title: Genetic determinants of capsular serotype K1 of Klebsiella pneumoniae causing primary pyogenic liver abscess.
abstract: BACKGROUND
  Primary pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae is an emerging infectious disease. Capsular serotype K1 and the magA gene have been reported to be associated with this disease.
  
  
  METHODS
  The prevalence of magA was determined by polymerase chain reaction (PCR). The sequences of the magA flanking region were completed by inverse PCR and direct sequencing. Serotyping was performed by double immunodiffusion. Insertion mutations and trans-complementation were used to define the K1 genetic determination region.
  
  
  RESULTS
  Thirty-five of 42 strains from patients with PLA were magA positive, whereas only 1 of 32 non-PLA strains was magA positive. All 36 magA-positive strains were serotype K1, and the 38 magA-negative strains were not (36/36 vs. 0/38; P<.0001). Sequencing of the magA flanking region revealed a putative capsular polysaccharide synthesis (cps) region; this region was 25 kb in length and contained 20 open reading frames (ORFs); of these ORFs, 9 were cotranscribed as part of an operon and differed from both MGH78578 and the Chedid strain. Mutation of 4 genes in this region turned the mutant strains anti-K1 negative. Trans-complementation restored the K1 phenotype.
  
  
  CONCLUSIONS
  The operon containing magA is responsible for capsular serotype K1 of K. pneumoniae. Several loci in the operon are unique determinants of K1 strains.
authors.affiliation: Department of Microbiology, National Taiwan University College of Medicine, and Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Chuang
authors.forename: Chi-Tai
authors.initials: CT
authors.lastname: Fang
authors.forename: Shau-Yan
authors.initials: SY
authors.lastname: Lai
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Jin-Town
authors.initials: JT
authors.lastname: Wang
mesh_terms: D000942:Antigens, Bacterial / Q000235:genetics* / Q000502:physiology; D016667:Bacterial Capsules; D001426:Bacterial Proteins / Q000235:genetics* / Q000502:physiology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D005816:Genetic Complementation Test; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D046290:Liver Abscess, Pyogenic / Q000382:microbiology*; D016254:Mutagenesis, Insertional; D016366:Open Reading Frames; D009876:Operon; D016133:Polymerase Chain Reaction; D011135:Polysaccharides, Bacterial / Q000235:genetics* / Q000502:physiology; D012333:RNA, Messenger / Q000032:analysis / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D012703:Serotyping; D014158:Transcription, Genetic; D037521:Virulence Factors / Q000235:genetics* / Q000502:physiology
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C501254:MagA protein, Klebsiella pneumoniae; D011135:Polysaccharides, Bacterial; D012333:RNA, Messenger; D037521:Virulence Factors; C036962:capsular polysaccharide K1