Frequency of colonization with “hypervirulent” Klebsiella pneumoniae strains of newborns and infants with community-acquired and nosocomial klebsiella infection

Abstract

Currently, there is a trend towards the increase in invasive forms of infection (liver abscess, meningitis, endophthalmitis, etc.) caused by “hypervirulent” strains of Klebsiella pneumoniae (hvKP) in adults. We have studied the frequency of hvKP release in newborns and infants with various forms of community-acquired and nosocomial klebsiella infection. Strains of Klebsiella possessing the rmp A gene, which is associated with hypermucoid phenotype, were considered “hypervirulent. Klebsiella strains with the “hypermucoid phenotype”-associated rmpA gene were considered “hypervirulent”. The gene was detected by polymerase chain reaction. The authors studied a total of 85 strains. The rmpA gene was found in 20 (23%) Kl. pneumoniae strains, including 14 (33.3%) intestinal strains, 3 (25%) urine strains, 3 (15.7%) pharyngeal mucosa strains. The Klebsiella strains isolated from blood (n=5), endotracheal tube (n=6), cerebrospinal fluid (n=1) did not contain the gene. hvKP were significantly more often isolated in children with community-acquired infection (32%) than in children with nosocomial infection (11.4%; OR 3.647; 95% CI 1.100—12.096). Out of 20 children infected with hvKP, 12 (60%) patients were asymptomatic carriers, 3 (15%) children had symptoms of a urinary tract infection, and 5 (25%) children had symptoms of an intestinal infection. Infected children have both a potential risk of endogenous dissemination of the pathogen, and they are an epidemiologically dangerous to others.

Keywords

• дети
• грудной возраст
• «гипервирулентная» klebsiella pneumoniae
• колонизация
• нозокомиальная инфекция
• ген rmpа