichino et al, 2012; Rahimian et al, 2004; Siu et al, 2012). 73 Male Caucasian USA Necrotizing fasciitis of abdomen Septic shock, acute renal failure

Results

Discussion

73 Male Caucasian USA Liver abscess