title: Community-acquired meningitis caused by a CG86 hypervirulent Klebsiella pneumoniae strain: first case report in the Caribbean.
abstract: 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.
  
  
  
  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.
  
  
  
  This is the first case of community-acquired meningitis caused by a hypervirulent strain of hvKP ever reported in the Caribbean.
authors.affiliation: Inserm-CIC 1424 et Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Melot
authors.affiliation: Microbial Evolutionary Genomics, Institut Pasteur, 28 rue du Dr Roux, 75724, Paris, France. sylvain.brisse@pasteur.fr.|UMR3525, CNRS, Paris, France. sylvain.brisse@pasteur.fr.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Brisse
authors.affiliation: Laboratoire de Microbiologie clinique et environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France.|Unité Environnement et Santé, Institut Pasteur de Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe, France.|Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles et de la Guyane, Pointe-à-Pitre, Guadeloupe, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Breurec
authors.affiliation: Microbial Evolutionary Genomics, Institut Pasteur, 28 rue du Dr Roux, 75724, Paris, France.|UMR3525, CNRS, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Passet
authors.affiliation: Laboratoire de Microbiologie clinique et environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France.
authors.forename: Edith
authors.initials: E
authors.lastname: Malpote
authors.affiliation: Inserm-CIC 1424 et Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Lamaury
authors.affiliation: Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles et de la Guyane, Pointe-à-Pitre, Guadeloupe, France.|Service de Réanimation, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Thiery
authors.affiliation: Inserm-CIC 1424 et Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France. bruno.hoen@chu-guadeloupe.fr.|Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles et de la Guyane, Pointe-à-Pitre, Guadeloupe, France. bruno.hoen@chu-guadeloupe.fr.|Centre Hospitalier Universitaire de Pointe-à-Pitre, Service de Maladies Infectieuses et Tropicales, BP 465, 97159, Pointe-à-Pitre Cedex, France. bruno.hoen@chu-guadeloupe.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hoen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D002439:Cefotaxime / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology*; D005838:Genotype; D019430:Guadeloupe; D006801:Humans; D006877:Hydroxamic Acids / Q000378:metabolism; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology*; D007711:Klebsiella pneumoniae / Q000235:genetics* / Q000472:pathogenicity*; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D010957:Plasmids; D065288:Serogroup; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D006877:Hydroxamic Acids; C512267:RmpA protein, Klebsiella pneumoniae; D037521:Virulence Factors; C031819:aerobactin; D002439:Cefotaxime
keywords: Caribbean; Community acquired meningitis; ST86 hypervirulent Klebsiella pneumoniae strain