NDLI: Clinical and microbiological characteristics of peritoneal dialysis-related peritonitis caused by Klebsiella pneumoniae in southern Taiwan.

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Clinical and microbiological characteristics of peritoneal dialysis-related peritonitis caused by Klebsiella pneumoniae in southern Taiwan.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lin, Wei-Hung Tseng, Chin-Chung Wu, An-Bang Yang, Deng-Chi Cheng, Shian-Wen Wang, Ming-Cheng Wu, Jiunn-Jong
Spatial Coverage	Taiwan
Description	Country affiliation: Taiwan Author Affiliation: Lin WH ( Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan); Tseng CC ( Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.); Wu AB ( Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.); Yang DC ( Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.); Cheng SW ( Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.); Wang MC ( Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan); Wu JJ ( Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan)
Abstract	BACKGROUND/PURPOSE(S): Gram-negative peritonitis is a frequent and serious complication of peritoneal dialysis (PD). No previous reports have focused on Klebsiella pneumoniae infection. The aim of this study was to investigate the host and bacterial factors associated with K. pneumoniae PD-related peritonitis. METHODS: We retrospectively studied K. pneumoniae PD-peritonitis cases treated at a university hospital in southern Taiwan during 1990-2011, and analyzed the clinical features and outcomes and bacterial characteristics of serotypes, hypermucoviscosity (HV), and virulence-associated genes such as wabG, uge, and rmpA in K. pneumoniae PD-related peritonitis. Fifty-four isolates of K. pneumoniae-related community-acquired urinary tract infection (UTI) and 76 morphologically different nonpathogenic K. pneumoniae isolates from healthy adults were used as controls. RESULTS: K. pneumoniae was the second most common monomicrobial pathogen causing Gram-negative PD-related peritonitis (n = 13, 2.7%), and the most common pathogen involved in polymicrobial peritonitis (16/43, 37.2%) and associated with high catheter removal rate (7/16, 43.8%). Compared with Escherichia coli peritonitis cases, patients with monomicrobial K. pneumoniae peritonitis also had insignificantly higher incidence of sepsis/bacteremia [n = 5 (38%), p = 0.11] and a higher mortality rate [n = 3 (23%), p = 0.36]. The prevalence of K1/K2 (n = 1, 7.7%) serotypes was low, but there was a higher prevalence of serotype K20 (n = 3, 23.1%) in K. pneumoniae isolates derived from monomicrobial PD-related peritonitis compared with control groups. HV phenotype (p < 0.001) and rmpA genotype (p = 0.007) were absent in the peritonitis group. CONCLUSION: This is the first study focused on clinical and microbiological characteristics of K. pneumoniae PD-related peritonitis. K. pneumoniae was a common Gram-negative pathogen causing monomicrobial and polymicrobial PD-related peritonitis in southern Taiwan. The bacterial characteristics with low percentage of capsular serotype K1/K2, no significant HV, and absence of rmpA suggest a different pathogenesis in K. pneumoniae PD-related peritonitis compared with that in UTI and liver abscess.
File Format	HTM / HTML
ISSN	16841182
e-ISSN	19959133
Journal	Journal of Microbiology, Immunology and Infection
Issue Number	3
Volume Number	48
Language	English
Publisher	Elsevier
Publisher Date	2015-06-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Microbiology Discipline Immunology Klebsiella Infections Epidemiology Klebsiella Pneumoniae Isolation & Purification Peritoneal Dialysis Adverse Effects Peritonitis Hospitals, University Drug Therapy Microbiology Pathology Classification Retrospective Studies Serotyping Taiwan Virulence Factors Genetics Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Immunology and Microbiology Immunology and Allergy Microbiology (medical)

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