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Recurrent Klebsiella pneumoniae liver abscess: clinical and microbiological characteristics

Ya-Sung Yang1, L K Siu, Kuo-Ming Yeh

  • 1Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.

Journal of Clinical Microbiology
|August 21, 2009
PubMed

Insights

Recurrent Klebsiella pneumoniae liver abscesses (KLAs) are uncommon. This study found distinct molecular fingerprints in recurrent KLAs, suggesting different bacterial strains may cause repeat infections, even in patients with diabetes.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Microbiology

Background:

  • Recurrent pyogenic liver abscesses caused by Klebsiella pneumoniae (KLAs) are infrequently documented.
  • Klebsiella pneumoniae liver abscesses pose a significant clinical challenge, particularly in recurrent cases.

Purpose of the Study:

  • To characterize the clinical features and microbiological profiles of recurrent Klebsiella pneumoniae liver abscesses.
  • To investigate the molecular relatedness of bacterial strains in primary versus recurrent KLAs.

Main Methods:

  • Case series analysis of six patients with recurrent KLAs.
  • Serotyping of Klebsiella pneumoniae isolates.
  • Antimicrobial susceptibility testing, focusing on cefazolin.
  • Molecular fingerprinting (e.g., pulsed-field gel electrophoresis) to compare strains from initial and subsequent abscesses.

Main Results:

  • Six cases of recurrent KLAs were identified and characterized.
  • A majority of patients presented with diabetes mellitus.
  • K1 serotype strains were prevalent among the KLAs.
  • All Klebsiella pneumoniae isolates demonstrated uniform susceptibility to cefazolin.
  • Distinct molecular fingerprints were observed between strains from primary and recurrent KLAs, indicating potential reinfection or distinct seeding events.

Conclusions:

  • Recurrent KLAs, though rare, necessitate thorough investigation.
  • The presence of distinct molecular fingerprints in recurrent KLAs suggests that reinfection with different strains or the emergence of distinct clones may underlie recurrence.
  • Cefazolin appears to be a consistently effective antibiotic against these recurrent KLA isolates.

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