193. Comparison of Clinical and microbiologic characteristics between K1/K2 and non-K1/K2 serotype of hypervirulent Klebsiella pneumoniae infections in Korea
Session: Poster Abstract Session: Diagnostics: Bacteriology, Sequencing, and Resistance
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDSA hypervirulent KP.pdf (274.1 kB)
  • Background: Hypermucoviscous K. pneumoniae is emerging pathogen associated with K1/K2 serotypes. The purpose of study is to compare clinical and microbiologic characteristics between K1/K2 and non-K1/K2 serotype of hypervirulent K. Pneumoniae.

    Methods: This study was performed on 155 hypervirulent K. pneumoniaeisolates, from December 2013 through November 2015 in Dongsan Medical Center. Asymptomatic colonizers were excluded. The capsular serotypes were identified using specific primers by polymerase chain reaction. The hypermucoviscous phenotype was confirmed with string test.

    Results: K1/K2 was 105 isolates (67.7%) of hypervirulent K. pneumoniae. Community-acquired infection was more associated with K1/K2 (68.6% vs 44.0%, p=0.031). Male were 78 (74.3%) of K1/K2 and 29 (58.0%) of non-K1/K2 (p=0.040). K1/K2 was less associated with antimicrobial resistance and comorbid conditions. rmpA gene and magA gene were more detected in K1/K2 than non-K1/K2 (rmpA: 95.2% vs 42.0%, p=0.001; magA: 58.1% vs 2.0%, p=0.001). Infection sources were distributed as follows: intraabdominal infection (IAI, 41.0%), pneumonia (34.3%), urinary tract infection (UTI, 8.6%) in K1/K2 and pneumonia (54.5%), IAI (28 .0%), and UTI (14.0%) in non-K1/K2. Percutaneous catheter drainage (p=0.048) was more needed for treatment in K1/K2. Infection related 30-day mortality was higher (10.7% vs 25.0%, p=0.044) in non-K1/K2 than K1/K2. Risk factors of 30-day mortality was solid tumor (95% CI, 1.412 to 14.397; p=0.011) and pneumonia (95% CI, 1.192 to 13.423; p=0.025).

    Conclusion: IAI was most common cause of hypervirulent K. pneumoniae infection with K1/K2 serotype and pneumonia was the most common cause in non-K1/K2 serotype. Present study result showed 30-day mortality in hypervirulent K. pneumoniae infection is more related comorbidity and infection focus rather than serotype.

    Seong Yeol Ryu, M.D., Ph.D, Infectious Disease, Keimyung University Dongsan Medical Center, Daegu, South Korea, Miri Hyun, MD, Department of Infectious Disease, Keimyung University Dongsan Medical Center, Daegu, Korea, The Republic of, Hyun Ah Kim, M.D., Ph.D, Department of Infectious Disease, Keimyung University Dongsan Medical Center, Daegu, South Korea, Hyo-Lim Hong, MD, Department of Infectious Diseases, Catholic university of Daegu shool of medicine, Daegu, South Korea and Hyun Hee Kwon, MD, Ph.D, Department of Infectious Disease, Catholic university of Daegu school of Medicine, Daegu, Korea, The Republic of

    Disclosures:

    S. Y. Ryu, None

    M. Hyun, None

    H. A. Kim, None

    H. L. Hong, None

    H. H. Kwon, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.