title: Influence of the bacterial phenotypes on the clinical manifestations in Klebsiella pneumoniae bacteremia patients: A retrospective cohort study.
abstract: Ninety-four episodes of Klebsiella pneumoniae bloodstream infection were identified at a university hospital in Japan. After excluding extended-spectrum beta lactamase-producing strains, 83 blood isolates from these patients were assayed in terms of their bacterial phenotypes such as the mucoid and hypermucoviscosity phenotypes. Bacterial phenotypes were correlated with the patients' clinical manifestations. The hypermucoviscosity phenotype was significantly associated with septic shock at the onset of infections (odds ratio, 15.92; 95% confidence interval, 1.27-468.12), but was not associated with liver abscess formation. Mortality was determined by the presence of septic shock. RmpA gene was associated with the induction of the hypermucoviscosity phenotype. These results reveal unique roles of bacterial phenotypes on the patient's clinical condition in K. pneumoniae bacteremia.
authors.affiliation: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Medicine, Fukuoka University, Japan. Electronic address: atogawa@fukuoka-u.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Togawa
authors.affiliation: Division of Microbiology Laboratory, Fukuoka University Hospital, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Toh
authors.affiliation: Department of Internal Medicine I, Kyushu University, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Onozawa
authors.affiliation: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Medicine, Fukuoka University, Japan.
authors.forename: Michinobu
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Division of Microbiology Laboratory, Fukuoka University Hospital, Japan.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Tokushige
authors.affiliation: Department of Internal Medicine I, Kyushu University, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimono
authors.affiliation: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Medicine, Fukuoka University, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Takata
authors.affiliation: Division of Medical Oncology, Hematology, and Infectious Diseases, Department of Medicine, Fukuoka University, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tamura
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity*; D008100:Liver Abscess; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies
keywords: Bacteremia; Klebsiella pneumoniae; Liver abscess; Mortality; Septic shock