Analysis of virulence profiles in clinical isolates of Klebsiella pneumoniae from renal abscesses: clinical significance of hypervirulent isolates

Jaehyeon Lee; Jeong-Hwan Hwang; Ji Hyun Yeom; Sik Lee; Joo-Hee Hwang

doi:10.3389/fcimb.2024.1367111

Analysis of virulence profiles in clinical isolates of Klebsiella pneumoniae from renal abscesses: clinical significance of hypervirulent isolates

Front Cell Infect Microbiol. 2024 Mar 28:14:1367111. doi: 10.3389/fcimb.2024.1367111. eCollection 2024.

Authors

Jaehyeon Lee^#^{1

2}, Jeong-Hwan Hwang^#^{2

3}, Ji Hyun Yeom^{2

3}, Sik Lee^{2

3}, Joo-Hee Hwang^{2

3}

Affiliations

¹ Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
² Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
³ Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.

^# Contributed equally.

Abstract

Introduction: Klebsiella pneumoniae can cause a wide range of infections. Hypervirulent K. pneumoniae (hvKp), particularly associated with the K1 and K2 capsular types, is an increasingly significant microorganism with the potential to cause invasive infections, including renal abscesses. Despite the rising prevalence of hvKp infections, information on renal abscesses caused by K. pneumoniae is limited, and the clinical significance of hvKp associated with specific virulence genes remains elusive.

Methods: This study performed at a 1200-bed tertiary hospital sought to identify the clinical and microbiological characteristics of renal abscesses caused by K. pneumoniae, focusing on various virulence genes, including capsular serotypes and multilocus sequence typing (MLST).

Results: Over an 8-year period, 64 patients with suspected renal abscesses were reviewed. Ten patients diagnosed with K. pneumoniae-related renal abscesses were ultimately enrolled in the study. Among the isolates from the 10 patients, capsular serotype K2 was predominant (40.0%), followed by K1 (30.0%). The most common sequence type by MLST was 23 (40.0%). In particular, six patients (60.0%) harbored specific genes indicative of hvKp: iucA, peg-344, rmpA, and rmpA2.

Conclusions: Our findings highlight the importance of hvKp as a pathogen in renal abscesses. Although the nature of hvKp is relatively unknown, it is widely recognized as a highly virulent pathogen that can infect relatively healthy individuals of various ages and simultaneously cause infections at multiple anatomical sites. Therefore, when treating patients with K. pneumoniae-related renal abscesses, caution is necessary when considering the characteristics of hvKp, such as potential bacteremia, multi-organ abscess formation, and metastatic spread.

Keywords: Klebsiella pneumoniae; antibiotic resistance; hypervirulence; renal abscess; virulence.

MeSH terms

Abscess / complications
Abscess / drug therapy
Anti-Bacterial Agents / therapeutic use
Clinical Relevance
Humans
Klebsiella Infections* / microbiology
Klebsiella pneumoniae
Multilocus Sequence Typing
Urinary Tract Infections* / complications
Virulence / genetics

Substances

Anti-Bacterial Agents

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by research funds for newly appointed professors of Jeonbuk National University in 2023.