Community-acquired meningitis caused by a CG86 hypervirulent Klebsiella pneumoniae strain: first case report in the Caribbean

BMC Infect Dis. 2016 Dec 7;16(1):736. doi: 10.1186/s12879-016-2065-2.

Abstract

Background: Community-acquired bacterial meningitis due to Klebsiella pneumoniae has mainly been described in Southeast Asia and has a poor prognosis. Severe invasive infections caused by K. pneumoniae, including meningitis, are often due to hypervirulent strains (hvKP), which are characterized by capsular serotypes K1 and K2, a gene responsible for hypermucoviscosity, and the cluster for synthesis of the siderophore aerobactin.

Case presentation: A 55 year old man with a history of essential hypertension, benign prostate hyperplasia, hyperlipidemia, obstructive sleep apnea, and chronic alcoholism was admitted for meningitis due to Klebsiella pneumoniae with a wild-type susceptibility profile. Its genomic features were consistent with a capsular K2 strain belonging to clonal group 86 (CG86) displaying the large virulence of Klebsiella plasmid (pLVPK) with heavy metal resistance gene clusters, aerobactin, rmpA.

Conclusion: This is the first case of community-acquired meningitis caused by a hypervirulent strain of hvKP ever reported in the Caribbean.

Keywords: Caribbean; Community acquired meningitis; ST86 hypervirulent Klebsiella pneumoniae strain.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Proteins / genetics
  • Cefotaxime / therapeutic use
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology*
  • Genotype
  • Guadeloupe
  • Humans
  • Hydroxamic Acids / metabolism
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / etiology*
  • Klebsiella pneumoniae / genetics*
  • Klebsiella pneumoniae / pathogenicity*
  • Male
  • Meningitis, Bacterial / drug therapy
  • Meningitis, Bacterial / etiology*
  • Middle Aged
  • Plasmids
  • Serogroup
  • Virulence Factors / genetics

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Hydroxamic Acids
  • RmpA protein, Klebsiella pneumoniae
  • Virulence Factors
  • aerobactin
  • Cefotaxime