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Spontaneous and postsurgical/traumatic Klebsiella pneumoniae meningitis: two distinct clinico-microbiological

Guillaume Rollin1, Benjamin Rossi2, Sylvain Brisse3

  • 1Internal Medicine, Hôpital Beaujon, Clichy, France.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|November 12, 2021
PubMed
Abstract

Insights

Spontaneous meningitis (SM) caused by Klebsiella pneumoniae is more severe with higher mortality than postsurgical/traumatic meningitis (PSTM). Hypervirulent strains of K. pneumoniae were linked to SM, while PSTM showed higher relapse rates.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Klebsiella pneumoniae meningitis presents as spontaneous (SM) or postsurgical/traumatic (PSTM) forms.
  • Understanding the distinct characteristics and outcomes of these forms is crucial for effective management.

Purpose of the Study:

  • To compare the clinical and microbiological features of spontaneous meningitis (SM) versus postsurgical/traumatic meningitis (PSTM) caused by Klebsiella pneumoniae.
  • To identify factors associated with severity and outcomes in K. pneumoniae meningitis.

Main Methods:

  • Retrospective multicentric cohort study of K. pneumoniae meningitis cases (2007-2018).
  • Analysis of microbiological characteristics and whole-genome sequencing of selected isolates.
  • Comparison of clinical outcomes between SM and PSTM groups.

Main Results:

  • Spontaneous meningitis (SM) cases exhibited higher rates of septic shock and in-hospital mortality compared to PSTM.
  • Relapse occurred exclusively in the PSTM group.
  • K. pneumoniae strains from SM cases displayed hypervirulent traits (K1/K2 serotypes, rmpA, iutA), unlike those from PSTM.

Conclusions:

  • Spontaneous meningitis (SM) and postsurgical/traumatic meningitis (PSTM) are distinct entities with differing clinical and microbiological profiles.
  • SM is a more severe infection associated with hypervirulent K. pneumoniae strains.
  • PSTM is associated with higher relapse rates and potentially polymicrobial infections.
Keywords:
hypervirulent Klebsiella pneumoniaemeningitispostsurgical/traumatic meningitisspontaneous meningitis

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