Emerging Infectious Diseases (Feb 2018)

Hypervirulent Klebsiella pneumoniae in Cryptogenic Liver Abscesses, Paris, France

  • Benjamin Rossi,
  • Maria Ludovica Gasperini,
  • Véronique Leflon-Guibout,
  • Alice Gioanni,
  • Victoire de Lastours,
  • Geoffrey Rossi,
  • Safi Dokmak,
  • Maxime Ronot,
  • Olivier Roux,
  • Marie-Hélène Nicolas-Chanoine,
  • Bruno Fantin,
  • Agnès Lefort

DOI
https://doi.org/10.3201/eid2402.170957
Journal volume & issue
Vol. 24, no. 2
pp. 221 – 229

Abstract

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Liver abscesses containing hypervirulent Klebsiella pneumoniae have emerged during the past 2 decades, originally in Southeast Asia and then worldwide. We hypothesized that hypervirulent K. pneumoniae might also be emerging in France. In a retrospective, monocentric, cohort study, we analyzed characteristics and outcomes for 199 consecutive patients in Paris, France, with liver abscesses during 2010−2015. We focused on 31 patients with abscesses containing K. pneumoniae. This bacterium was present in most (14/27, 52%) cryptogenic liver abscesses. Cryptogenic K. pneumoniae abscesses were more frequently community-acquired (p<0.00001) and monomicrobial (p = 0.008), less likely to involve cancer patients (p<0.01), and relapsed less often (p<0.01) than did noncryptogenic K. pneumoniae liver abscesses. K. pneumoniae isolates from cryptogenic abscesses belonged to either the K1 or K2 serotypes and had more virulence factors than noncryptogenic K. pneumoniae isolates. Hypervirulent K. pneumoniae are emerging as the main pathogen isolated from cryptogenic liver abscesses in the study area.

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