Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea.
OBJECTIVE
The high incidence of invasive liver abscess caused by Klebsiella pneumoniae in Taiwan, contrasted with the rareness of this disease in Western countries, has aroused special interest. There have been few detailed reports from other Asian countries. To investigate a current epidemiology of K. pneumoniae liver abscess in Korea and to determine K serotype distribution in K. pneumoniae strains causing liver abscess, we performed a nationwide prospective study.


METHODS
Community-acquired, culture-proven liver abscess cases were enrolled between 2004 and 2005. Etiologies and clinical features were analyzed. K. pneumoniae isolates were serotyped according to K antigen. Meta-analysis was done to determine the time trend of the etiologies of liver abscess in Korea.


RESULTS
Out of 371 cases collected prospectively, 290 (78.2%) were caused by K. pneumoniae. Most K. pneumoniae liver abscesses were monomicrobial. Diabetes mellitus was the most common underlying disease (39.9%). Distant metastatic infections were frequently observed (8.7%). magA PCR revealed that 95 (59.4%) out of 160 K. pneumoniae isolates belonged to the K1 serotype.


CONCLUSIONS
Our study indicates that K. pneumoniae has emerged as a major etiologic agent of liver abscess in Korea, and these emerging infections seem to be attributable to invasive K. pneumoniae strains with capsular K1 serotype.
Chung
D R
DR
Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do 431-070, South Korea. drchung@hallym.ac.kr
Lee
S S
SS
Lee
H R
HR
Kim
H B
HB
Choi
H J
HJ
Eom
J S
JS
Kim
J S
JS
Choi
Y H
YH
Lee
J S
JS
Chung
M H
MH
Kim
Y S
YS
Lee
H
H
Lee
M S
MS
Park
C K
CK
D000368:Aged; D000942:Antigens, Bacterial / Q000276:immunology; D001483:Base Sequence; D021821:Communicable Diseases, Emerging; D017931:DNA Primers; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000276:immunology / Q000302:isolation & purification*; D007723:Korea / Q000453:epidemiology; D008100:Liver Abscess / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000942:Antigens, Bacterial; D017931:DNA Primers