Patients without a history of hepatobiliary disease presented with community-acquired pyogenic liver abscesses (CA-PLA) and a propensity for metastatic spread to distant sites. In the mid-1980s and 1990s, reports from Taiwan described a unique clinical syndrome of community-acquired K. 5, 6Ī new hypervirulent variant of Klebsiella pneumoniae is emerging pneumoniae outbreak at the Clinical Center Hospital on the National Institutes of Health campus have captured the attention of physicians, scientists and the lay press. The spread of New Delhi metallo-β-lactamase (NDM-1)-containing strains from India associated with medical tourism and more recently the extreme drug-resistant K. As a result, treatment has become more challenging. pneumoniae (cKP) strains have received increased notoriety due to their propensity for acquiring antimicrobial resistance determinants. 1 - 4 Infections involving the urinary tract, lungs, abdominal cavity, intra-vascular devices, surgical sites, soft tissues and subsequent bacteremia were the most common clinical syndromes. pneumoniae infections has evolved in the antibiotic era, with most infections, particularly in developed Western countries, occurring in hospitals and long-term care facilities. It was also an established uropathogen, and a cause of biliary tract infections, osteomyelitis and bacteremia. pneumoniae was implicated as a cause of pneumonia, especially in alcoholics and diabetic patients. It was initially named Friedlander’s bacillus but was changed to Klebsiella in 1886. This predated the Gram stain technique, which was developed in 1884. pneumoniae strainsįriedlander, in 1882, described an encapsulated bacillus isolated from the lungs of patients who died of pneumonia. The majority of infections due to Klebsiella pneumoniae in Western countries are due to “classic” K. If/when these strains become increasingly resistant to antimicrobials, we will be faced with a frightening clinical scenario. An objective diagnostic test suitable for routine use in the clinical microbiology laboratory is needed. pneumoniae are the ability to more efficiently acquire iron and perhaps an increase in capsule production, which confers the hypermucoviscous phenotype. The traits that enhance its virulence when compared with “classical” K. The majority of cases described to date are in Asians, raising the issue of a genetic predisposition vs. However the route of entry remains unclear. Although epidemiologic features are still being defined, colonization, particularly intestinal colonization, appears to be a critical step leading to infection. Despite infecting a healthier population, significant morbidity and mortality occurs. Defining clinical features are the ability to cause serious, life-threatening community-acquired infection in younger healthy hosts, including liver abscess, pneumonia, meningitis and endophthalmitis and the ability to metastatically spread, an unusual feature for enteric Gram-negative bacilli in the non-immunocompromised. First described in the Asian Pacific Rim, it now increasingly recognized in Western countries. A new hypervirulent (hypermucoviscous) variant of Klebsiella pneumoniae has emerged.
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